1. Which of the following statements could be used to describe a neutronphil?

 They possess the property of phagocytosis

 When activated, they release a pyrogen that causes fever
 When the body is injured, they are produced rapidly and in large number
2. The inflammatory response is activated whenever cell injury occurs. An inflammatory respsonse
would involve which of the following activities?
 Activation of Hageman factor
 Vasodilation in the area of the injury
 Changes in capillary permeability to allow proteins to leak out of the capillaries
3. The nurse providing teaching for patients taking immunosuppressants will include which
information? (select all that apply)
 The amount and tongue should be inspected carefully for white patches
 Patients should avoid crowd to minimize the risk of infection
 Patients should report any fever, sore throat, chills or joint pain
 Patients should take oral forms with food to avoid gastrointestinal upset
4. Which drugs are indicated for the treatment of multiple sclerosis? (select that apply)
 Glatiramer acetate (copaxone)
 Fingolimod (gilenya)
5. A nurse is discussing drug therapy with cyclosporine (sandimmune). Which food product inhibits
metabolism enzymes and possibly increases the activity of cyclosporine?
 Grapefruit juice
6. When teaching patients who are taking oral dose of immunosuppressants, how will the nurse
instruct instruct the patient to take the medication?
 With food to minimize gastrointestinal upset
7. The nurse is reviewing the use of COX-2 inhibitor celecoxib (Celebrex). Which conditions are
indications for celecoxib? (Select all that apply).
 Osteoarthritis
 Rheumatoid arthritis
 Primary dysmenorrhea
8. The nurse is reviewing a patient’s medications and sees an order for ketorolac (Toradol). This
drug is ordered for which condition?
 Moderate to severe acute pain
9. When monitoring patients on immunosuppressant therapy, the nurse must keep in mind that
the major risk factor for patients taking these drugs is which condition?
 Increased susceptibility to opportunistic infections
10. A patient is experiencing rejection of transplanted organ. The nurse expects which drug to be
given to manage this?
 Muromonb-CD3 (orthoclone OKT3)
11. The immunity is passed from the mother to her nursing infant through antibodies in breast mil is
known as which type of immunity?
 Naturally acquired passive immunity
12. Which substance contains microorganisms that trigger the formation of antibodies against
specific pathogens?
 Vaccine
13. When teaching a patient about the common adverse effects of therapy with nonsteroidal anti-
inflammatory drugs (NSAIDs), the nurse will mention which possible adverse effect?
 Dizziness or heartburn
14. A 13-year-old patient has the flue, and her mother is concerned about her fever of 103 degree F
(39.4 degree C). Which of these medications will the prescriber suggest the mother used to treat
the teen’s fever?
 Acetaminophen (Tylenol)
15. Which of the following is not a cytokine?
 Interleukin 2
16. As part of the nonspecific defense against infection
 Particles in the respiratory tract are engulfed by phagocytes
17. Which of the following statements could be used to describe a neutrophil?
 They possess the property of phagocytosis
18. Antibodies
 Are effective only against specific antigens
19. B and T cells are similar in that they both
 Play important roles in the immune response
20. The immunity that is passed from a mother to her nursing infant through antibodies is breast
milk is known as which type of immunity?
 Naturally acquired passive immunity
21. Which substance contains microorganisms that trigger the formation of antibodies against
specific pathogens
 Vaccine
22. A client is being treated for severe rheumatoid arthritis. The nurse could anticipate treatment
with which of the following.
 Etanercept – tumor necrosis factor
 Gold therapy
 Hylan G-F 20 – hylans with elastic properties
 Methotrexate
23. The nurse notes an order for oxaprozin (Daypro) for the treatment of arthritis. Before
administering the drug, the nurse would assess the patient for which problems that could be
cautions or contraindications?
 Active peptic ulcer disease
 Renal impairment
 Bleeding disorders
24. When reviewing various immunizing drugs, the nurse recalls that some products provide long-
lasting immunity against a particular pathogen. Which is an example of this type of product?
 Poliovirus vaccine
25. The nurse is preparing to give a second dose of DTaP vaccine to a 6-month-old infant. The
infant’s mother tells the nurse that the last time he received this vaccination, the injection site
on his leg became warm and slightly reddened. Which is the nurse’s best action?
 Explain that these effects can be expected and give the medication
26. A nurse has been stuck by a used needle while starting an intravenous line. Which preparation is
used as prophylaxis against disease after exposure to blood and body fluids?
 Hepatitis B immune globulin
27. The nurse is providing patient to a 24-year-old woman regarding the human papillomavirus
(HPV) vaccine. Which statement by the woman indicates the more teaching is needed? (select
all that apply).
 “This vaccine only takes one injection”
 It is safe to take this vaccine if I am pregnant.”
28. A patient will be taking cyclosporine (Sandimmune) after transplant surgery. Which of these are
potential adverse effects of cyclosporine therapy? (select that apply)
 Hypertension
 Nephrotoxicity
 Post-transplant diabetes mellitus
29. The nurse is assigned to care for a client who is receiving immune suppressant. The nurse
continually assesses the client for which of the following anticipated adverse effects?
 Development of cancer
 Increased risk of infection
 Development of secondary infections
30. Teaching points that the nurse would incorporate into the care of a client receiving cyclosporine
would include which of the following?
 Use barrier contraceptives to avoid pregnancy
 Dilute the solution with milk, chocolate milk, or orange juice and drink immediately
 Avoid drinking grapefruit juice when on this drug
31. When reviewing the health history of a patient who is to receive NSAID therapy, the nurse keeps
in mind that contraindications for the use of these drugs include which condition?
 Bleeding disorder
32. When monitoring patients on immunosuppressant therapy, the nurse must keep in mind that
the major risk factor for patients taking these drugs is which condition?
 Increased susceptibility to opportunistic infections
33. A patient is receiving treatment with allopurinol (Zyloprim) for an acute flare-up of gout. Which
statements will the nurse include during patient teaching? (Select all that apply)
 "Call your provider immediately if you note any skin rashes or abnormalities"
 "Be sure to avoid alcohol and caffeine"
 "You need to increase fluid intake to up to 3 liters per day"
 "Take the medication with meals to prevent stomach problems"
CASE STUDY

