Patho/Pharm: Immune System Medication- SAUNDER'S ?'s
Correct answer: 4
Rationale: Frequent adverse effects
of this medication include leukope-
The client with acquired immunode-
nia, thrombocytopenia, and anemia. The
ficiency syndrome and Pneumocystis
client should be monitored routinely for
jiroveci infection has been receiving pen-
signs and symptoms of infection. Options
tamidine. The client develops a temper-
1, 2, and 3 are inaccurate interpretations.
ature of 101°F (38.3°C). The nurse con-
tinues to assess the client, knowing that
Rationale: Acquired immunodeficiency
this sign most likely indicates which con-
syndrome is a viral disease caused
dition?
by the human immunodeficiency virus
(HIV), which destroys T cells, there-
1. That the dose of the medication is too
by increasing susceptibility to infection
low
and malignancy. Pneumocystis jiroveci
2. That the client is experiencing toxic
pneumonia (PCP) is a fungal infection
effects of the medication
and is a common opportunistic infection.
3. That the client has developed inade-
Pentamidine is an antimicrobial used to
quacy of thermoregulation
treat PCP. Frequent side and adverse ef-
4. That the client has developed another
fects of this medication include leukope-
infection caused by leukopenic effects of
nia, thrombocytopenia, and anemia. The
the medication
client should be monitored routinely for
signs and symptoms of infection. The re-
maining options are inaccurate interpre-
tations.
The nurse is caring for a post-renal trans- Correct answer: 3
plantation client taking cyclosporine. The
nurse notes an increase in one of the Rationale: Hypertension can occur in
client's vital signs and the client is com- a client taking cyclosporine, and be-
plaining of a headache. What vital sign is cause this client is also complaining of
most likely increased? a headache, the blood pressure is the
vital sign to be monitored most closely.
1. Pulse Other adverse effects include infection,
2. Respirations nephrotoxicity, and hirsutism. Options 1,
3. Blood pressure 2, and 4 are unrelated to the use of this
4. Pulse oximetry medication.
Correct answer: 3
, Patho/Pharm: Immune System Medication- SAUNDER'S ?'s
Rationale: Cyclosporine is an immuno-
suppressant used for prevention of rejec-
The nurse is caring for a postrenal trans-
tion following allogeneic organ transplan-
plantation client taking cyclosporine. The
tation. Hypertension can occur in a client
nurse notes an increase in one of the
taking cyclosporine and because this
client's vital signs, and the client is com-
client is also complaining of a headache,
plaining of a headache. What vital sign is
the blood pressure is the vital sign to be
most likely increased?
monitored most closely. Other adverse
effects of Cyclosporine include infection,
1. Pulse
nephrotoxicity, infection; hepatotoxicity;
2. Respirations
hypertension. leukopenia, hyperkalemia;
3. Blood pressure
“ urine flow (oliguria), and hirsutism. The
4. Pulse oximetry
remaining options are unrelated to the
use of this medication.
Correct answer: 2
Tacrolimus is prescribed to a client for
Rationale: Tacrolimus is an immunosup-
prevention of organ rejection after re-
pressant used as an alternative medica-
nal transplantation. Which prescription
tion to cyclosporine for prevention of or-
should the nurse anticipate to be pre-
gan rejection in clients after transplan-
scribed, along with the tacrolimus, for
tation. The medication is more effective
this client?
than cyclosporine but is more toxic. Con-
current use of glucocorticoidssuch as
1. Phenytoin
prednisone is recommended during ad-
2. Prednisone
ministration of this medication. The med-
3. Fluconazole
ications in the remaining options would
4. Erythromycin
not be prescribed unless a secondary
disorder existed.
Azathioprine is prescribed for a client
Correct answer: 3
to suppress rejection of a renal trans-
plant. In planning for administration of the
Rationale: Azathioprine is an immuno-
medication, the nurse understands that
suppressant; it suppresses cell-mediat-
which description is the mechanism of
ed and humoral immune responses by
action of this medication?
inhibiting the proliferation of B and T
lymphocytes. It generally is used as an
1. It crosslinks DNA.
adjunct to cyclosporine and glucocorti-
2. It blocks all T cell functions.
coids to help suppress transplant rejec-
3. It inhibits the proliferation of B and T
, Patho/Pharm: Immune System Medication- SAUNDER'S ?'s
lymphocytes.
tion. The remaining options are incorrect
4. It decreases the activity of thymus-de-
mechanisms of action.
rived lymphocytes.
