Answer to Question 1
Correct Answer: 3
Rationale 1: Drinking milk is not contraindicated with cyclosporine.
Rationale 2: Eating fish is not contraindicated with cyclosporine.
Rationale 3: Drinking grapefruit juice concurrently can increase cyclosporine levels by 50200.
Rationale 4: Eating leafy green vegetables is not contraindicated with cyclosporine.
Global Rationale: Grapefruit juice significantly increases cyclosporine levels, and should be avoided or eliminated while on immunosuppressant therapy. Teach the patient to avoid or eliminate grapefruit and grapefruit juice while on cyclosporine. Flavored beverages without juice are permissible. Drinking milk, eating fish, and eating leafy green vegetables are not contraindicated.
Answer to Question 2
Correct Answer: 1
Rationale 1: A single dose can decrease lymphocytes by 8590.
Rationale 2: This percentage of reduction is not indicative of the effectiveness of antithymocyte globulin.
Rationale 3: This percentage of reduction is not indicative of the effectiveness of antithymocyte globulin.
Rationale 4: This percentage of reduction is not indicative of the effectiveness of antithymocyte globulin.
Global Rationale: Antithymocyte globulin consists of polyclonal antibodies obtained from the serum of horses (Atgam) or rabbits (Thymoglobulin) exposed to human T cells. The drug is a potent immunosuppressant used for the prophylaxis and management of transplant rejection and for the treatment of moderate to severe aplastic anemia in patients who are unable to have bone marrow transplantation. A single infusion may lower the lymphocyte count by 85 to 90.