Chapter 38 Immunosuppressants
1. A patient has been diagnosed with hairy cell leukemia. The patient is to begin
taking interferon alfa 2b. What will the nurse include in her instructions to the
patient concerning this drug?
A) Avoid drinking alcohol while taking the drug.
B) Continue to maintain maximal physical activity.
C) Increase fluid intake while taking the drug.
D) Treat constipation with over-the-counter laxatives.
Ans C
Feedback
Interferon alfa 2b is metabolized in the kidney so adequate fluid intake is needed to
promote metabolism and excretion of the drug as well as to minimize common adverse
effects including dry skin and dizziness. Maintaining maximal physical activity is a
good idea but has no relationship to the use of the drug. Fluids should be increased not
decreased while taking the drug. Constipation is not an associated adverse effect of this
medication.
2. The health care provider plans to inject an interferon directly into the patients wart. What
interferon will the nurse prepare?
A) Interferon alfa 2a (Roferon-A)
B) Interferon alfacon 1 (Infergen)
C) Interferon alfa n3 (Alferon N)
D) Interferon beta 1a (Avonex)
Ans C
Feedback
Interferon alf n3 is used for intralesional treatment of warts. Interferon alfa 2a is used in
the treatment of leukemia. Interferon alfacon 1 is used in the treatment of chronic
hepatitis C infection in adults. Interferon beta 1a is used to treat multiple sclerosis in
adults.
3. A 30-year-old woman has been diagnosed with leukemia and will be using an immune
modulator for treatment. What will be important to discuss with the patient when the
nurse provides patient teaching about her treatment?
, A) The need to continue oral contraceptives
B) The need to use barrier contraceptives while taking the drug
C) The need to avoid sexual intercourse while taking the drug
D) The importance of taking an aspirin daily to decrease the adverse effects of the
drug
Ans B
Feedback
A patient taking an immune modulator would be advised to use barrier contraceptives to
prevent pregnancy. The interaction of the immune modulator and the oral contraceptive
may interfere with the oral contraceptives ability to work properly. Asking patients to
avoid sexual intercourse is not necessary if barrier methods are properly used. Daily
aspirin would not decrease adverse effects of this drug.
4. The nurse has an order to administer oprelvekin (Neumega) to a patient for the first time.
Before administering the drug, what allergy would the nurse want to specifically
question the patient about?
A) Egg products
B) Escherichia coliproduced products
C) Lactose intolerance
D) Penicillin
Ans B
Feedback
The interleukins are produced using deoxyribonucleic acid technology and E. coli
bacteria. Patients with known allergy to E. coli products should not receive
oprelvekin. The allergies to penicillin, egg products, or lactose intolerance would not
be of concern with this drug.
5. The physician has decided to prescribe T- and B-cell suppressors for a patient diagnosed
with psoriasis. What drug will be ordered for this patient?
A) Alefacept (Amevive) B)
Azathioprine (Imuran)
C) Cyclosporine (Neoral)
D) Glatiramer acetate (Copaxone)
, Ans A
Feedback
Alefacept is prescribed for patients with severe chronic plaque psoriasis. Cyclosporine
is used to suppress rejection in a variety of transplant situations. Azathioprine is used
to treat patients with rheumatoid arthritis and in prevention of rejection in renal
homotransplants. Tacrolimus is used for prevention of rejection after renal or liver
transplantation.
6. A patient who is receiving an immune suppressant has been admitted to the unit.
What would be a priority action by the nurse? A) Monitor nutritional status.
B) Provide patient teaching regarding the drug.
C) Protect the patient from exposure to infection.
D) Provide support and comfort measures in relation to adverse effects of the drug.
Ans C
Feedback
Patients taking immune suppressant drugs are more susceptible to infection because the
patients normal body defenses will be diminished. As a result, the priority action by the
nurse would to protect the patient from exposure to infection through room selection,
good hand hygiene, and taking care to avoid exposure to sick staff members. Teaching
will need to include avoiding crowded places and people with known infection and those
working in soil. Nutritional status is important as are comfort and support measures and
other instructions concerning the drug. However, protecting the patient from infection
should be the priority action.
7. A nurse is discussing interferon alfa 2b with a patient. What will the nurse encourage the
patient to do while taking this drug?
A) To avoid crowds
B) To increase salt intake
C) To decrease milk intake
D) To eat three meals a day
Ans A
Feedback
Potential adverse effects in addition to the types of conditions interferon alfa 2b is
prescribed to contribute to the need for the patient to take care to avoid people with
infections so the patient should be taught to avoid crowds whenever possible. Adverse
1. A patient has been diagnosed with hairy cell leukemia. The patient is to begin
taking interferon alfa 2b. What will the nurse include in her instructions to the
patient concerning this drug?
