Hunter College - CUNY, NURS3310 / NURS 3310: Drugs Affecting the Immune System Exam | A+ Graded Answers + Rationales | Latest Fall 2025/26.

Drugs Affecting the Immune System Exam Q&A’s + Rationales 2025/26. Question 1. A patient is receiving biologic therapy. Which disease process would the APN be alert for in response to this type of therapy? 1.Tuberculosis (TB) 2.Pneumonia 3.Acne Rosacea 4.Congestive heart failure (CHF) Option 1:Patients who are immunosuppressed while being treated with biologics may experience reactivation of tuberculosis. Option 2:There is no correlation between biologic therapy and the occurrence of pneumonia. Option 3:Although the patient may experience rashes, there is no correlation between Acne Rosacea and biologic therapy. Option 4:There is no correlation between the use of biologic therapy and CHF. Question 2. Which single technique is best for preventing infectious disease? 1.Vaccines 2.Antibiotics 3.Routine screenings 4.Titers Option 1:Vaccination is the single best technique for preventing infectious disease and is considered a primary prevention. Option 2:Antibiotics are used in the treatment of bacterial infections. They are considered tertiary prevention in the management of a disease. Option 3:Routine screenings are secondary prevention measures for asymptomatic persons who have risk factors for a given disease. Option 4:A titer is a laboratory test that measures the presence and amount of antibodies in the blood and may be used to prove immunity to disease. Question 3. A patient has been prescribed cyclosporine as part of a treatment regimen but needs a diuretic to decrease fluid retention due to vascular insufficiency. Which diuretic would the APN prescribe? 1.Triamterene 2.Amiloride 3.Furosemide 4.Spironolactone Option 1:Potassium sparing diuretics (amiloride, spironolactone, triamterene) should be avoided as they can lead to hyperkalemia when taking cyclosporine. Option 2:Potassium sparing diuretics (amiloride, spironolactone, triamterene) should be avoided as they can lead to hyperkalemia when taking cyclosporine. Option 3:Furosemide is a loop diuretic and can be administered without interactions from cyclosporine therapy. Option 4:Potassium sparing diuretics (amiloride, spironolactone, triamterene) should be avoided as they can lead to hyperkalemia when taking cyclosporine. Question 4. A patient is receiving an infusion of monoclonal antibodies. When is it most likely that a transfusion reaction would occur? 1.24 hours post-infusion 2.6 hours after infusion 3.Within 15 minutes of the start of the infusion 4.Between 1 and 2 hours after the infusion has started Option 1:Infusion reactions occur in the first 1 to 2 hours of starting an infusion and can range from mild injection site reactions to anaphylaxis. Option 2:Infusion reactions occur in the first 1 to 2 hours of starting an infusion and can range from mild injection site reactions to anaphylaxis. Option 3:Infusion reactions occur in the first 1 to 2 hours of starting an infusion and can range from mild injection site reactions to anaphylaxis. Option 4:Infusion reactions occur in the first 1 to 2 hours of starting an infusion and can range from mild injection site reactions to anaphylaxis. Question 5. Which finding indicates a side effect of azathioprine in an adult patient? 1.Platelet count of 100,000 2.Creatinine clearance 120 mL/min 3.Red Blood Cell count of 5.0 cells/mcL 4.White cell count of 7,000 per mL Option 1:This finding would indicate thrombocytopenia. Azathioprine can lead to blood dyscrasias, so this would be a significant finding. Option 2:This finding indicates a normal range and would not pose a problem. Option 3:This finding indicates a normal range and would not pose a problem. Option 4:This finding indicates a normal range and would not pose a problem.Question 6. The measles, mumps, and rubella (MMR) vaccine should not be given to which persons? 