A client with acquired immunodeficiency Correct answer: 4
syndrome who is taking zidovudine 200
mg orally 3 times daily has severe neu- Rationale: Zidovudine is a nucleo-
tropenia noted on follow-up laboratory side-nucleotide reverse transcriptase in-
studies. The nurse interprets that which hibitor. Hematological monitoring should
change is likely to occur at this point? be done every 2 weeks in the client
taking zidovudine. If severe anemia or
1. The medication dose probably will be severe neutropenia develops, treatment
reduced. should be discontinued until evidence of
2. Prednisone probably will be added to bone marrow recovery is noted. If ane-
the medication regimen. mia or neutropenia is mild, a reduction
3. Epoetin alfa probably will be added to in dosage may be sufficient. The admin-
the medication regimen. istration of prednisone may further alter
4.The medication probably will be dis- the immune function. Epoetin alfa is ad-
continued until laboratory results indi- ministered to clients experiencing ane-
cate bone marrow recovery. mia.
Correct answer: 4
Rationale: Acyclovir is an antiviral med-
The nurse is monitoring a client who is ication. Although the most common side
receiving intravenous (IV) acyclovir. The and adverse reactions with this med-
nurse would monitor the client closely for ication are phlebitis and inflammation
which primary toxic effect of the medica- at the IV site, reversible nephrotoxici-
tion? ty, evidenced by elevated serum creati-
nine and BUN levels, can occur in some
1. Ototoxicity clients. The cause of nephrotoxicity is de-
2. Neurotoxicity position of acyclovir in the renal tubules.
3. Cardiotoxicity The risk of renal injury is increased by
4. Nephrotoxicity dehydration and the use of other nephro-
toxic medications. Ototoxicity, neurotoxi-
city, and cardiotoxicity are not specific to
this medication.
A client is receiving acyclovir by the in- Correct answer: 1
travenous (IV) route for treatment of cy-
tomegalovirus (CMV) infection. After re- Rationale: Acyclovir is an antiviral med-
Correct answer: 4
Rationale: Frequent adverse effects
of this medication include leukope-
The client with acquired immunode-
nia, thrombocytopenia, and anemia. The
ficiency syndrome and Pneumocystis
client should be monitored routinely for
jiroveci infection has been receiving pen-
signs and symptoms of infection. Options
tamidine. The client develops a temper-
1, 2, and 3 are inaccurate interpretations.
ature of 101°F (38.3°C). The nurse con-
tinues to assess the client, knowing that
Rationale: Acquired immunodeficiency
this sign most likely indicates which con-
syndrome is a viral disease caused
dition?
by the human immunodeficiency virus
(HIV), which destroys T cells, there-
1. That the dose of the medication is too
by increasing susceptibility to infection
low
and malignancy. Pneumocystis jiroveci
2. That the client is experiencing toxic
pneumonia (PCP) is a fungal infection
effects of the medication
and is a common opportunistic infection.
3. That the client has developed inade-
Pentamidine is an antimicrobial used to
quacy of thermoregulation
treat PCP. Frequent side and adverse ef-
4. That the client has developed another
fects of this medication include leukope-
infection caused by leukopenic effects of
nia, thrombocytopenia, and anemia. The
the medication
client should be monitored routinely for
signs and symptoms of infection. The re-
maining options are inaccurate interpre-
tations.
The nurse is caring for a post-renal trans- Correct answer: 3
plantation client taking cyclosporine. The
nurse notes an increase in one of the Rationale: Hypertension can occur in
client's vital signs and the client is com- a client taking cyclosporine, and be-
plaining of a headache. What vital sign is cause this client is also complaining of
most likely increased? a headache, the blood pressure is the
vital sign to be monitored most closely.