Sadie has been taking indomethacin (Indocin) as part of therapy for osteoarthritis, but lately has noticed
that it has been less effective. Her provider has decided to try celecoxib (Celebrex). Sadie has a history of
hepatitis (15 years earlier).

1. What advantage might there be to treatment with celecoxib rather than indomethacin?
2. What potential adverse effects will you want Sadie about before she takes this medication?
What should she report?
3. What allergies are important to assess before Sadie takes this medication?
4. She asks you if she can drink her usual glass of wine each evening while taking this medication.
What will you tell her?

CASE STUDY

Mr. K had renal transplant surgery 6 months ago and so far, has had no problems with organ rejection.
He is taking cyclosporine (Sandimmune) in a maintenance dose. He wants to go back to work and is in
for checkup before approval is given for a return to his job

1. He asks if he will have to continue the cyclosporine. What is your reponse?

2. He complains difficulty swallowing, and as you examine his mouth, you look for signs or oral
candidiasis. What findings would indicate that he has his condition?
3. After 2 weeks at work Mr. K calls to report that he has the flu. He has a sore throat, chills
and achy joints, and he is very tired. What is your advice?
4. Mr. K tells you that his job sometimes requires him to travel to remote areas in the world.
What concerns are there with vaccinations, if any?

CASE STUDY

You are volunteering at a local animal shelter and helping to care for a sick dog that has just been
admitted. During the examination, the dog nipped both you and the veterinarian. A little later, the
veterinarian tells your that she fears that the dog has rabies and that both of you have been exposed.
The veterinarian tells you that she has received a vaccine for rabies, but that you will need to be
vaccinated immediately.

1. Is rabies a virus or bacteria?

2. Dis the vaccine the veterinarian received previously give her actives or passive immunization?
3. Will the vaccine you receive give you active or passive immunization? Explain why this particular
type of vaccine is preferred in your situation.