1.Children 2.Pregnant women 3.Breastfeeding mothers 4.Children with pregnant mothers Option 1:MMR vaccine may be safely administered to children of all ages. Option 2:MMR vaccine should not be given to pregnant women or women who may become pregnant within 3 months after administration. There is a theoretical possibility of congenital rubella syndrome in the infant if the mother is given rubella vaccine when pregnant. Women should be asked if they are pregnant before administering MMR and advised to avoid pregnancy for 3 months after administration of the vaccine. Option 3:MMR may be administered to breastfeeding women. Option 4:Pregnancy in the mother of a patient receiving MMR is not a contraindication. Question 7. Which age group is appropriate for the administration of the live attenuated influenza vaccine (LAIV)? 1.Newborns 2.Infants 3.Toddlers 4.School age Option 1:Use of live influenza vaccine is contraindicated in children under 2 years owing to significant increased incidence of reactive airway disease and asthma. Option 2:Use of live influenza vaccine is contraindicated in children under 2 years owing to significant increased incidence of reactive airway disease and asthma. Option 3:Use of live influenza vaccine is contraindicated in children under 2 years owing to significant increased incidence of reactive airway disease and asthma. Toddlers may still be too young to receive the LAIV. Option 4:Children and adults ages 9 through 49 years should receive 0.2 mL of LAIV as soon as it becomes available in the fall. Question 8. The patient has been prescribed cyclosporine as part of the treatment plan. Which finding in the patient's history would be of concern to the APN? 1.Patient taking several medications to control blood pressure 2.Patient received flu vaccine 3.Patient's GFR is within normal range4.Patient's surgical history indicates appendectomy Option 1:Patients with uncontrolled HTN should avoid its use. As the patient is on a multidrug regimen to control BP, the use of this medication would be contraindicated. Option 2:Most flu vaccines contain attenuated viruses and are not considered to be live. Therefore, it would not pose a problem. Patients should not take live vaccines when prescribed cyclosporine. Option 3:Adequate renal function does not pose a concern. Patients may be at risk if they have compromised renal function and/or high-dose cyclosporine therapy is administered. Option 4:An appendectomy poses no concern relative to treatment with cyclosporine. Question 9. Which of these is an attenuated (live) vaccine? 1.Measles, mumps, rubella (MMR) 2.Diphtheria, tetanus, and pertussis (DTP) 3.Hepatitis 4.Pneumococcal Option 1:MMR is an attenuated (live) vaccine. Option 2:DTP is an inactivated vaccine. Option 3:Hepatitis A and hepatitis B are both inactivated vaccines. Option 4:Pneumococcal polysaccharide (PPSV23) and pneumococcal conjugate vaccine (PCV13) are both inactivated vaccines. Question 10. Which disease process is treated with monoclonal antibodies? 1.Urinary tract infection 2.Leukemia 3.Community acquired pneumonia 4.Acute COVID infections Option 1:Monoclonal antibodies are used to treat hematologic and solid tumor malignancies providing targeted therapy. They are not used to treat UTIs. Option 2:Monoclonal antibodies are used to treat hematologic and solid tumor malignancies providing targeted therapy. Option 3:Monoclonal antibodies are used to treat hematologic and solid tumor malignancies providing targeted therapy. They are not used to treat CAP. Option 4:Monoclonal antibodies are used to treat hematologic and solid tumor malignancies providing targeted therapy. They are no longer approved by the FDA for treatment of COVID infections.Question 11. For which patient is the measles, mumps, and rubella (MMR) vaccine considered unnecessary? 1.An 18-year-old student entering college 2.An older adult born prior to 1957 3.A 24-year-old health-care worker 4.A 50-year-old adult who is traveling internationally Option 1:Adults in high-risk groups, such as students entering college or military recruits, should receive a total of two doses of MMR. Option 2:Adults born before 1957 are considered immune, but proof of immunity may be desirable for health-care workers. Option 3:Health-care workers should receive a total of two doses of MMR. Option 4:International travelers should receive a total of two doses of MMR. Question 12. Which vaccination is contraindicated in asthma patients? 