Pharm Exam Chapter 47, 48, 50 PDF

Chapter 47,48,50 Pharm Exam 1. Which type of immunity is associated with B cells? o A. Cell-mediated immunity o B. Humoral immunity o C. Passive immunity o D. None of the above Answer: B Rationale: Humoral immunity involves B cells creating antibodies in...

Chapter 47,48,50 Pharm Exam 1. Which type of immunity is associated with B cells? o A. Cell-mediated immunity o B. Humoral immunity o C. Passive immunity o D. None of the above Answer: B Rationale: Humoral immunity involves B cells creating antibodies in response to antigens. 2. What happens to antibody production in older adults? o A. It increases significantly after vaccinations. o B. It remains the same as in younger individuals. o C. It decreases, even after vaccinations. o D. It ceases entirely. Answer: C Rationale: Older adults produce fewer antibodies, making them more susceptible to infections. 3. Which of the following is a characteristic of cell-mediated immunity (CMI)? o A. Involves T cells as first responders o B. Based on antigen-antibody responses o C. Creates antibodies o D. Provides passive immunity Answer: A Rationale: T cells are the primary responders in cell-mediated immunity. 4. Which is true about antigens? o A. Antigens are proteins that destroy B cells. o B. Antigens stimulate the production of antibodies. o C. Antigens are produced by B lymphocytes. o D. Antigens provide passive immunity. Answer: B Rationale: Antigens are substances, usually proteins, that stimulate the body to produce antibodies. 5. What is the primary role of vaccines? o A. To provide passive immunity o B. To stimulate the immune response and create active immunity o C. To eliminate toxins o D. To prevent fever and pain at the injection site Answer: B Rationale: Vaccines introduce antigens to stimulate active immunity. 6. Which disease is preventable by vaccination before traveling to endemic areas? o A. Influenza o B. Cholera o C. Tetanus o D. Varicella Answer: B  Rationale: Vaccines for cholera are recommended before traveling to areas where it is endemic. 7. What kind of immunity does an immune globulin provide? o A. Active immunity o B. Long-term immunity o C. Passive immunity with short duration o D. Antibody suppression Answer: C Rationale: Immune globulins provide rapid passive immunity but last only 1- 3 months. 8. What is the primary precaution for storing vaccines? o A. Store at room temperature o B. Refrigerate and have a backup power source o C. Store in a dry, warm area o D. Keep frozen Answer: B Rationale: Vaccines must be refrigerated with a backup power plan to ensure stability. 9. What is a contraindication for administering the varicella vaccine? o A. Use of acetaminophen o B. Egg allergy o C. Use of salicylates o D. Febrile illness Answer: C Rationale: Using salicylates with the varicella vaccine increases the risk of Reye’s syndrome. 10. What is the recommended treatment for local pain after vaccine administration? o A. Aspirin o B. Massage, rest, and apply heat or ice o C. Antibiotics o D. Increase dietary protein Answer: B Rationale: Non-invasive treatments like massage and ice/heat are recommended. 11. What type of vaccine contains attenuated antigens? o A. Live vaccines o B. Killed vaccines o C. Recombinant vaccines o D. Inactivated vaccines Answer: A Rationale: Live vaccines use weakened antigens to stimulate immunity. 12. Which condition requires the recombinant zoster vaccine? o A. History of herpes simplex o B. History of shingles o C. History of influenza  o D. Egg allergy Answer: B Rationale: Adults with a history of shingles should receive the recombinant zoster vaccine. 13. What is the risk of administering antivenom after 4 hours of exposure? o A. It can cause hypertension. o B. It may not be effective. o C. It leads to chronic immunity. o D. It increases urticaria risk. Answer: B Rationale: Administering antivenom promptly ensures maximum effectiveness. 14. What is a major adverse reaction to interferons? o A. Increased appetite o B. Flu-like symptoms o C. Rash and itching o D. Increased red blood cell production Answer: B Rationale: Interferons commonly cause flu-like symptoms such as chills, fever, and malaise. 15. Why are colony-stimulating factors used after chemotherapy? o A. To prevent alopecia o B. To stimulate platelet production o C. To reduce neutropenia and infection risk o D. To inhibit erythropoiesis Answer: C Rationale: Colony-stimulating factors reduce the risk of infection by boosting neutrophil production. 16. Which of the following is a potential adverse reaction to colony-stimulating factors? o A. Alopecia o B. Hypotension o C. Bone pain o D. Hyperpigmentation Answer: C Rationale: Bone pain is a common adverse reaction to colony-stimulating factors. 