Big Biologics and MABs and the Increasing Immunosuppressed World

~ Exam ~

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This test has 15 questions.

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1. The acquired type of immunosuppression is also known as:

  a. Primary

  b. Self-induced

  c. Secondary

  d. Congenital

2. Which of the following patients does not have acquired immunosuppression?

  a. A 28 year old kidney transplant recipient.

  b. A 78 year old female.

  c. A male who is status post nephrectomy.

  d. A patient with long-standing diabetes.

3. Which of these statements is true about immunosuppression?

  a. The level of immune response is standard between patients and for each patient.

  b. The WBC and ANC are always abnormal in patients on immunosuppressive therapy.

  c. The longer a patient is on immunosuppression, the lower the risk for infection and other adverse effects will be.

  d. Immunosuppressants can affect the entire body, potentially causing renal damage, cancer, cardiovascular events and neurological problems.

4. Patient A takes a biologic MAB drug and patient B takes anti-rejection medications. Which patient is more immunosuppressed?

  a. Patient A because he is on an anti-TNF medication.

  b. Unable to determine due to variability between patients.

  c. Both patients are equally immunosuppressed.

  d. Patient B because he takes more immunosuppressant drugs.

5. Biologics include which of the following?

  a. Monoclonal antibodies (MABs)

  b. Oncolytic agents

  c. Vaccines

  d. All of the above

6. The following are common biologic therapeutic drugs EXCEPT:

  a. Rituximab

  b. Tacrolimus

  c. Adalimumab

  d. Etanercept

7. The FDA has approved biologics for the management of many diseases and conditions. The following conditions or diseases are commonly treated with biologic therapy EXCEPT:

  a. Psoriatic arthritis

  b. Crohn’s disease

  c. Juvenile diabetes

  d. Ulcerative colitis

8. Which serious adverse effect of MABs and anti-TNF-alpha class drugs has resulted in black box warnings by the FDA?

  a. Migraine headaches

  b. Paronychia

  c. Tuberculosis

  d. Injection site erythema

9. What are essential elements to consider in the assessment of the patient on biologic therapy?

  a. The initial assessment should focus on immunosuppression risks.

  b. The nurse should obtain the history of infections, cancers, respiratory problems, or cardiac symptoms related to biologic therapy.

  c. The caregiver’s knowledge of reportable symptoms should be assessed, especially if the patient is an unreliable historian.

  d. All of the above.

10. Which of the following is NOT a nurse’s responsibility in managing patients on biologics?

  a. Educating staff and patients.

  b. Including immunosuppressant status in the Nursing Diagnosis and Care Plan.

  c. Monitoring of labs and test results.

  d. Adjusting immunosuppression level based on dose.

11. What is one of the first actions the nurse can take to minimize the risk of infection in the non-isolated patient taking a biologic?

  a. Include risk of infection due to immunosuppression in the care plan.

  b. Place a no visitors sign on the door.

  c. Get a physician’s order to draw daily CBC’s.

  d. Revise the current policy on administering MAB class drugs.

12. Which of the following is NOT a proactive measure the nurse can implement to help reduce infection in the patient taking biologic therapy?

  a. Close patient’s door and place isolation cart nearby.

  b. Develop protocols specifically for the patient on biologic/immunosuppressant therapy.

  c. Consult with the infection control manager regarding ways to reduce risks.

  d. Consider in-unit bed transfer or staffing assignment changes.

13. Mr. Jones tells his nurse during the assessment that he takes Humira for his RA. He is in a semi private room with a patient who has a draining wound. The nurse should take the following steps EXCEPT:

  a. Consult with the pharmacist regarding decreasing the Humira dose.

  b. Speak with a supervisor or bed placement coordinator to arrange a bed transfer.

  c. Ensure staffing is arranged to help prevent cross-contamination.

  d. Communicate with staff to monitor roommate situation during Mr. Jones’ admission.

14. When educating patients about biologic therapy, the nurse should include which of the following?

  a. Advise caregivers to keep the home germ free by using a bleach solution.

  b. Encourage patients to tell all healthcare providers that they are taking biologics.

  c. Ignore reportable symptoms such as cough, night sweats, or painful lumps.

  d. Remind patients that reporting a fever can wait until the next clinic visit.

15. Hospital and home care nurses should focus patient education on the following points EXCEPT:

  a. Encouraging the patient to tell healthcare providers that they are on biologic therapy.

  b. Tell friends and family that they must wear masks around them.

  c. Continuous review of reportable symptoms.

  d. Using common sense techniques to prevent infections like handwashing.