1.Measles, mumps, and rubella (MMR) 2.Oral polio vaccine (OPV) 3.Live attenuated virus influenza vaccine (LAIV) 4.Varicella virus vaccine (Varivax) Option 1:MMR is an attenuated (modified live) vaccine, but there are a few true contraindications to administering MMR vaccine. This includes anaphylactic reaction to MMR. Option 2:OPV is an attenuated (modified live) vaccine. An anaphylactic reactive to any previous dose of OPV is a contraindication to its use. Option 3:LAIV is contraindicated in patients with egg hypersensitivity, asthma, reactive airway disease, other disorders of the pulmonary or cardiovascular systems; metabolic diseases such as diabetes, renal dysfunction, hemoglobinopathies; known or suspected immunodeficiency diseases; or in patients who are receiving immunosuppressive therapies. Option 4:Varicella vaccine is an attenuated (modified live) vaccine and is contraindicated in patients with neomycin or gelatin hypersensitivity, HIV infection. Question 13. Which dietary instruction should the APN provide to a patient who is taking cyclosporine? 1.Do not use St. John's Wort 2.Avoid apple juice 3.Increase foods high in potassium4.Increase foods high in sodium Option 1:Use of this herbal supplement can lead to decreased drug levels and potential organ rejection. Option 2:Apple juice has no impact on this medication. The patient should not take grapefruit or grapefruit juice which can lead to increased drug levels. Option 3:Foods high in potassium should be avoided when taking cyclosporine as it can lead to increased drug levels. Option 4:Foods high in sodium should be avoided as they can lead to fluid retention Question 14. The live attenuated influenza vaccine (LAIV3 [FluMist] & LAIV4 [FluMist Quadrivalent]) is administered by which route? 1.Oral 2.Intranasal 3.Subcutaneously 4.Intramuscularly Option 1:FluMist is not administered orally. Option 2:FluMist is administered intranasally with half of the dose administered in each nostril. Option 3:FluMist is not administered subcutaneously. Option 4:FluMist is not administered intramuscularly. Question 15. A patient has been prescribed azathioprine therapy. Which medication in the patient's history would indicate a potential interaction? 1.Tylenol 2.Allopurinol 3.Labetalol 4.Aspirin Option 1:There are no known drug interactions with Tylenol and azathioprine. Option 2:Avoid concurrent use, specialty provider may reduce dose of azathioprine by one-third to one-half if concurrent use of allopurinol (xanthine oxidase inhibitor). Option 3:There are no known drug interactions with labetalol (Beta blocker) and azathioprine. Option 4:There are no known drug interactions with ASA and azathioprine.Question 16. The nurse practitioner student needs more education regarding the oral polio vaccine (OPV) after the student makes which statement? 1."The OPV is no longer used in the U.S." 2."The OPV is a live vaccine." 3."Three doses of OPV are required." 4."The OPV is no longer used in non–U.S. countries due to high costs." Option 1:OPV has been eradicated in the U.S. and is no longer used in the U.S. Option 2:OPV is a live attenuated virus that enters the small intestine where it replicates. Option 3:Three doses of OPV result in sustaining lifelong immunity. This is no longer necessary in the U.S., however. Option 4:Although OPV is no longer used in the U.S., it is still used in other countries because of administrative ease and low cost. Question 17. Which information should the APN provide to parents of a child undergoing biologic therapy? 1.Do not resume vaccination schedule until 6 months post-therapy 2.Avoid live vaccines and resume schedule 3 months after completed therapy 3.Your child will no longer be able to take routine vaccinations 4.Vaccination schedule will be individualized based on need Option 1:Children receiving biologic therapy should maintain their routine vaccine schedule, other than avoiding live vaccines until 3 months after last mAb dose. Option 2:Children receiving biologic therapy should maintain their routine vaccine schedule, other than avoiding live vaccines until 3 months after last mAb dose. Option 3:Children receiving biologic therapy should maintain their routine vaccine schedule, other than avoiding live vaccines until 3 months after last mAb dose. Option 4:Children receiving biologic therapy should maintain their routine vaccine schedule, other than avoiding live vaccines until 3 months after last mAb dose. Question 18. When is the measles, mumps, and rubella (MMR) vaccine routinely given? 