FINAL EXAM NURS-106 ALL CONTENT
QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS 100%
CORRECT!!! (GRADED A+) UPDATED
2026
Cells Involved in Cellular Immunity
T-cells (T-lymphocytes)
Cell-mediated immunity relies on T-lymphocytes (including cytotoxic T-cells,
helper T-cells, and memory T-cells) to directly attack infected or abnormal host
cells and coordinate the immune response.
Indications for Immunosuppressant Therapy
Prevent Organ/Tissue Transplant Rejection: Suppresses host immune
response against foreign graft antigens.
Treat Autoimmune Diseases: Controls inappropriate immune attacks on
self-tissues (e.g., Rheumatoid Arthritis, Lupus, Multiple Sclerosis).
Manage Chronic Inflammatory Conditions: Controls long-term tissue
destruction (e.g., Inflammatory Bowel Disease).
Contraindications and Cautions for Immunosuppressants
Renal Failure: Impaired drug clearance increases risk of nephrotoxicity.
Hepatic Failure: Compromised drug metabolism leads to severe toxicity.
Hypertension (HTN): Calcineurin inhibitors (e.g., cyclosporine) can
exacerbate high blood pressure.
Concurrent Radiation Therapy: Significantly increases bone marrow
suppression and severe infection risks.
Pregnancy: Many agents carry teratogenic risks (requires extreme caution).
Live Vaccines: STRICTLY CONTRAINDICATED due to risk of
uninhibited viral/bacterial replication causing active disease in an
immunocompromised host.
,**regardless of contraindications, patient may need an immunosuppressant
anyway**
How do cellular immunosuppressants work?
they inhibit T-cells
remember that corticosteroids do this too and are considered immunosuppressants
as well
What are the common black box warnings for immunosuppressants?
They have many black box warnings!
The most common one is bone marrow suppression which includes many AEs on
its own:
• suppress RBCs, prone to anemia
• suppress WBC, prone to infection
• decrease platelets, prone to bleeding
Immediately associate bone marrow suppression with immunosuppressants!
,• increased risk for cancer, especially skin cancer
---teaching: avoid UV light, wear hats, sunscreen, protective clothing, have
frequent skin inspections
• new onset diabetes risk
----teaching s/sx diabetes, BG screening
• hepatic impairment
---assess jaundice, ascites, platelet count, discolored urine, labs
• renal impairment
---monitor urinalysis, bedside urine dipsticks, output
• fatal infections
General AEs for most immunosuppressants?
Remember lots of black box warnings (on their own card)
• risk for opportunistic infections
, -----often fungal (UTI, yeast infection, thrush)
-----opportunistic cancer
• HTN
• fluid retention
• pulmonary edema
• hepatotoxicity
• nephrotoxicity
• neurotoxicity including tremors
• leukopenia, thrombocytopenia
more on p 758 - table 48.2, these are the ones she explicitly mentioned
General interactions for immunosuppressants?
Remember increased risk for interactions because patients are on these for a
lifetime
QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS 100%
CORRECT!!! (GRADED A+) UPDATED
2026
Cells Involved in Cellular Immunity
T-cells (T-lymphocytes)
Cell-mediated immunity relies on T-lymphocytes (including cytotoxic T-cells,
helper T-cells, and memory T-cells) to directly attack infected or abnormal host
cells and coordinate the immune response.
Indications for Immunosuppressant Therapy
Prevent Organ/Tissue Transplant Rejection: Suppresses host immune
response against foreign graft antigens.
Treat Autoimmune Diseases: Controls inappropriate immune attacks on
self-tissues (e.g., Rheumatoid Arthritis, Lupus, Multiple Sclerosis).
Manage Chronic Inflammatory Conditions: Controls long-term tissue
destruction (e.g., Inflammatory Bowel Disease).
Contraindications and Cautions for Immunosuppressants
Renal Failure: Impaired drug clearance increases risk of nephrotoxicity.
Hepatic Failure: Compromised drug metabolism leads to severe toxicity.
Hypertension (HTN): Calcineurin inhibitors (e.g., cyclosporine) can
exacerbate high blood pressure.
Concurrent Radiation Therapy: Significantly increases bone marrow
suppression and severe infection risks.
Pregnancy: Many agents carry teratogenic risks (requires extreme caution).
Live Vaccines: STRICTLY CONTRAINDICATED due to risk of
uninhibited viral/bacterial replication causing active disease in an
immunocompromised host.
,**regardless of contraindications, patient may need an immunosuppressant
anyway**
How do cellular immunosuppressants work?
they inhibit T-cells
remember that corticosteroids do this too and are considered immunosuppressants
as well
What are the common black box warnings for immunosuppressants?
They have many black box warnings!
The most common one is bone marrow suppression which includes many AEs on
its own:
• suppress RBCs, prone to anemia
• suppress WBC, prone to infection
• decrease platelets, prone to bleeding
Immediately associate bone marrow suppression with immunosuppressants!
,• increased risk for cancer, especially skin cancer
---teaching: avoid UV light, wear hats, sunscreen, protective clothing, have
frequent skin inspections
• new onset diabetes risk
----teaching s/sx diabetes, BG screening
• hepatic impairment
---assess jaundice, ascites, platelet count, discolored urine, labs
• renal impairment
---monitor urinalysis, bedside urine dipsticks, output
• fatal infections
General AEs for most immunosuppressants?
Remember lots of black box warnings (on their own card)
• risk for opportunistic infections
, -----often fungal (UTI, yeast infection, thrush)
-----opportunistic cancer
• HTN
• fluid retention
• pulmonary edema
• hepatotoxicity
• nephrotoxicity
• neurotoxicity including tremors
• leukopenia, thrombocytopenia
more on p 758 - table 48.2, these are the ones she explicitly mentioned
General interactions for immunosuppressants?
Remember increased risk for interactions because patients are on these for a
lifetime
