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Chapter 17 - Immune Modulators |Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch)

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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 patient’s 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 contraceptive’s 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)

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Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch)

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 patient’s
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 contraceptive’s 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.

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