1.12 to 15 months with a repeat dose at age 4 to 6 years 2.12 to 15 months with a repeat dose at age 12 3.One dose any time prior to the start of school 4.12 to 15 months with second dose 4 weeks after Option 1:MMR is routinely given subcutaneously (SC) at 12 to 15 months of age with a repeat dose at age 4 to 6 years. Option 2:Those children who have not received their second dose of MMR by age 12 should have it at this time. Option 3:People who receive two doses of MMR develop a higher percentage of immunity. Option 4:The second dose of MMR may be given as soon as 4 weeks after the first dose, which is indicated during an epidemic or before international travel. Question 19. Which is a true contraindication to administering the measles, mumps, and rubella (MMR) vaccine to a patient? 1.A previous reaction to a prior MMR vaccine 2.Egg hypersensitivity 3.Age under 2 years 4.History of asthma Option 1:A previous anaphylactic reaction to the MMR vaccine or any component of the vaccine including neomycin (topically or systemically administered) or gelatin is a contraindication to administering the vaccine. Option 2:Anaphylactic reaction or hypersensitivity to eggs is no longer a contraindication to MMR. Option 3:The MMR vaccine may be safely administered to children of all ages, although it may not be immunogenic in infants younger than age 12 months. Option 4:MMR is contraindicated in immunocompromised patients but is not contraindicated in asthmatic patients. Question 20. Which biologic is indicated for the treatment of rheumatoid arthritis ? 1.Humira 2.Blincyto 3.Hemlibra 4.Repatha Option 1:Humira is indicated for the treatment of inflammatory bowel disease, rheumatoid arthritis, psoriatic arthritis, and severe psoriasis. Option 2:Blincyto is indicated for the treatment of acute lymphoblastic leukemia (ALL). Option 3:Hemlibra is indicated for treatment of hemophilia A. Option 4:Repatha is indicated for treatment of hypercholesterolemia.Question 1. Which medication category would be indicated in the prevention of organ rejection for patients who have undergone a transplant? 1.Antibiotics 2.Antivirals 3.Immunosuppressants 4.Monoclonal antibodies Option 1:Antibiotic therapy would be used in the treatment of infections. It is not prescribed to prevent organ rejection. Option 2:Antiviral therapy would be used in the treatment of viruses. It is not prescribed to prevent organ rejection. Option 3:Cyclosporine and azathioprine are immunosuppressants that are used in the prevention of organ rejection in patients who have undergone transplants. Option 4:Monoclonal antibodies are used to modulate an immune response. They are not prescribed to prevent organ rejection. Question 2. After receiving the human papillomavirus (HPV) vaccine (Gardasil-9), the patient should be monitored for 15 minutes to watch for which side effect? 1.Tachycardia 2.Headache 3.Syncope 4.Pain and redness at the site Option 1:Tachycardia is not an adverse reaction to the HPV vaccine. Option 2:This is a common, general adverse reaction to the HPV vaccine but does not require monitoring postinjection. Option 3:The most common serious reaction to HPV vaccine is syncopal episodes. Recommendations are that all patients who receive the HPV vaccine be observed for 15 minutes. Option 4:Pain, redness, and swelling at the infection site were the most common local adverse reactions reported but do not require monitoring postinjection. Question 3. A parent is asking the APN how his daughter would benefit from Gardasil 9. The APN informs the parent that this vaccine will cause immunity to which virus? 1.Hepatitis B (HBV) 2.Herpes virus 3.Chlamydia 4.Human papillomavirus (HPV) Option 1:HBV provides immunity to hepatitis B. Option 2:There is not a herpes vaccine because the herpes virus is more complicated and more evasive than most infections. Option 3:Chlamydia is the most common sexually transmitted infection (STI) and can be cured with antibiotics. There is not a vaccine to prevent it. Option 4:Gardasil 9 is the only vaccine in the United States to treat HPV and provides immunity against nine types of HPV. Question 4. The APN is performing a follow-up assessment for a patient who has been prescribed cyclosporine therapy. Which finding warrants immediate intervention? 