Ch 17 Immune Modulators
06/20/22
1. Most of the drugs that affect the immune system are not recommended for use in
children or have not been tested in children.
 True
2. A 53-year-old man is receiving cyclosporine in order to prevent rejection of a
transplanted kidney. The nurse should prioritize assessments related to:
 Infection
3. A client is experiencing flu-like symptoms related to immune stimulant therapy. Which
instructions would be most appropriate for the client?
 “Drink plenty of fluids throughout the day.”
4. The nurse is discussing adverse reactions involving the cardiovascular system after
administration of oprelvekin. The nurse would include which reactions in the client
teaching plan?
 Arrhythmia
5. A client is receiving immunosuppressant therapy. Which adverse effects should the
client be educated about regarding these effects?
 The importance of keeping the home clean
6. When describing the production of interferons, the instructor discusses recombinant
DNA technology. What would the instructor include as being produced this way?
 Interferon alfacon-1
7. A 78-year-old male client begins an immunosuppressant therapy for his rheumatoid
arthritis. The nurse is concerned because this client is at greater risk for what
complication, compared with younger adults using the same treatment modality?
 Infections
8. A client has been prescribed oral cyclosporine following a successful liver transplant.
When providing education, the nurse should advise the client to avoid mixing the drug
with what liquid?
 grapefruit juice
9. A nurse is providing patient education to a 45-year-old man who is taking cyclosporine
(Sandimmune). The nurse will provide the patient with education related to one of the
most common and severe adverse effects of cyclosporine, which is:
 Nephrotoxicity.
10. Which is the most likely indication for the use of immunosuppressant agents?
 Organ transplantation
11. The nurse educator is teaching an online pharmacology class. The topic of the online
seminar is the contraindications for the use of colony stimulation factor. The nurse
includes which contraindication?
 Known hypersensitivity
12. A nurse is reviewing laboratory values of a client who has a urinary tract infection. Which
cells protect the body from microorganisms?
 WBCs
13. Many of the immunosuppressant drugs that are administered following organ
transplantation may also be used for treatment of what condition?
 Autoimmune disorder
14. To help understand immunostimulant drug therapy, the client has come to the clinic for a
class on thrombopoiesis. The nurse explains that the term means the formation of which
types of blood cells?
 Platelets
15. Interferons are substances naturally produced and released by human cells that have
been invaded by viruses. Which are not examples of interferons? (Select all that apply.)
 Aldesleukin (Proleukin)
16. An adult client experienced a kidney transplant 2 days ago, and the regimen of
antirejection drugs began just prior to surgery. What nursing action should be integrated
into this client's plan of care?
 Place the client in a single, protective isolation room.
17. A client underwent a solid organ transplant several years ago and has remained largely
symptom free. The nurse should educate the client on long-term immunosuppressant
therapy of what increased risk?
 cancer
18. A patient is receiving omalizumab to treat allergic asthma, which is not relieved by
inhaled corticosteroids. Which nursing intervention is appropriate with each dose
administration of omalizumab?
 Have epinephrine available
19. A client diagnosed with anemia asks what the cause of anemia is. Which is the
nurse’s best response?
 It is caused by a decrease in the number of RBCs.
20. A client is receiving an IV immune stimulant and develops a cardiac arrhythmia. What is
the nurse’s priority action?
 Stop the drug immediately.
21. What is the role of interferons in the normal function of the immune system?
 countering the replication and spread of viruses
22. A client is receiving omalizumab to treat allergic asthma, which is not relieved by inhaled
corticosteroids. Which nursing intervention is appropriate with each dose administration
of omalizumab?
 Have epinephrine available during administration.
23. Which would the nurse expect to administer orally?
 Cyclosporine
24. What is an adverse effect of excessive immunosuppression?
 Serious infection
25. A nurse is caring for a patient who is receiving azathioprine following kidney transplant.
For what serious adverse effect should the nurse monitor the patient?
 Infection
26. The nurse has administered a client’s prescribed daily dose of filgrastim. When
assessing for a therapeutic effect, what laboratory finding should the nurse prioritize?
 White cell differential
27. A client is prescribed filgrastim. Which is the nurse’s best explanation of how this drug
works?
 It stimulates growth and production of WBCs to fight off infection.
28. A nurse is reviewing the laboratory values of a client admitted for gastrointestinal bleed.
Which cells control bleeding?
 platelets
29. Six months after undergoing transplantation, a female client asks her health care
provider if it would be all right for her to volunteer at the local children’s health clinic. She
has limited adverse effects from her immunosuppressant drugs and is beginning to feel
healthy again. The provider suggests alternate volunteer options because:
 She may develop an infectious process at the clinic.
30. A 53-year-old man is receiving cyclosporine in order to prevent rejection of a
transplanted kidney. The nurse should prioritize assessments related to:
 Infection. ADV- CYC
31. The nurse is caring for diverse group of clients. Which client is most likely to benefit from
the administration of cyclosporine?
