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NURSING 6005 CHAPTER 69: IMMUNOSUPPRESSANTS | COMPLETE GUIDE

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NURSING 6005 CHAPTER 69: IMMUNOSUPPRESSANTS Test Bank MULTIPLE CHOICE 1. A patient has undergone liver transplantation. The provider orders cyclosporine (Sandimmune), prednisone, and sirolimus ... (Rapamune). What will the nurse do? a. Question the order for sirolimus. b. Request an order for a serum glucose level. c. Request an order for a macrolide antibiotic. d. Suggest changing the cyclosporine to tacrolimus. 2. A patient with a liver transplant has been receiving cyclosporine (Sandimmune) for 6 months. The nurse reviews this patient’s laboratory results and notes a sharp increase in the blood urea nitrogen (BUN) and serum creatinine. Vital signs are normal, and the patient reports no discomfort. What does the nurse suspect? a. Hepatotoxicity b. Infection c. Organ rejection d. Nephrotoxicity 3. A nurse provides teaching to a patient who has undergone kidney transplantation and will begin taking cyclosporine (Sandimmune), a glucocorticoid, and sirolimus (Rapamune). Which statement by the patient indicates understanding of the teaching? a. “I should take sirolimus at the same time as the cyclosporine.” b. “I will need to have my blood sugar checked regularly.” c. “I will need to take an antibiotic to prevent lung infections.” d. “Taking this combination of drugs lowers my risk of kidney damage.” 4. A patient with a history of lung transplantation is admitted for treatment for a respiratory infection. The patient has been taking cyclosporine (Sandimmune), prednisone, and azathioprine (Imuran) for 8 months. The provider has ordered azithromycin (Zithromax) to treat the infection and acetaminophen (Tylenol) as needed for fever. The nurse will contact the provider to: a. ask whether a different antibiotic can be used. b. ask that the prednisone be discontinued until the infection clears. c. suggest increasing the dose of cyclosporine. d. suggest using ibuprofen instead of acetaminophen. 5. A patient is taking cyclosporine (Sandimmune) and prednisone to prevent organ rejection after right renal transplantation. The patient is febrile and complains of right-sided flank pain. The nurse reviews the patient’s chart and finds that the patient’s BUN and serum creatinine are elevated. The cyclosporine trough is 150 ng/mL. What will the nurse do? a. Be concerned that the left kidney is failing. b. Expect the provider to order intravenous methylprednisolone. c. Request an order for a urine culture. d. Suspect nephrotoxicity secondary to an elevated cyclosporine level. 6. A patient is started on immunosuppressant drugs after kidney transplantation and will be taking azathioprine (Imuran) as part of the drug regimen. The patient asks the nurse why it is necessary to have a specimen for a complete blood count drawn at the beginning of therapy and then periodically thereafter. The nurse explains that azathioprine can alter blood cells and tells the patient to report: [Show More]

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