Pharmacotherapeutics for Advanced Practice Nurse Prescribers 4th Edition by Teri Moser Woo Marylou V. Robinson Test Bank

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Pharmacotherapeutics for Advanced Practice Nurse Prescribers 4th Edition by Teri Moser Woo Marylou V. Robinson Test Bank

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Chapter 19. Drugs Affecting the Immune System

Multiple Choice
Identify the choice that best completes the statement or answers the question.

____ 1. Attenuated vaccines are also known as:
1. Killed vaccines
2. Booster vaccines
3. Inactivated vaccines
4. Live vaccines

____ 2. Live attenuated influenza vaccine (FluMist) may be administered to:
1. All patients over 6 months of age
2. Patients between ages 2 and 49 with no risk factors
3. Patients with an upper respiratory infection (URI) or asthma
4. Pregnant women

____ 3. The reason that two MMR vaccines at least a month apart are recommended is:
1. The second dose of MMR boosts the immunity built from the first dose.
2. Two vaccines 1 month apart is the standard dosing for all live virus vaccines.
3. If the two MMR vaccine doses are given too close together there is a greater likelihood of severe localized reaction to the vaccine.
4. Only 95% of patients are fully immunized for measles after the first vaccine, with 99% having immunity after two doses of MMR.

____ 4. The MMR vaccine is not recommended for pregnant women because:
1. Pregnant women do not build adequate immunity to the vaccine.
2. There is a risk of the pregnant women developing measles encephalopathy.
3. There is a risk of the fetus developing congenital rubella syndrome.
4. Pregnant women can receive the MMR vaccine.

____ 5. If the measles, mumps, rubella, and varicella (MMRV) combined vaccine is ordered to be given as the first MMR and varicella dose to a child the CDC recommends:
1. Parents be informed of the increased risk of fever and febrile seizures over the MMR plus varicella two-shot regimen.
2. Patients must also receive MMRV as the second dose of MMR and varicella in order to build adequate immunity.
3. Patients be premedicated with acetaminophen 15 minutes before the vaccine is given.
4. Patients should not be around pregnant women for the first 48 hours after the vaccine is given.

____ 6. The rotavirus vaccine (RotaTeq, Rotarix):
1. Is a live vaccine that replicates in the small intestine, providing active immunity against rotavirus
2. Should not be administered to infants who are or may be potentially immunocompromised
3. Is not given to an infant who has a febrile illness (temperature greater than 100.5oF)
4. All of the above

____ 7. Varicella vaccine is recommended to be given to patients who are:
1. HIV positive with a CD4+ T-lymphocyte percentage less than 15%
2. Taking corticosteroids (up to 2 mg/kg/day or less than 20 mg/day)
3. Pregnant
4. Immunocompromised

____ 8. Zoster vaccine (Zostavax) is:
1. A live varicella zoster vaccine from the same strain used to develop the varicella vaccine
2. Effective in preventing varicella zoster in patients of all ages
3. Recommended for patients age 40 to 80 who have had chickenpox
4. Administered at the same time as other live vaccines, as long as they are given the same day

____ 9. True contraindications to diphtheria, tetanus, and acellular pertussis (DTaP or Tdap) vaccine include:
1. Fever up to 104oF (40.5oC) after previous DTaP vaccine
2. Family history of seizures after DTaP vaccine
3. Adolescent pregnancy
4. Anaphylactic reaction with a previous dose

____ 10. Hepatitis B vaccine is contraindicated in patients who:
1. Were born after less than 32 weeks gestation (give first dose at age 6 months)
2. Are pregnant
3. Are on hemodialysis
4. Are allergic to yeast

____ 11. Human papillomavirus (HPV) vaccine (Gardasil, Cervarix):
1. Is a live virus vaccine that provides immunity to six strains of HPV virus
2. Has a common adverse effect of syncope within 15 minutes of giving the vaccine
3. Should not be given to males younger than age 12 years
4. May be given to pregnant women

____ 12. Influenza vaccine may be administered annually to:
1. Patients with an egg allergy
2. Pregnant patients
3. Patients age 6 weeks or older
4. Patients with acute febrile illness

____ 13. Immune globulin serums:
1. Provide active immunity against infectious diseases
2. Are contraindicated during pregnancy
3. Are heated to above body temperature to kill most hepatitis, HIV, and other viruses such as parvovirus
4. Are derived from pooled plasma of adults and contain specific antibodies in proportion to the donor population

____ 14. Hepatitis B immune globulin is administered to provide passive immunity to:
1. Infants born to HBsAg-positive mothers
2. Household contacts of hepatitis-B virus infected people
3. Persons exposed to blood containing hepatitis B virus
4. All of the above

____ 15. Rho(D) immune globulin (RhoGAM) is given to:
1. Infants born to women who are Rh positive
2. Sexual partners of Rh-positive women
3. Rh-negative women after a birth, miscarriage, or abortion
4. Rh-negative women at 36 weeks gestation

____ 16. Tuberculin purified protein derivative:
1. Is administered to patients who are known tuberculin-positive reactors
2. May be administered to patients who are on immunosuppressives
3. May be administered 2 to 3 weeks after an MMR or varicella vaccine
4. May be administered the same day as the MMR and/or varicella vaccine

____ 17. Diane may benefit from cyclosporine (Sandimmune). Cyclosporin may be prescribed to:
1. Treat rheumatoid arthritis
2. Treat patients with corn allergy
3. Pregnant patients
4. Treat patients with liver dysfunction

____ 18. Azathioprine has significant adverse drug effects, including:
1. Hypertension
2. Hirsutism
3. Risk of cancer
4. Gingival hyperplasia

____ 19. Pregnant women should receive the Tdap vaccine:
1. In the first trimester
2. Once every 10 years
3. In the third trimester of every pregnancy
4. Tdap is contraindicated in pregnancy

____ 20. Children who should receive meningococcal conjugate vaccine (Hib-MenCY, MenHibrix) include:
1. Children traveling to the Haj
2. Infants, routinely at 2, 4, 6, and 12 to 15 months
3. Infants with functional asplenia (including sickle cell disease)
4. Two year olds with complement deficiencies

Chapter 19. Drugs Affecting the Immune System
Answer Section

MULTIPLE CHOICE

1. ANS: 3 PTS: 1

2. ANS: 1 PTS: 1

3. ANS: 4 PTS: 1

4. ANS: 3 PTS: 1

5. ANS: 4 PTS: 1

6. ANS: 4 PTS: 1

7. ANS: 2 PTS: 1

8. ANS: 2 PTS: 1

9. ANS: 4 PTS: 1

10. ANS: 4 PTS: 1

11. ANS: 1 PTS: 1

12. ANS: 2 PTS: 1

13. ANS: 4 PTS: 1

14. ANS: 1 PTS: 1

15. ANS: 3 PTS: 1

16. ANS: 4 PTS: 1

17. ANS: 2 PTS: 1

18. ANS: 4 PTS: 1

19. ANS: 3 PTS: 1

20. ANS: 3 PTS: 1

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