NURS 111 Immunosuppressants Quiz – Holy Names University | NURS111 Immunosuppressants Quiz – 2020

NURS 111 Immunosuppressants Quiz – Holy Names University Chapter 69: Test Bank MULTIPLE CHOICE 1. A patient has undergone liver transplantation. The provider orders cyclosporine (Sandimmune), prednisone, and sirolimus (Rapamune). What will the nurse do? a. Question the order for sirolimus. b. Request an order for a serum glucose level. c. Request an order for a macrolide antibiotic. d. Suggest changing the cyclosporine to tacrolimus. 2. A patient with a liver transplant has been receiving cyclosporine (Sandimmune) for 6 months. The nurse reviews this patient’s laboratory results and notes a sharp increase in the blood urea nitrogen (BUN) and serum creatinine. Vital signs are normal, and the patient reports no discomfort. What does the nurse suspect? a. Hepatotoxicity b. Infection c. Organ rejection d. Nephrotoxicity 3. A nurse provides teaching to a patient who has undergone kidney transplantation and will begin taking cyclosporine (Sandimmune), a glucocorticoid, and sirolimus (Rapamune). Which statement by the patient indicates understanding of the teaching? a. “I should take sirolimus at the same time as the cyclosporine.” b. “I will need to have my blood sugar checked regularly.” c. “I will need to take an antibiotic to prevent lung infections.” d. “Taking this combination of drugs lowers my risk of kidney damage.” 4. A patient with a history of lung transplantation is admitted for treatment for a respiratory infection. The patient has been taking cyclosporine (Sandimmune), prednisone, and azathioprine (Imuran) for 8 months. The provider has ordered azithromycin (Zithromax) to treat the infection and acetaminophen (Tylenol) as needed for fever. The nurse will contact the provider to: a. ask whether a different antibiotic can be used. b. ask that the prednisone be discontinued until the infection clears. c. suggest increasing the dose of cyclosporine. d. suggest using ibuprofen instead of acetaminophen. 5. A patient is taking cyclosporine (Sandimmune) and prednisone to prevent organ rejection after right renal transplantation. The patient is febrile and complains of right-sided flank pain. The nurse reviews the patient’s chart and finds that the patient’s BUN and serum creatinine are elevated. The cyclosporine trough is 150 ng/mL. What will the nurse do? a. Be concerned that the left kidney is failing. b. Expect the provider to order intravenous methylprednisolone. c. Request an order for a urine culture. d. Suspect nephrotoxicity secondary to an elevated cyclosporine level. 6. A patient is started on immunosuppressant drugs after kidney transplantation and will be taking azathioprine (Imuran) as part of the drug regimen. The patient asks the nurse why it is necessary to have a specimen for a complete blood count drawn at the beginning of therapy and then periodically thereafter. The nurse explains that azathioprine can alter blood cells and tells the patient to report: a. alopecia. b. easy bruising. c. fatigue. d. gastrointestinal (GI) upset. 7. A nurse is teaching a patient who is about to undergo allograft transplantation of the liver. Which statement by the patient indicates understanding of the post-transplant medications? a. “Immunosuppressants help reduce the risk of postoperative infection.” b. “I will need to have periodic laboratory work to assess for toxicity.” c. “I will need to take immunosuppressants until all signs of organ rejection are gone.” d. “These drugs will prevent organ rejection.” 8. The nurse knows that which two immunosuppressants are the most effective? a. Azathioprine (Imuran) and everolimus (Zortress) b. Cyclosporine (Sandimmune) and tacrolimus (Prograf) c. Methotrexate (Rheumatrex) and muromonab-CD3 (Orthoclone OKT3) d. Sirolimus (Rapamune) and methylprednisolone 9. A nursing student asks the nurse how antibodies provide immune suppression. The nurse responds by telling the student that antibodies: a. block T-cell function. b. boost immune responses. c. reduce proliferation of B cells. d. suppress interferon production. 10. The nurse is preparing to administer antibodies to a patient to prevent acute rejection. By which route will the nurse administer the antibodies? a. Oral b. Intramuscular c. Intravenous d. Transdermal 11. The nurse is caring for a patient after recent renal transplantation. The patient is taking sirolimus (Rapamune) to prevent transplant rejection. What other medications would the nurse expect the patient to be taking? a. Rifampin and ketoconazole b. Carbamazepine and phenobarbital c. Cyclosporine and glucocorticoids d. Amphotericin B and erythromycin 12. The nurse is administering medications to a patient who is receiving cyclosporine (Sandimmune). Which medication, when administered concurrently with cyclosporine, would warrant a reduction in the dosage of cyclosporine? a. Phenytoin (Dilantin) b. Prednisone c. Ketoconazole (Nizoral) d. Trimethoprim/sulfamethoxazole (Bactrim)