1.Patient is taking medication as directed. 2.Patient is now using Neoral as the pharmacy can no longer obtain Sandimmune. 3.Patient is not taking any herbal supplements. 4.Patient has been reporting for follow-up lab monitoring. Option 1:This finding does not require immediate action. Option 2:Formulations are not bioequivalent, and monitoring of blood concentration is required. Option 3:This finding does not require immediate action. Option 4:This finding does not require immediate action. Patients prescribed cyclosporine medications need monitoring of their potassium, magnesium, uric acid, lipid panel, blood pressure, renal function, and hepatic function. Question 5. The human papillomavirus (HPV) vaccine is recommended for girls of which age group? 1.Any age 2.Ages 11 and older 3.Ages 15 and older 4.Ages 18 and older Option 1:The HPV vaccine is not recommended for girls of all ages. Option 2:The HPV vaccine (Gardasil) is approved for use in girls and women ages 9 to 26 years. It is recommended for all girls starting at age 11 but may be started as early as 9 years. Option 3:The HPV vaccine is recommended for all girls younger than 15 years. Option 4:The HPV vaccine is recommended for all girls younger than 18 years.Question 6. Which age group is recommended to receive the hepatitis B vaccine (HBV)? 1.Patients age 1 year and older 2.Patients age 6 years and older 3.Patients age 50 years and older 4.Patients of all ages Option 1:This age group does not represent the full range of the group recommended to receive HBV. Option 2:This age group does not represent the full range of the group recommended to receive HBV. Option 3:This age group does not represent the full range of the group recommended to receive HBV. Option 4:Vaccination with HBV is recommended for all ages, particularly patients at high risk for contracting hepatitis B. Question 7. A patient is on azathioprine therapy for a few months and reports feeling more tired than usual. Which lab/diagnostic test should the APN order at this time? 1.Urinalysis with culture 2.CBC and WBC with differentials 3.Chest x-ray 4.Bone marrow aspiration Option 1:There is no presented evidence of a urinary tract infection (UTI) based on reported symptoms; therefore, this test would not be indicated at this time. Option 2:Azathioprine can cause bone marrow suppression; therefore, the APN should order both a CBC and WBC count with differential to evaluate for possible dyscrasias leading to pancytopenia. Option 3:There is no presented evidence related to respiratory dysfunction based on reported symptoms; therefore, this test would not be indicated at this time. Option 4:The APN would first determine potential dyscrasias by ordering a CBC and WBC with differentials rather than going to a more invasive procedure such as a bone marrow aspiration at this time.Question 8. Which should the healthcare provider consider when administering the influenza vaccine to a patient? 1.The vaccine can be given to individuals who are immunocompromised. 2.The use is limited to ages 2 years and older. 3.The vaccine does not contain a live virus. 4.Its use is for all persons ages 6 months and older, including pregnant women. Option 1:Patients who are immunocompromised or who have HIV should not be vaccinated with the influenza vaccine. Option 2:The influenza vaccine should be administered annually to individuals ages 2 years and older who meet the established criteria. Option 3:Influenza live, attenuated influenza vaccine (LAIV4; FluMist Quadrivalent), contains two strains of influenza A and two strains of influenza B, strains of which vary by season. Option 4:The influenza vaccine should not be administered to individuals who are less than 2 years of age as well as to pregnant women. Question 9. The APN is evaluating lab results for a patient who has been prescribed cyclosporine. Which finding is not related to this medication? 