A) Avoid drinking alcohol while taking the drug.
B) Continue to maintain maximal physical activity.
C) Increase fluid intake while taking the drug.
D) Treat constipation with over-the-counter laxatives.
Ans C
Feedback
Interferon alfa 2b is metabolized in the kidney so adequate fluid intake is needed to
promote metabolism and excretion of the drug as well as to minimize common adverse
effects including dry skin and dizziness. Maintaining maximal physical activity is a
good idea but has no relationship to the use of the drug. Fluids should be increased not
decreased while taking the drug. Constipation is not an associated adverse effect of this
medication.
2. The health care provider plans to inject an interferon directly into the patients wart. What
interferon will the nurse prepare?
A) Interferon alfa 2a (Roferon-A)
B) Interferon alfacon 1 (Infergen)
C) Interferon alfa n3 (Alferon N)
D) Interferon beta 1a (Avonex)
Ans C
Feedback
Interferon alf n3 is used for intralesional treatment of warts. Interferon alfa 2a is used in
the treatment of leukemia. Interferon alfacon 1 is used in the treatment of chronic
hepatitis C infection in adults. Interferon beta 1a is used to treat multiple sclerosis in
adults.
3. A 30-year-old woman has been diagnosed with leukemia and will be using an immune
modulator for treatment. What will be important to discuss with the patient when the
nurse provides patient teaching about her treatment?
, A) The need to continue oral contraceptives
B) The need to use barrier contraceptives while taking the drug
C) The need to avoid sexual intercourse while taking the drug
D) The importance of taking an aspirin daily to decrease the adverse effects of the
drug
Ans B
Feedback
A patient taking an immune modulator would be advised to use barrier contraceptives to
prevent pregnancy. The interaction of the immune modulator and the oral contraceptive
may interfere with the oral contraceptives ability to work properly. Asking patients to
avoid sexual intercourse is not necessary if barrier methods are properly used. Daily
aspirin would not decrease adverse effects of this drug.
4. The nurse has an order to administer oprelvekin (Neumega) to a patient for the first time.
Before administering the drug, what allergy would the nurse want to specifically
question the patient about?
A) Egg products
B) Escherichia coliproduced products
C) Lactose intolerance
D) Penicillin
Ans B
Feedback
The interleukins are produced using deoxyribonucleic acid technology and E. coli
bacteria. Patients with known allergy to E. coli products should not receive
oprelvekin. The allergies to penicillin, egg products, or lactose intolerance would not
be of concern with this drug.
5. The physician has decided to prescribe T- and B-cell suppressors for a patient diagnosed
with psoriasis. What drug will be ordered for this patient?
A) Alefacept (Amevive) B)
Azathioprine (Imuran)
C) Cyclosporine (Neoral)
D) Glatiramer acetate (Copaxone)
, Ans A
Feedback
Alefacept is prescribed for patients with severe chronic plaque psoriasis. Cyclosporine
is used to suppress rejection in a variety of transplant situations. Azathioprine is used
to treat patients with rheumatoid arthritis and in prevention of rejection in renal
homotransplants. Tacrolimus is used for prevention of rejection after renal or liver
transplantation.
6. A patient who is receiving an immune suppressant has been admitted to the unit.
What would be a priority action by the nurse? A) Monitor nutritional status.
B) Provide patient teaching regarding the drug.
C) Protect the patient from exposure to infection.
D) Provide support and comfort measures in relation to adverse effects of the drug.
Ans C
Feedback
Patients taking immune suppressant drugs are more susceptible to infection because the
patients normal body defenses will be diminished. As a result, the priority action by the
nurse would to protect the patient from exposure to infection through room selection,
good hand hygiene, and taking care to avoid exposure to sick staff members. Teaching
will need to include avoiding crowded places and people with known infection and those
working in soil. Nutritional status is important as are comfort and support measures and
other instructions concerning the drug. However, protecting the patient from infection
should be the priority action.
7. A nurse is discussing interferon alfa 2b with a patient. What will the nurse encourage the
patient to do while taking this drug?
A) To avoid crowds
B) To increase salt intake
C) To decrease milk intake
D) To eat three meals a day
Ans A
Feedback
Potential adverse effects in addition to the types of conditions interferon alfa 2b is
prescribed to contribute to the need for the patient to take care to avoid people with
infections so the patient should be taught to avoid crowds whenever possible. Adverse
