Answer to Question 1
Correct Answer: 4
Rationale 1: Flulike symptoms do not occur with azathioprine and an ACE inhibitor.
Rationale 2: Hypercholesteremia is not an adverse effect of these two agents.
Rationale 3: Concurrent use with ACE inhibitors and azathioprine does not result in hematuria.
Rationale 4: Concurrent use of azathioprine and an ACE inhibitor could result in anemia and severe leukopenia.
Global Rationale: The use of angiotensin-converting enzyme (ACE) inhibitors with azathioprine may induce anemia and severe leukopenia. Flulike symptoms, hypercholesteremia, and hematuria are not adverse effects of concurrent use of these two drugs.
Answer to Question 2
Correct Answer: 2,5
Rationale 1: Monoclonal antibodies are contraindicated in clients with a fever of greater than 100F.
Rationale 2: Monoclonal antibodies target a single type of cell, reducing side effects.
Rationale 3: Monoclonal antibodies must be administered intravenously.
Rationale 4: Multiple days of dosing are needed with monoclonal antibodies.
Rationale 5: Because of their specificity, smaller doses of monoclonal antibodies can be given.
Global Rationale: Because a single B cell produces a single antibody, it is called a monoclonal antibody (MAB). A MAB is very specific, targeting a single type of target cell or receptor. This allows greater effects on the target cell or receptor at lower doses and with fewer adverse effects than using polyclonal antibodies. They are contraindicated in the presence of a fever, are administered intravenously, and require multiple days of dosing.