1.Hyperkalemia 2.Digoxin toxicity 3.Pancytopenia 4.Hypoglycemia Option 1:Hyperkalemia can occur when cyclosporine is taken in conjunction with potassiumsparing diuretics. Option 2:Decreased clearance leading to toxic levels can occur when cyclosporine is taken in conjunction with digitalis preparations. Option 3:Cyclosporine does not cause myelosuppression. Option 4:Hypoglycemia can occur when cyclosporine is taken in conjunction with repaglinide. Question 10. Which disease is treated with Janus kinase inhibitors (JAK)? 1.Multiple sclerosis 2.Asthma 3.Inflammatory bowel disease 4.Inflammatory arthritis Option 1:Monoclonal antibodies are used to treat multiple sclerosis. Option 2:Monoclonal antibodies are used to treat asthma. Option 3:Monoclonal antibodies used to treat autoimmune diseases target inflammatory cytokines. Option 4:Janus kinase (JAK) enzyme inhibitors used for inflammatory arthritis and other autoinflammatory diseases inhibit JAK enzymes, which prevent cytokine or growth factor– mediated gene expression. Question 11. Which information is critical for the APN to review when determining whether biologic therapy is indicated? 1.Comprehensive history of medical/surgical with designated therapies 2.Age, family history, and occupational status 3.Allergy status and medication profile 4.Diagnosis that warrants the clinical indication for biologic therapy Option 1:It is critical that the APN prescriber obtain an accurate history, including any biologic therapy, when obtaining a drug history to determine comanagement issues. Option 2:While the patient's age, family history, and occupational status are important, they do not include all of the critical information that that APN must review. Option 3:Allergy status and medication profile are important, but a comprehensive medical/surgical history with designated therapies represents critical information that the APN must review. Option 4:Although it is important to understand the diagnosis that warrants the use of therapy, it is critical that the APN prescriber obtain an accurate history, including any biologic therapy, when obtaining a drug history to determine comanagement issues. Question 12. Which vaccine is required to be given to a patient who is having an elective splenectomy? 1.Tetanus 2.Influenza 3.Polyvalent pneumococcal polysaccharide (PPS23) 4.Hepatitis Option 1:Tetanus immunization is not required before splenectomy. Option 2:Influenza vaccine is not required before splenectomy. Option 3:Pneumococcal vaccine should be given 10 to 14 days before elective splenectomy, organ transplant, immunosuppressive therapy, or chemotherapy. Option 4:Hepatitis vaccine is not required before a splenectomy.Question 13. A patient will be started on biologic therapy. Which preassessment finding should be determined before starting therapy? 1.Tuberculosis 2.Pneumonia 3.Serum cholesterol level 4.History of blood clots Option 1:Before starting a biologic agent, the patient is evaluated for hepatitis B (HBsAg, HBsAb, hepatitis B core antibody), hepatitis C (HCV antibody), tuberculosis (QuantiFERON-TB Gold), Epstein-Barr virus (EPV), and cytomegalovirus (CMV) and documented immunity to varicella. Option 2:Determination of presence of pneumonia is not indicated before starting therapy with biologics. Option 3:Determination of serum cholesterol level is not indicated before starting therapy with biologics. Option 4:Determination of history of blood clots is not indicated before starting therapy with biologics. Question 14. Which is the recommendation for a 65-year-old patient in good health who has not received a pneumococcal vaccine? 1.PCV13 only 2.PPSV23 only 3.PPSV23 now and PCV13 in 1 month 4.PCV 13 now and PPSV23 in 1 year Option 1:PCV13 is not the only vaccine recommended for this patient. Option 2:PPSV23 is not the only vaccine recommended for this patient. Option 3:Adults ages 65 years and older who have not had any doses of pneumococcal vaccine should receive a dose of PCV13 followed by a dose of PPSV in 12 months or more. Option 4:Adults ages 65 years and older who have not had any doses of pneumococcal vaccine should receive a dose of PCV13 followed by a dose of PPSV in 12 months or more. Question 15. Which action should the APN take for a patient who is going to start biologic therapy who is immune to varicella? 