17. Which condition is treated using thrombopoietin receptor agonists? o A. Neutropenia o B. Thrombocytopenia o C. Anemia o D. Erythrocytosis Answer: B Rationale: Thrombopoietin receptor agonists stimulate platelet production to treat thrombocytopenia. 18. Why is epoetin alpha used in patients with CKD-related anemia?  o A. It lowers blood pressure. o B. It stimulates erythropoiesis. o C. It increases platelet count. o D. It reduces iron absorption. Answer: B Rationale: Epoetin alpha increases RBC production, helping manage CKD- related anemia. 19. What is a contraindication for using darbepoetin alfa? o A. Hypertension o B. Neutropenia o C. Low platelet count o D. Chronic liver disease Answer: A Rationale: Uncontrolled hypertension is a contraindication for darbepoetin alfa. 20. What type of anemia results from a lack of intrinsic factor? o A. Iron deficiency anemia o B. Hemolytic anemia o C. Pernicious anemia o D. Aplastic anemia Answer: C Rationale: Pernicious anemia occurs due to a lack of intrinsic factor, impairing vitamin B12 absorption. 21. Which of the following is true about pernicious anemia? o A. It can resolve without treatment. o B. It requires lifelong therapy with vitamin B12. o C. It is caused by iron deficiency. o D. It is unrelated to diet. Answer: B Rationale: Lifelong vitamin B12 therapy is required for managing pernicious anemia. 22. What is a common adverse reaction to oral iron supplementation? o A. Hypotension o B. Black or dark stools o C. Hyperkalemia o D. Jaundice Answer: B Rationale: Black or dark stools are a common side effect of oral iron supplements. 23. What precaution should be taken when administering iron injections? o A. Use a small-bore needle. o B. Inject into fatty tissue. o C. Avoid milk and antacids before administration. o D. Mix with tetracyclines. Answer: C  Rationale: Milk and antacids interfere with iron absorption and should be avoided. 24. Which symptom indicates a hypersensitivity reaction to immune globulin therapy? o A. Hypotension o B. Cyanosis o C. Increased appetite o D. Dehydration Answer: B Rationale: Cyanosis is a symptom of hypersensitivity during immune globulin therapy. 25. What is a contraindication for receiving interferons? o A. Advanced age o B. Pregnancy, unless at high risk for MS o C. Immunosuppressive therapy o D. Use of corticosteroids Answer: B Rationale: Interferons should not be used in pregnancy unless the risk of MS outweighs potential harm. 26. How should folic acid be administered to treat megaloblastic anemia? o A. Intravenously only o B. By IM injection only o C. Orally, unless the patient cannot tolerate it o D. Subcutaneously with no restrictions Answer: C Rationale: Folic acid is usually given orally unless GI intolerance is an issue. 27. Which medication is used to reduce hematologic effects after methotrexate therapy? o A. Vitamin B12 o B. Leucovorin o C. Cyanocobalamin o D. Epoetin alpha Answer: B Rationale: Leucovorin diminishes the hematologic effects of methotrexate. 28. What is the role of chemotherapy in cancer treatment? o A. To stimulate red blood cell production o B. To target rapidly dividing cancer cells o C. To permanently stop cell division o D. To provide immunity against cancer Answer: B Rationale: Chemotherapy targets rapidly dividing cancer cells. 29. What is the recommended action for pregnant nurses regarding chemotherapy drugs? o A. Use protective gloves when administering drugs. o B. Avoid preparing, administering, or handling these drugs. o C. Administer only oral chemotherapy drugs. o D. Consult with a supervisor before handling drugs. Answer: B  Rationale: Pregnant nurses should avoid handling chemotherapy drugs due to potential harm. 30. What adverse reaction should be monitored in patients taking temozolomide with radiation? o A. Hypertension o B. Alopecia o C. Pneumocystis pneumonia o D. Weight loss Answer: C Rationale: Patients taking temozolomide with brain radiation are at risk for pneumocystis pneumonia. 31. What precaution is essential when administering antivenoms? o A. Always dilute with saline. o B. Resuscitation equipment must be available. o C. Administer only through oral routes. o D. Avoid in patients with egg allergies. Answer: B Rationale: Resuscitation equipment should be nearby in case of hypersensitivity reactions to antivenoms. 32. What type of immunity do immune globulins provide? o A. Active, long-lasting immunity o B. Passive, short-term immunity o C. Artificial, lifelong immunity o D. Innate, broad-spectrum immunity Answer: B Rationale: Immune globulins provide rapid, passive immunity that is short-lived. 33. Which of the following is an example of a live attenuated vaccine? o A. Influenza (killed) o B. Measles, Mumps, Rubella (MMR) o C. Hepatitis B (recombinant) o D. Pneumococcal (polysaccharide) Answer: B Rationale: MMR is a live attenuated vaccine designed to stimulate immunity. 