Immunomodulators/Hematopoietic Drugs

1.

1 point

What type of allergy must patients be screened for prior to receving Etanercept (Enbrel) ? -- a disease modifying antirheumatic drug.

drug allergy

latex allergy

peanut allergy

human albumin allergy

2.

1 point

Immunomodulating drugs modify the tumor's biology, making it more difficult for the tumor to thrive and grow. ie: the tumor can't make babies.

True

False

3.

1 point

Which drug is said to have been reported to reactivate TB and hepatitis in patients taking it.

Aldeskleukin

Etanercept

Gemfibrozil

Adalimumab

4.

1 point

Epoetin alfa decreases the duration of a decreased neutrophil count, thus, reducing the incidence of .....

thrombocytopenia

adverse reaction

infection

cell destruction

5.

1 point

What is the reason for administering interferon meds in the evening?

because they can cause fatigue

because they can cause insomnia

because they can cause night terrors

because they can cause dizziness

6.

1 point

Live vaccines can be given with Etanercept (Enbrel)

True

False

7.

1 point

DMARD's interact with which of the following drugs?

Aldesleukin

NSAIDs

Anakinra

Albuterol

8.

1 point

What is the contraindication for the use of Etanercept?

Coronary Artery Disease

<65 years of age

active infection

Diabetes Type I

9.

1 point

IL-2 (interleukin) Denileukin diftitox has what main effect on a malignant cell?

stimulates T cells to multiply after binding

marks the malignant cell for destruction

damages the endoplasmic reticulum of the cancer cell

causes cell death upon binding

10.

1 point

Etanercept should be used with caution in patients with....

heart failure

renal failure

atelectasis

rhinoplasty

11.

1 point

A major contraindication for the use of Interleukin drugs is....

AIDS

hepatitis

COPD

thrombocytopenia

12.

1 point

Long-term therapy with interferon drugs can lead to an increase in bone marrow.

True- it causes an increase in bone marrow production

False- it can lead to bone marrow supression

13.

1 point

Multiple Sclerosis is treated by which of the following drugs?

interferon alfa 2a

interferon gamma 1b

interferon beta 1a

interferon alfacon 1

14.

1 point

Anakinra (what a beautiful name for a drug)........Anakinra is indicated for which of the following conditions?

Renal Cell Carcinoma

Rheumatoid Arthritis

Cuteanous T-Cell lymphoma

Multiple Sclerosis

15.

1 point

Which hematopoietic drug stimulates platelet production?

Filgrastim (Neupogen)

Epoetin alfa (Epogen)

Sagramostim (leukine)

Oprelvekin (Neumega)

16.

1 point

Alemtuzumab: is used to treat which type of cancer?

Metastatic colorectal cancer

Breast cancer

Ovarian cancer

B-cell chronic lymphocytic leukemia

17.

1 point

Iron stores must be at least __________ % in order for appropriate erythropoietin stimulation to occur.

15%

10%

25%

20%

18.

1 point

Filgrastim should not be given if the 'absolute' neutrophil count exceeds what level?

10,000

1800

800

1000

19.

1 point

Methotrexate, a nonbiologic DMARD, should be given once daily at 25mg/day

True- CORRECT, once daily, 25 mg/day PO for the treatment of Rheumatoid Arthritis

False- WRONG, it should be given once weekly, 25 mg/wk for the treatment of Rheumatoid Arthritis

20.

1 point

When administering Abatacept (Orencia), caution should be used in patients with....

infections, COPD

heart murmur, hypotension

renal impairment

a fractured bone

21.

1 point

Which of the followings (mabs) monoclonal antibodies is not used for cancer treatment?

alemtuzumab

cetuximab

adalimumab

bevacizumab

22.

1 point

A patient is taking Aldesleukin, and he complains to the doctor that he has gained 20-30 lbs, the doctor would inform the patient that...

that's normal, reassess your diet while on this medication

omg, you're going to die

that is an adverse rxn to taking this drug, we must discontinue it immediately

don't lie to me Mr. Jones, you look just fine!

23.

1 point

Denileukin diftitox is indicated only as therapy for one form of cancer...select the correct answer below, s'il vous plait ~*

metastatic colorectal cancer

cutaneous T-cell lymphoma

malignant melanoma

B-cell mediated lymphocytic leukemia

24.

1 point

Denileukin diftitox (interleukin) has a cytocidal effect which inhibits protein synthesis; this is due to which component of its chemical make up?

recombinant form of the human IL-1 receptor antagonist

IL-2 receptor antagonist abilities

because it activates LAK cells

presence of the diphtheria toxin

25.

1 point

Filgrastim is antagonized by which of the following drugs? ...therefore, they should not be taken together.

epoetin alfa

myelosupressants

sargramostim

antivirals

26.

