Test Bank for Introductory
Clinical Pharmacology 12th
Edition by Susan M Ford
Chapter 51-54
C HAPTER 51: I MMUNE M ODULATING
T HERAPIES
Ford: Introductory Clinical Pharmacology 12th Edition
Multiple Choice
1. The nurse caring for a client who is receiving treatment for cancer. The client
has been informed that they will be receiving a drug to support passive
immunit y. When the client asks the nurse to explain passive immunit y, how will
the nurse respond?
A) “It involves administration of antibodies from another person or animal.”
B) “Passive immunit y is based on previous exposure to an antigen.”
C) “It involves your body’s abilit y to recognize antigens as different from
your own cells.”
D) “It is the form of immunit y pr ovided by vaccines.”
Answer: A
Rationale: Passive immunit y results from the administration of ready -made
antibodies from another individual or animal. It creates no memory to protect
against a later infection, so therapies must be repeated for sustained
, protection. Active immunit y is ba sed on exposure to antigens. The immune
s ystem regards them as foreign and over time develops the abilit y to
recognize and attack them. Vaccines provide active immunit y to disease.
Question format: Multiple Choice
Chapter: 51
Learning Objective: 1
Cognitive Level: Appl y
Client Needs: Physiological Integrit y: Pharmacological Therapies
Integrated Process: Clinical Problem -solving Process (Nursing Process)
Reference: p. 699, Agents That Support Passive Immunit y
2. A client asks the nurse to explain how c ancer cells grow. What term should the
nurse use to describe the process by which cancer cells develop their own blood
vessels?
A) Metastasis
B) Angiogenesis
C) Allogeneic
D) Cytotoxic
Answer: B
Rationale: Angiogenesis occurs when the cancer cells that have in vaded the
body grow their own blood vessels. Metastasis is the development of
secondary malignant growths at a distance from a primary site of cancer.
Allogeneic refers to items derived from an external source; in the context of
cancer vaccines, the term d escribes vaccines derived from cells other than the
client’s. The term cytotoxic indicates toxicit y to living cells.
Question format: Multiple Choice
Chapter: 51
Learning Objective: 1 Cognitive
Level: Understand
Client Needs: Physiological Integrit y: Pharmacological Therapies
Integrated Process: Clinical Problem -solving Process (Nursing Process)
Reference: p. 698, Key Terms
,3. A nurse is preparing to administer aldesleukin. The health care provider has
ordered a full set of vital signs before the administration, after 20 minutes of
infusion, and at the completion of the infusion. Which statement best supports
the vital sign assessment?
A) The heart rate will indicate a transfusion reaction.
B) A change in blood pressu re may indicate capillary leak syndrome.
C) The respiratory rate will monitor ox ygen and carbon dioxide exchange.
D) Changes in temperature will signal an allergic reaction.
Answer: B
Rationale: Administration of cytokines such as aldesleukin (an interleukin)
results in increased vascular permeability. This can result in capillary leak
s yndrome, in which fluid leaks out of the circulation an into surrounding
tissues, causing edema and d angerousl y low blood flow. Monitoring the vital
signs helps identify the presence of capillary leak syndrome. Low blood
pressure is the first clinical sign, and heart rate and respiratory rate would
increase as the body attempts to correct the low blood pr essure.
Question format: Multiple Choice
Chapter: 51
Learning Objective: 3
Cognitive Level: Appl y
Client Needs: Physiological Integrit y: Pharmacological Therapies
Integrated Process: Clinical Problem -solving Process (Nursing Process)
Reference: p. 699, Cytokines
4. A nurse is preparing to administer interferon alfa -2b to a client being treated for
renal cell carcinoma. Which condition in the client’s history would this
medication be used cautiousl y?
A) Seizure disorder
B) Osteoarthritis
C) Endometriosis
D) Attention deficit disorder (ADD)
Answer: A
, Rationale: Interferon alfa -2b is cytokine is a class of drugs that warrants
caution in clients with cardiac or liver disease, history of seizure disorder, or
thyroid problems. No similar precautions are requir ed for history of
osteoarthritis, endometriosis, or ADD.
Question format: Multiple Choice
Chapter: 51
Learning Objective: 3
Cognitive Level: Appl y
Client Needs: Physiological Integrit y: Pharmacological Therapies
Integrated Process: Clinical Problem -solving Process (Nursing Process)
Reference: p. 699, Cytokines
5. A nurse is caring for a client who has been prescribed rituximab for treatment of
non- Hodgkin l ymphoma. The client is being treated prophylacticall y to reduce
the risk of tumor l ysis syndrom e. Which laboratory value would the nurse
interpret as a possible indication that prophylaxis was unsuccessful?
A) Potassium 6.0 mEq/L (6.0 mmol/ L)
B) Calcium 9.0 mg/dL (2.25 mmol/L)
C) Uric acid 4.0 mg/dL (0.24 mmol/ L)
D) Phosphate 3.1 mg/dL (1.0 mmol/ L)
Answer: A
Rationale: Tumor l ysis syndrome is accompanied by hyperkalemia,
hypocalcemia, hyperuricemia, and hyperphosphatemia. A potassium level of
6.0 mmol/ L is above the normal range of 3.5 –5.2 mEq/L (3.5–5.2 mmol/ L),
indicating hyperkalemia and potentiall y u nsuccessful prophylaxis. Calcium,
uric acid, and phosphate levels are all within normal ranges.