1.Give a shingles vaccine.2.Give an influenza vaccine. 3.Isolate the patient before starting therapy. 4.Prescribe antibiotic therapy. Option 1:Patients who are immune to varicella may need a shingles vaccine before starting treatment. Option 2:Live vaccines are avoided in any patient taking a biologic agent. Option 3:There is no need to isolate the patient when starting biologic therapy. Option 4:Antibiotic therapy is ineffective against viruses. Question 16. The APN is reviewing the labs of an adult patient who is undergoing therapy with azathioprine. Which finding is significant? 1.WBC 10,000 mL 2.Platelet count 175,000 mL 3.BUN 10 mg/dL 4.Hemoglobin 8.0 mg/dL Option 1:This finding is within a normal range (4,500–11,000) for an adult patient. Option 2:This finding is within a normal range (150,000––450,000) for an adult patient. Option 3:This finding is within a normal range (8–20) for an adult patient. Option 4:Patients taking azathioprine need close monitoring with a complete blood count (CBC) and liver function tests. This finding indicates anemia. Question 17. Which finding indicates an adverse drug reaction to the use of cyclosporine? 1.Increased WBC count 2.Muscle pain 3.Fever 4.Dental caries Option 1:One would expect to see leukopenia, not an increased WBC count, as an adverse drug reaction to cyclosporine. Option 2:One would expect to see myalgia as an adverse drug reaction to cyclosporine. Option 3:One would not expect to see fever as an adverse drug reaction to cyclosporine. Option 4:One would expect to see gingival hyperplasia, not dental caries, as an adverse drug reaction to cyclosporine.Question 18. The APN is reviewing the immunization history for an adult patient born in 1968. Which finding indicates that additional information is needed relative to the MMR vaccination? 1.The patient is considered not to be immune based on year of birth. 2.As long as there is proof of immunization, no further action is needed. 3.The patient requires another dose of MMR regardless of proof of vaccination. 4.The patient needs two doses of MMR to be immune to the disease. Option 1:Adults born before 1957 are considered immune, but as the patient was born in 1968, this is not applicable. Option 2:Adults born in 1957 or later who are at least age 18 (including those born outside the United States) should receive at least one dose of MMR if there is no serological proof of immunity or documentation of a dose given on or after the patient's first birthday. Option 3:Proof of vaccination would not require another dose of MMR. Option 4:Two doses of MMR are required for individuals who are healthcare workers and other adults in high-risk groups such as students entering college, military recruits, and international travelers. There are no clinical data to support these findings. Question 19. The APN knows that which medication is prescribed by a specialist for organ transplant patients? 1.Isoniazid 2.Dolutegravir 3.Etanercept 4.Sandimmune Option 1:This drug is an antibiotic used in the treatment of tuberculosis. Option 2:This drug is used for the treatment of HIV infection. Option 3:This drug is a biologic that is used in the treatment of moderate to severe arthritis. Option 4:Sandimmune (cyclosporine) is an immunomodulatory and is prescribed to organ transplant patients, and it is used for severe rheumatoid arthritis and psoriasis. Question 20. Which finding would indicate a potential adverse reaction for a patient who has been prescribed azathioprine? 1.Up to date with immunizations 2.Takes occasional acetaminophen for aches and pains 3.Patient takes labetalol to manage hypertension 4.History of gout Option 1:Live vaccines are not recommended for patients who are taking azathioprine. As the patient is up to date with immunizations, this would not indicate a potential adverse reaction. Option 2:There is no potential adverse reaction with acetaminophen and azathioprine. Option 3:Labetalol is a beta blocker, and there is no potential adverse reaction with a beta blocker and azathioprine. There is a potential adverse reaction with ACE inhibitors. Option 4:Xanthine oxidase inhibitors such as allopurinol are used in the treatment of gout. When taking azathioprine, concurrent therapy is not recommended.