1 point

Interferon drugs have 3 basic properties:

antiviral- destroy viruses: hepatitis, genital warts

antibacterial - destroy bacterial infections: E. coli, Staph aureas

antineoplastic - attack cancer cells - malignant melanoma

immunomodulating - decreased progression of MS

27.

1 point

Epogen should not be given to patients with a hemoglobin level above?....because it create a higher risk of thrombotic events

14

10

12

8

28.

1 point

If a patient's disease does not respond to Methotrexate or Leflunomide (both non-biologic DMARDS)...the next step would be to administer...

Interleukins- Aldesleukin

Inteferons- Gamma-1b

biologic DMARD- Etanercept

CSF- Filgrastim

29.

1 point

What is the main adverse effect of aldesleukin therapy that leads to severe toxicity?

decreased protein binding

an allergic reaction, as result of its interaction with IgE

capillary leak leading to a decrease in vital colloids

drug overdosing

30.

1 point

One of the main contraindications in the use of Interferon drugs is...

hepatitis/liver disease

renal insufficiency

hx of DVT

COPD

31.

1 point

Which drug would be used to treat serious granulomatous infections and osteopetrosis?

interferon alpha-2a

interferon gamma-1b

interferon beta-1b

interferon beta-1a

32.

1 point

Massive fluid retention that may result from capillary leak syndrome can lead to further consequences...they are

heart failure

dysrhthmias

respiratory distress

MI

33.

1 point

A patient is ordered Epogen to treat his anemia, he tells the nurse that he has uncontrolled hypertension, what would be the correct nursing intervention.

Inform the patient that the drug will not affect or worsen his hypertension and administer the drug

administer the drug, but closely monitor any changes in BP

do not administer the drug, uncontrolled hypertension is a contraindication for hematopoietic medication use

do not administer this drug, instead administer some iron dextran IM

34.

1 point

Blood abnormalities may arise if Interferon drugs are given with which drug?

Beta Blockers

ARBs

CCB

ACE Inhibitors

35.

1 point

Capillary leak syndrome is associated with which category of drugs?

Interferons

Hematopoietic

Interleukins

DMARDs

36.

1 point

When should Filgrastim (Neupogen) be discontinued?

when the RBC count has normalized

when the hemoglobin count has normalized

when the blood pressure and temperature fall within normal values

when the WBC count has normalized

37.

1 point

The use of immunomodulating medications are the first resort when attempting to thwart the development of malignant tumors.

True- medications first and most effective method in treating malignancies

False- medications are the 4th part of therapy, surgery, chemo, and radiation are also used.

38.

1 point

Aldesleukin (IL-2) -- acts in which manner to attack cancers cells

directly- through cytocidal activity of antibodies

indirectly- modify immune system through enhancement of neutrophils

directly- activates cytocidal T-cells, which then lyse the cell membrane

indirectly- activates T-cells, stimulates LAK cells which destroy only cancer cells

39.

1 point

For erythropoietic drugs, it is important to assess patients for a history of________________because the drug can exacerbate these conditions.

hypertension

seizures

renal impairment

thrombosis

40.

1 point

When taking DMARDs or any immunosuppressant, it is essential to inform the patient of any signs of infection, even if they appear trivial...ex: scratchy or sore throat, vomiting, diarrhea, and temperature over 100 F.

True

False

41.

1 point

A patient taking Filgrastim complains of nausea and occasional diarrhea, the nurse should inform the patient that these are....

severe adverse reactions

typical side effects that occur in 25% of patients

sign of drug toxicity

sign of a medication administration error

42.

1 point

Which of the following is NOT a main action of hematopoietic drugs?

decrease duration of anemia

decrease duration of neutropenia, thrombocytopenia

decrease duration of mestatic activity

increase bone marrow recovery time

43.

1 point

Abatacept is dosed according to....

age

weight

severity of RA

route of administration

44.

1 point

Epogen (Epoetin alfa) is ineffective in manufacturing RBC production and maturation without the presence of ....

glucose

plasma

blood

iron

45.

1 point

Interferons: 1) restore impaired function, 2) augment immune defense 3) inhibit immune system in the case of an autoimmune disease

True

False

46.

1 point

For colony stimulating factors: ie Filgrastim, which labs should be taken before and during therapy to monitor for leukocytosis and thrombocytosis?

aPTT

urinalysis

CBC test

BAC test

47.

1 point

Interferon beta-1a and beta-1b are contraindicated for patients with...

leukocytosis

thrombocytopenia

allergy to human albumin

Hairy cell leukiemia

48.

1 point

Which one is not an adverse reaction of Abatacept (Orenicia)- a DMARD?

headache

diarrhea

upper respiratory infection

hypertension

49.

1 point

It is safe to use the same needle to inject your patient, after drawing up Epogen from the vial.

True

False

50.

1 point

Which of the following is not a contraindication in the use of Aldesleukin (interleukin)?

abnormal results on pulmonary function test

abnormal CBC results

abnormal results on cardiac stress test

organ transplantation