Question format: Multiple Choice
Chapter: 51
Learning Objective: 3
Cognitive Level: Appl y
Client Needs: Physiological Integrit y: Pharmacological Therapies
Clinical Pharmacology 12th
Edition by Susan M Ford
Chapter 51-54
C HAPTER 51: I MMUNE M ODULATING
T HERAPIES
Ford: Introductory Clinical Pharmacology 12th Edition
Multiple Choice
1. The nurse caring for a client who is receiving treatment for cancer. The client
has been informed that they will be receiving a drug to support passive
immunit y. When the client asks the nurse to explain passive immunit y, how will
the nurse respond?
A) “It involves administration of antibodies from another person or animal.”
B) “Passive immunit y is based on previous exposure to an antigen.”
C) “It involves your body’s abilit y to recognize antigens as different from
your own cells.”
D) “It is the form of immunit y pr ovided by vaccines.”
Answer: A
Rationale: Passive immunit y results from the administration of ready -made
antibodies from another individual or animal. It creates no memory to protect
against a later infection, so therapies must be repeated for sustained
, protection. Active immunit y is ba sed on exposure to antigens. The immune
s ystem regards them as foreign and over time develops the abilit y to
recognize and attack them. Vaccines provide active immunit y to disease.
Question format: Multiple Choice
Chapter: 51
Learning Objective: 1
Cognitive Level: Appl y
Client Needs: Physiological Integrit y: Pharmacological Therapies
Integrated Process: Clinical Problem -solving Process (Nursing Process)
Reference: p. 699, Agents That Support Passive Immunit y
2. A client asks the nurse to explain how c ancer cells grow. What term should the
nurse use to describe the process by which cancer cells develop their own blood
vessels?
A) Metastasis
B) Angiogenesis
C) Allogeneic
D) Cytotoxic
Answer: B
Rationale: Angiogenesis occurs when the cancer cells that have in vaded the
body grow their own blood vessels. Metastasis is the development of
secondary malignant growths at a distance from a primary site of cancer.
Allogeneic refers to items derived from an external source; in the context of
cancer vaccines, the term d escribes vaccines derived from cells other than the
client’s. The term cytotoxic indicates toxicit y to living cells.
Question format: Multiple Choice
Chapter: 51
Learning Objective: 1 Cognitive
Level: Understand
Client Needs: Physiological Integrit y: Pharmacological Therapies
Integrated Process: Clinical Problem -solving Process (Nursing Process)
Reference: p. 698, Key Terms
,3. A nurse is preparing to administer aldesleukin. The health care provider has
ordered a full set of vital signs before the administration, after 20 minutes of
infusion, and at the completion of the infusion. Which statement best supports
the vital sign assessment?
A) The heart rate will indicate a transfusion reaction.
B) A change in blood pressu re may indicate capillary leak syndrome.
C) The respiratory rate will monitor ox ygen and carbon dioxide exchange.
D) Changes in temperature will signal an allergic reaction.
Answer: B
Rationale: Administration of cytokines such as aldesleukin (an interleukin)
results in increased vascular permeability. This can result in capillary leak
s yndrome, in which fluid leaks out of the circulation an into surrounding
tissues, causing edema and d angerousl y low blood flow. Monitoring the vital
signs helps identify the presence of capillary leak syndrome. Low blood
pressure is the first clinical sign, and heart rate and respiratory rate would
increase as the body attempts to correct the low blood pr essure.
Question format: Multiple Choice
Chapter: 51
Learning Objective: 3
Cognitive Level: Appl y
Client Needs: Physiological Integrit y: Pharmacological Therapies
Integrated Process: Clinical Problem -solving Process (Nursing Process)
Reference: p. 699, Cytokines
4. A nurse is preparing to administer interferon alfa -2b to a client being treated for
renal cell carcinoma. Which condition in the client’s history would this
medication be used cautiousl y?
A) Seizure disorder
B) Osteoarthritis
C) Endometriosis
D) Attention deficit disorder (ADD)
Answer: A
, Rationale: Interferon alfa -2b is cytokine is a class of drugs that warrants
caution in clients with cardiac or liver disease, history of seizure disorder, or
thyroid problems. No similar precautions are requir ed for history of
osteoarthritis, endometriosis, or ADD.
Question format: Multiple Choice
Chapter: 51
Learning Objective: 3
Cognitive Level: Appl y
Client Needs: Physiological Integrit y: Pharmacological Therapies
Integrated Process: Clinical Problem -solving Process (Nursing Process)
Reference: p. 699, Cytokines
5. A nurse is caring for a client who has been prescribed rituximab for treatment of
non- Hodgkin l ymphoma. The client is being treated prophylacticall y to reduce
the risk of tumor l ysis syndrom e. Which laboratory value would the nurse
interpret as a possible indication that prophylaxis was unsuccessful?
A) Potassium 6.0 mEq/L (6.0 mmol/ L)
B) Calcium 9.0 mg/dL (2.25 mmol/L)
C) Uric acid 4.0 mg/dL (0.24 mmol/ L)
D) Phosphate 3.1 mg/dL (1.0 mmol/ L)
Answer: A
Rationale: Tumor l ysis syndrome is accompanied by hyperkalemia,
hypocalcemia, hyperuricemia, and hyperphosphatemia. A potassium level of
6.0 mmol/ L is above the normal range of 3.5 –5.2 mEq/L (3.5–5.2 mmol/ L),
indicating hyperkalemia and potentiall y u nsuccessful prophylaxis. Calcium,
uric acid, and phosphate levels are all within normal ranges.
Question format: Multiple Choice
Chapter: 51
Learning Objective: 3
Cognitive Level: Appl y
Client Needs: Physiological Integrit y: Pharmacological Therapies