 A client with chronic renal failure who is recovering from a kidney
transplant
32. Which is the most likely indication for the use of immunosuppressant agents?
 Organ transplantation
33. A client is receiving anakinra for treatment of rheumatoid arthritis. The client is
scheduled to have arthroscopic evaluation of the right knee. What is the priority nursing
diagnosis for this client after the procedure?
 Risk for infection
34. Oprelvekin is a drug that stimulates the process of making which blood cells?
 Platelets OP
35. A patient who is receiving an immune modulator has been admitted to the unit. What
would be a priority action by the nurse?
 Protect the patient from exposure to infection.
36. The nurse is caring for a child who will be receiving a renal transplant and who has been
prescribed cyclosporine. When teaching the parents and child about this drug, the nurse
should explain what primary rationale for administering this drug?
 Prevention of organ rejection
37. The nurse is preparing to administer oprelvekin to a client diagnosed with a
chemotherapy-induced bleeding disorder. The nurse is explaining to the client the
reason for administering this drug? Which explanation is best?
 "The drug is used to increase platelet count during chemotherapy."
38. A hospital patient began treatment with interferon alfa-2a several days ago and the care
team is pleased with the patient's response at this point in treatment. However, the
patient has stated to the nurse that he feels increasingly despondent and claims to have
lost all hope of recovering from his disease, despite being an optimistic person. How
should the nurse best interpret the patient's statements?
 The patient may be having psychological adverse effects of interferon alfa2a.
39. A client is administered mycophenolate to prevent rejection of the transplanted heart. It
is recommended that the client have a CBC drawn weekly. The client asks the nurse the
reason for the weekly CBC. What is the nurse's best response?
 “The weekly CBC assesses for the development of infection.”
40. A client diagnosed with anemia asks what the cause of anemia is. Which is the
nurse’s best response?
 It is caused by a decrease in the number of RBCs.
41. The nurse is caring for a client who has been prescribed mycophenolate mofetil
following kidney transplant. What instruction should the nurse provide during client
teaching to minimize the risk of undesired effects?
 taking the pills on an empty stomach
42. A 78-year-old male client begins an immunosuppressant therapy for his rheumatoid
arthritis. The nurse is concerned because this client is at greater risk for what
complication, compared with younger adults using the same treatment modality?
 Infections
43. A 42-year-old client is experiencing chemotherapy-induced thrombocytopenia. The
nurse is providing information to the client regarding the medication oprelvekin. Which
information would the nurse include in the explanation?
 “Chemotherapy has caused you to have a low platelet count, which puts
you at risk for bleeding. Oprelvekin is used to increase platelet production
to decrease the risk.”
44. What assessment(s) should the nurse perform when monitoring for the most serious
adverse effects that can occur with the use of monoclonal antibodies? Select all that
apply.
 lung auscultation
45. A client asks what neutropenia is. Which is the nurse’s best response?
 a condition when the neutrophil level is very low
46. A female client is prescribed cyclosporine after her bone marrow transplant. What is the
mechanism of action of cyclosporine that makes this an ideal drug for this patient?
 Suppression of the normal effects of the immune system in the body
47. A 45-year-old male patient is receiving interferon alfa-2a therapy for hepatitis C. The
nurse should teach the patient that he may experience which adverse effect?
 Flu-like symptoms
48. A nurse is precepting a nursing student, and together they are caring for a patient who is
to receive interleukins. The student nurse asks what happens physiologically when a
patient receives interleukins. What would be the nurse's best response?
 “The patient has increases in the number of natural killer cells.”
49. To help understand immunostimulant drug therapy, the client has come to the clinic for a
class on thrombopoiesis. The nurse explains that the term means the formation of which
types of blood cells?
 Platelets
50. The health care provider has decided to prescribe T- and B-cell suppressors for a client
diagnosed with psoriasis. What drug will be ordered for this client?
 Cyclosporine
51. What would lead the nurse to suspect that a client receiving a monoclonal antibody is
experiencing pulmonary edema?
 Dyspnea
52. A nurse is caring for a client with a diagnosis of cancer. The nurse is teaching the client
about medications to treat cancer, including erythropoiesis-stimulating agents. Which
statement by the client is correct regarding how these medications work?
 “They regulate the production of erythrocytes.”
53. A client has been discharged from the hospital after a kidney transplant. Which nursing
intervention is the first line of defense against the immunosuppressant client developing
an infection?
 Teach the client the importance of personal hygiene.
54. An adult male client is being administered immunosuppressant agents on a long-term
basis. Which assessments should be made routinely with the use of long-term
immunosuppressant therapy?
 Yearly skin assessment
55. The pharmacology instructor is explaining interleukins to the class. What would be
the best definition of interleukins?
 They are chemicals used to communicate between leukocytes and are
produced by T cells.
56. The nurse is providing care for a client whose current medications include tacrolimus.
The nurse should anticipate that this client is likely to be taking what medication
concurrently?
 Prednisone
57. What client would be most likely to benefit from treatment with filgrastim (Neupogen)?
 A client who has recently undergone bone marrow transplant to treat
leukemia
58. A client is to receive erlotinib. The nurse would expect to administer this drug by which
route?

