Chapter 34: Drugs for Immune System Modulation
Question 1
Type: MCSA
A child has leukemia and is immunosuppressed due to chemotherapy. The mother frantically calls the clinic to
say that her child was exposed to varicella (chickenpox). What does the best plan by the nurse include?
1. The child should come to the clinic as soon as possible to receive an injection of varicella immune globulin if
he develops chickenpox.
2. The child should come to the clinic as soon as possible to receive an injection of varicella immune globulin.
3. The child should be brought to the clinic immediately to receive a vaccination for chickenpox.
4. The child should be kept away from other children to avoid further exposure to varicella.
Correct Answer: 2
Rationale 1: Immune globulin is not given after the disease develops.
Rationale 2: Immune globulin must be given before the disease develops.
Rationale 3: The child is immunosuppressed; administering a vaccination for chickenpox could result in
developing the disease.
Rationale 4: Keeping the child away from others will not help; the child has already been exposed.
Global Rationale: Immune globulin must be given before the disease develops. Immune globulin is not given
after the disease develops. The child is immunosuppressed; administering a vaccination for chickenpox could
result in developing the disease. Keeping the child away from others will not help; the child has already been
exposed.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.
AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.
NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 34-4 Distinguish between active immunity and passive immunity.
MNL Learning Outcome: 5.1.1 Examine specific and nonspecific body defenses and functions of the
inflammatory response. Page Number: 522
Question 2
,Type: MCSA
A mother brings her child to the clinic for his last diphtheria-pertussis-tetanus (DPT) immunization. The mother
tells the nurse that the child developed a red rash after the previous diphtheria-pertussis-tetanus (DPT)
immunization. What does the best action by the nurse include?
1. Administer only a pertussis-tetanus immunization.
2. Withhold this immunization and contact the physician.
3. Tell the mother to give the child acetaminophen (Tylenol) if another rash develops.
4. Administer diphenhydramine (Benadryl) prior to the diphtheria-pertussis-tetanus (DPT) immunization.
Correct Answer: 2
Rationale 1: There is no such immunization as pertussis-tetanus.
Rationale 2: This red rash is unexpected and could indicate a potential adverse reaction to the vaccine such as
anaphylaxis, so the nurse should withhold the immunization and contact the physician.
Rationale 3: The nurse should not tell the mother to administer acetaminophen (Tylenol); this will not prevent
anaphylaxis.
Rationale 4: The nurse cannot administer diphenhydramine (Benadryl) without a physician's order.
Global Rationale: This red rash is unexpected and could indicate a potential adverse reaction to the vaccine such
as anaphylaxis, so the nurse should withhold the immunization and contact the physician. There is no such
immunization as pertussis-tetanus. The nurse should not tell the mother to administer acetaminophen (Tylenol);
this will not prevent anaphylaxis. The nurse cannot administer diphenhydramine (Benadryl) without a
physician's order.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human
experience.
AACN Essentials Competencies: IX.3 Implement holistic, patient-centered care that reflects an understanding of
human growth and development, pathophysiology, pharmacology, medical management and nursing
management across the health-illness continuum, across lifespan, and in all healthcare settings.
NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 34-10 Use the nursing process to care for patients receiving pharmacotherapy for immune
conditions.
MNL Learning Outcome: 5.2.3 Compare medications used in pharmacotherapy and nurse’s role in
administration: Immunizing agents. Page Number: 522
Question 3
, Type: MCMA
The nurse is teaching a class on immunizations for women with newborn infants. The nurse evaluates that
learning has occurred when the women make which statements?
Note: Credit will be given only if all correct choices and no incorrect choices are selected
Standard Text: Select all that apply.
1. "The immunizations are more effective if they are given closer together."
2. "Our babies might have a mild fever and be fussy for a few days."
3. "If our babies develop a fever, we must call the doctor immediately."
4. "We can give acetaminophen (Tylenol) if our babies have a mild fever."
5. "If our babies develop a mild fever, it means an allergic reaction."
Correct Answer: 2,4
Rationale 1: The recommended immunization schedule should be followed. There is no benefit to giving the
immunizations closer together.
Rationale 2: A mild fever is a typical reaction to immunizations.
Rationale 3: The physician does not need to be called unless the fever is high.
Rationale 4: Acetaminophen (Tylenol) is indicted for relief of mild symptoms.
Rationale 5: A mild fever does not indicate an allergic reaction to the immunization.
Global Rationale: A mild fever is a typical reaction to immunizations. Acetaminophen (Tylenol) is indicted for
relief of mild symptoms. The recommended immunization schedule should be followed. There is no benefit to
giving the immunizations closer together. The physician does not need to be called unless the fever is high. A
mild fever does not indicate an allergic reaction to the immunization.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human
experience.
AACN Essentials Competencies: IX.3 Implement holistic, patient-centered care that reflects an understanding of
human growth and development, pathophysiology, pharmacology, medical management and nursing
management across the health-illness continuum, across lifespan, and in all healthcare settings.
NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.