1. Pulse Other adverse effects include infection,
2. Respirations nephrotoxicity, and hirsutism. Options 1,
3. Blood pressure 2, and 4 are unrelated to the use of this
4. Pulse oximetry medication.
Correct answer: 3
, Patho/Pharm: Immune System Medication- SAUNDER'S ?'s
Rationale: Cyclosporine is an immuno-
suppressant used for prevention of rejec-
The nurse is caring for a postrenal trans-
tion following allogeneic organ transplan-
plantation client taking cyclosporine. The
tation. Hypertension can occur in a client
nurse notes an increase in one of the
taking cyclosporine and because this
client's vital signs, and the client is com-
client is also complaining of a headache,
plaining of a headache. What vital sign is
the blood pressure is the vital sign to be
most likely increased?
monitored most closely. Other adverse
effects of Cyclosporine include infection,
1. Pulse
nephrotoxicity, infection; hepatotoxicity;
2. Respirations
hypertension. leukopenia, hyperkalemia;
3. Blood pressure
“ urine flow (oliguria), and hirsutism. The
4. Pulse oximetry
remaining options are unrelated to the
use of this medication.
Correct answer: 2
Tacrolimus is prescribed to a client for
Rationale: Tacrolimus is an immunosup-
prevention of organ rejection after re-
pressant used as an alternative medica-
nal transplantation. Which prescription
tion to cyclosporine for prevention of or-
should the nurse anticipate to be pre-
gan rejection in clients after transplan-
scribed, along with the tacrolimus, for
tation. The medication is more effective
this client?
than cyclosporine but is more toxic. Con-
current use of glucocorticoidssuch as
1. Phenytoin
prednisone is recommended during ad-
2. Prednisone
ministration of this medication. The med-
3. Fluconazole
ications in the remaining options would
4. Erythromycin
not be prescribed unless a secondary
disorder existed.
Azathioprine is prescribed for a client
Correct answer: 3
to suppress rejection of a renal trans-
plant. In planning for administration of the
Rationale: Azathioprine is an immuno-
medication, the nurse understands that
suppressant; it suppresses cell-mediat-
which description is the mechanism of
ed and humoral immune responses by
action of this medication?
inhibiting the proliferation of B and T
lymphocytes. It generally is used as an
1. It crosslinks DNA.
adjunct to cyclosporine and glucocorti-
2. It blocks all T cell functions.
coids to help suppress transplant rejec-
3. It inhibits the proliferation of B and T
, Patho/Pharm: Immune System Medication- SAUNDER'S ?'s
lymphocytes.
tion. The remaining options are incorrect
4. It decreases the activity of thymus-de-
mechanisms of action.
rived lymphocytes.
A client with acquired immunodeficiency Correct answer: 4
syndrome who is taking zidovudine 200
mg orally 3 times daily has severe neu- Rationale: Zidovudine is a nucleo-
tropenia noted on follow-up laboratory side-nucleotide reverse transcriptase in-
studies. The nurse interprets that which hibitor. Hematological monitoring should
change is likely to occur at this point? be done every 2 weeks in the client
taking zidovudine. If severe anemia or
1. The medication dose probably will be severe neutropenia develops, treatment
reduced. should be discontinued until evidence of
2. Prednisone probably will be added to bone marrow recovery is noted. If ane-
the medication regimen. mia or neutropenia is mild, a reduction
3. Epoetin alfa probably will be added to in dosage may be sufficient. The admin-
the medication regimen. istration of prednisone may further alter
4.The medication probably will be dis- the immune function. Epoetin alfa is ad-
continued until laboratory results indi- ministered to clients experiencing ane-
cate bone marrow recovery. mia.
Correct answer: 4
Rationale: Acyclovir is an antiviral med-
The nurse is monitoring a client who is ication. Although the most common side
receiving intravenous (IV) acyclovir. The and adverse reactions with this med-
nurse would monitor the client closely for ication are phlebitis and inflammation
which primary toxic effect of the medica- at the IV site, reversible nephrotoxici-
tion? ty, evidenced by elevated serum creati-
nine and BUN levels, can occur in some
1. Ototoxicity clients. The cause of nephrotoxicity is de-
2. Neurotoxicity position of acyclovir in the renal tubules.
3. Cardiotoxicity The risk of renal injury is increased by
4. Nephrotoxicity dehydration and the use of other nephro-
toxic medications. Ototoxicity, neurotoxi-
city, and cardiotoxicity are not specific to
this medication.
A client is receiving acyclovir by the in- Correct answer: 1
travenous (IV) route for treatment of cy-
tomegalovirus (CMV) infection. After re- Rationale: Acyclovir is an antiviral med-