Oral
59. The nurse is caring for diverse group of clients. Which client is most likely to benefit from
the administration of cyclosporine?
 A client with chronic renal failure who is recovering from a kidney
transplant
60. A 34-year-old man is prescribed interferon alfa-2a for the treatment of chronic hepatitis
C. When teaching John about the medication, which side effect will the nurse explain is
among the most common?
 Nausea and changes in taste
61. A female client's physician prescribes leflunomide for her rheumatoid arthritis. Six
months later, the client presents for routine laboratory testing. The physician would
discontinue the medication if what laboratory test was abnormal?
 LFT
62. A client with renal cancer is prescribed aldesleukin. What action should then nurse
perform?
 Ensure the client has adequate intravenous access
63. The nurse closely monitors a client who is receiving anakinra and etanercept for:
 Severe infection.
64. A client is administered methotrexate for the treatment of severe rheumatoid arthritis.
Administration of this drug should be performed with particular care because of the
associated high risk of what condition?
 Hepatotoxicity
65. Which monoclonal antibody would the nurse expect to administer orally?
 Erlotinib
66. The nurse educator is teaching a class of students about the actions and uses of colony
stimulating factor. The nurse should inform students CSF is indicated for what secondary
problem related to cancer treatment?
 Chemotherapy-induced neutropenia
67. A nurse is caring for a client who has been admitted for immunosuppressant treatment
of severe psoriasis. Which drug is the nurse likely to administer?
 Alefacept
68. A client is to begin treatment for rheumatoid arthritis with infliximab. What potential risk
should the nurse identify as being associated with this drug?
 Risk for infection
69. The nurse is reviewing laboratory values of client who has a respiratory illness. Which
cells supply oxygen to the tissues?
 RBCs
70. A group of students are reviewing information about immune modulators in preparation
for a test. The students demonstrate understanding of the material when they identify
what as an immune stimulant?
 Interferon
71. The nurse is caring for a client who has been prescribed cyclosporine following organ
transplant. While teaching the client about the medication, the nurse describes its
adverse effects. What would the nurse include in the discussion?
 Nephrotoxicity
72. Which statement indicates that the client understands immunosuppressant therapy
following a solid organ transplant?
 "I know that I will need to stay on this medication for the rest of my life."
73. A home care nurse is caring for a client who has received a liver transplant. The nurse is
reinforcing earlier teaching about the client's immunosuppressant therapy and the need
for appropriate self-care. Which client statement suggests that the client understands?
 "I will always be at risk for serious infection."
74. A nurse is teaching a client about an iron supplement. Which should be included in the
teaching a client about this medication?
 It should be taken on an empty stomach.
75. The nurse will appraise the success or failure of treatment of filgrastim therapy by
regularly monitoring the results of what diagnostic test?
 absolute neutrophil count
76. A client is administered methotrexate for the treatment of severe rheumatoid arthritis.
Administration of this drug should be performed with particular care because of the
associated high risk of what condition?
 Hepatotoxicity
77. If a client who is prescribed tacrolimus has impaired liver function, what would the nurse
expect the health care provider to do?
 Decrease the dose
78. Use caution and arrange to reduce the dose if this drug is combined with any other
immunosuppressant drug because severe immune suppression with increased
infections and neoplasms can occur.
 monoclonal antibody
79. The medication reconciliation of a newly admitted resident of a nursing home indicates
that the patient takes cyclosporine. The nurse should initially suspect that this resident
may have:
 A previous organ transplant.
80. The nurse has an order to administer oprelvekin to a patient for the first time. Prior to
administering the drug, what would the nurse question the patient about?
 Escherichia coli products
81. A nurse educator is teaching nursing students about the administration colonystimulating factors. Teaching is effective when the students identify the need to assess
for which adverse reaction related to this drug?
 Hypertension
82. A 34-year-old man is prescribed interferon alfa-2a for the treatment of chronic hepatitis
C. When teaching John about the medication, which side effect will the nurse explain is
among the most common?
 Nausea and changes in taste
83. The nurse is administering colony-stimulating factors to an older adult client after
chemotherapy. The nurse should explain to the client that this medication is being
administered for which reason?

"Your body is going to have trouble fighting off infections on it's
own. This medication will help with that."
84. A client has a low white blood cell count and is concerned about acquiring an infection.
The client will not sign the informed consent due to a knowledge deficit about the CSF.
How should the nurse respond?
 "Chemotherapy kills cancer cells as well as good cells needed to prevent
and control infection. The cells are called white blood cells that grow in
stages but are not effective until the cell is in the adult stage. A colonystimulating drug acts on these cells to stimulate growth to the mature adult
white blood cell stage, so that the cells can go to work to help protect you
from infection."
85. Which are examples of adverse effects of immune suppressants? Select all that apply.




Increased risk for infection
Hepatotoxicity
Renal toxicity
Pulmonary edema
Mastery Level 6 Met