Nursing/Integrated Concepts: Nursing Process: Evaluation
Question 1
Type: MCSA
A child has leukemia and is immunosuppressed due to chemotherapy. The mother frantically calls the clinic to
say that her child was exposed to varicella (chickenpox). What does the best plan by the nurse include?
1. The child should come to the clinic as soon as possible to receive an injection of varicella immune globulin if
he develops chickenpox.
2. The child should come to the clinic as soon as possible to receive an injection of varicella immune globulin.
3. The child should be brought to the clinic immediately to receive a vaccination for chickenpox.
4. The child should be kept away from other children to avoid further exposure to varicella.
Correct Answer: 2
Rationale 1: Immune globulin is not given after the disease develops.
Rationale 2: Immune globulin must be given before the disease develops.
Rationale 3: The child is immunosuppressed; administering a vaccination for chickenpox could result in
developing the disease.
Rationale 4: Keeping the child away from others will not help; the child has already been exposed.
Global Rationale: Immune globulin must be given before the disease develops. Immune globulin is not given
after the disease develops. The child is immunosuppressed; administering a vaccination for chickenpox could
result in developing the disease. Keeping the child away from others will not help; the child has already been
exposed.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.
AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.
NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 34-4 Distinguish between active immunity and passive immunity.
MNL Learning Outcome: 5.1.1 Examine specific and nonspecific body defenses and functions of the
inflammatory response. Page Number: 522
Question 2
,Type: MCSA
A mother brings her child to the clinic for his last diphtheria-pertussis-tetanus (DPT) immunization. The mother
tells the nurse that the child developed a red rash after the previous diphtheria-pertussis-tetanus (DPT)
immunization. What does the best action by the nurse include?
1. Administer only a pertussis-tetanus immunization.
2. Withhold this immunization and contact the physician.
3. Tell the mother to give the child acetaminophen (Tylenol) if another rash develops.
4. Administer diphenhydramine (Benadryl) prior to the diphtheria-pertussis-tetanus (DPT) immunization.
Correct Answer: 2
Rationale 1: There is no such immunization as pertussis-tetanus.
Rationale 2: This red rash is unexpected and could indicate a potential adverse reaction to the vaccine such as
anaphylaxis, so the nurse should withhold the immunization and contact the physician.
Rationale 3: The nurse should not tell the mother to administer acetaminophen (Tylenol); this will not prevent
anaphylaxis.
Rationale 4: The nurse cannot administer diphenhydramine (Benadryl) without a physician's order.
Global Rationale: This red rash is unexpected and could indicate a potential adverse reaction to the vaccine such
as anaphylaxis, so the nurse should withhold the immunization and contact the physician. There is no such
immunization as pertussis-tetanus. The nurse should not tell the mother to administer acetaminophen (Tylenol);
this will not prevent anaphylaxis. The nurse cannot administer diphenhydramine (Benadryl) without a
physician's order.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human
experience.
AACN Essentials Competencies: IX.3 Implement holistic, patient-centered care that reflects an understanding of
human growth and development, pathophysiology, pharmacology, medical management and nursing
management across the health-illness continuum, across lifespan, and in all healthcare settings.
NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 34-10 Use the nursing process to care for patients receiving pharmacotherapy for immune
conditions.
MNL Learning Outcome: 5.2.3 Compare medications used in pharmacotherapy and nurse’s role in
administration: Immunizing agents. Page Number: 522
Question 3
, Type: MCMA
The nurse is teaching a class on immunizations for women with newborn infants. The nurse evaluates that
learning has occurred when the women make which statements?
Note: Credit will be given only if all correct choices and no incorrect choices are selected
Standard Text: Select all that apply.
1. "The immunizations are more effective if they are given closer together."
2. "Our babies might have a mild fever and be fussy for a few days."
3. "If our babies develop a fever, we must call the doctor immediately."
4. "We can give acetaminophen (Tylenol) if our babies have a mild fever."
5. "If our babies develop a mild fever, it means an allergic reaction."
Correct Answer: 2,4
Rationale 1: The recommended immunization schedule should be followed. There is no benefit to giving the
immunizations closer together.
Rationale 2: A mild fever is a typical reaction to immunizations.
Rationale 3: The physician does not need to be called unless the fever is high.
Rationale 4: Acetaminophen (Tylenol) is indicted for relief of mild symptoms.
Rationale 5: A mild fever does not indicate an allergic reaction to the immunization.
Global Rationale: A mild fever is a typical reaction to immunizations. Acetaminophen (Tylenol) is indicted for
relief of mild symptoms. The recommended immunization schedule should be followed. There is no benefit to
giving the immunizations closer together. The physician does not need to be called unless the fever is high. A
mild fever does not indicate an allergic reaction to the immunization.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human
experience.
AACN Essentials Competencies: IX.3 Implement holistic, patient-centered care that reflects an understanding of
human growth and development, pathophysiology, pharmacology, medical management and nursing
management across the health-illness continuum, across lifespan, and in all healthcare settings.
NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.
Nursing/Integrated Concepts: Nursing Process: Evaluation