34. What is the function of colony-stimulating factors (CSFs)? o A. Stimulate the immune response to vaccines. o B. Promote WBC production to combat neutropenia. o C. Enhance platelet aggregation in thrombocytopenia. o D. Support RBC production in anemia. Answer: B Rationale: CSFs act on hematopoietic cells to stimulate WBC production, reducing infection risks. 35. What is the role of thrombopoietin receptor agonists? o A. Prevent neutropenia o B. Increase RBC counts o C. Elevate platelet counts  o D. Stimulate iron absorption Answer: C Rationale: Thrombopoietin receptor agonists stimulate megakaryocytes to produce platelets. 36. Which adverse reaction is most associated with interferons? o A. "Flu-like symptoms" o B. Cyanosis o C. Black stools o D. Alopecia Answer: A Rationale: "Flu-like symptoms" such as chills, fever, and malaise are common with interferons. 37. What should be avoided when administering interferons? o A. Antipyretics o B. Live-attenuated vaccines o C. Antihistamines o D. Low-dose corticosteroids Answer: B Rationale: Live-attenuated vaccines are contraindicated for patients receiving interferons. 38. When should colony-stimulating factors be started after chemotherapy? o A. 6 hours o B. 12 hours o C. 24 hours o D. 48 hours Answer: C Rationale: CSFs are initiated 24 hours after chemotherapy to stimulate WBC recovery. 39. What is a common adverse reaction to epoetin alpha? o A. Hypotension o B. Hypertension o C. Alopecia o D. Bone pain Answer: B Rationale: Hypertension is a frequent side effect of epoetin alpha due to increased RBC production. 40. What dietary component can interfere with iron absorption? o A. Protein-rich foods o B. High-calcium meals o C. Carbohydrate-rich diets o D. Low-fat meals Answer: B Rationale: Calcium-containing foods and drinks can reduce iron absorption. 41. Which vaccine is recommended for adults with a history of shingles? o A. Varicella vaccine o B. Recombinant zoster vaccine  o C. Hepatitis B vaccine o D. Pneumococcal vaccine Answer: B Rationale: Adults with a history of shingles are advised to receive the recombinant zoster vaccine. 42. What is an adverse reaction associated with antivenoms? o A. Pruritus o B. Hypothermia o C. Bradycardia o D. Hyperpigmentation Answer: A Rationale: Pruritus (itching) is a hypersensitivity reaction to antivenoms. 43. What precaution is required for administering vaccines stored in refrigeration? o A. Store vaccines at room temperature. o B. Always have a backup storage plan for power outages. o C. Administer frozen vaccines directly. o D. Store all vaccines in a freezer. Answer: B Rationale: A backup plan ensures vaccine efficacy during power interruptions. 44. What should be avoided while receiving oral iron therapy? o A. Mixing with juice o B. Dairy products o C. Drinking water o D. Taking on an empty stomach Answer: B Rationale: Dairy products interfere with iron absorption and should not be taken together. 45. Which lab parameter is crucial for monitoring during CSF therapy? o A. Hemoglobin o B. Platelet count o C. Absolute neutrophil count (ANC) o D. Serum iron levels Answer: C Rationale: ANC monitoring determines the effectiveness of CSF therapy. 46-60 46. What is the target hemoglobin level for patients receiving epoetin alpha therapy? o A. 8 g/dL o B. 10 g/dL o C. 11 g/dL o D. 13 g/dL Answer: C Rationale: Hemoglobin levels should not exceed 11 g/dL to minimize risks of MI or stroke. 47. What type of anemia requires lifelong vitamin B12 therapy?  o A. Iron-deficiency anemia o B. Pernicious anemia o C. Sickle cell anemia o D. Aplastic anemia Answer: B Rationale: Pernicious anemia results from the lack of intrinsic factor and requires lifelong vitamin B12 supplementation. 48. What dietary deficiency causes megaloblastic anemia? o A. Iron o B. Vitamin B12 or folic acid o C. Calcium o D. Protein Answer: B Rationale: Megaloblastic anemia is due to deficiencies in vitamin B12 or folic acid. 49. What is the role of leucovorin in folic acid deficiency? o A. Treats pernicious anemia. o B. Prevents neural tube defects. o C. Mitigates hematologic effects of methotrexate. o D. Stimulates intrinsic factor production. Answer: C Rationale: Leucovorin counteracts the adverse effects of methotrexate on hematologic cells. 50. Why is a test dose required before administering iron dextran? o A. To ensure optimal absorption. o B. To check for anaphylactic reactions. o C. To determine appropriate dosage. o D. To improve iron uptake. Answer: B Rationale: A test dose helps detect potential anaphylactic reactions to iron dextran. 51. What is a contraindication for darbepoetin alfa? o A. Anemia in CKD patients o B. Uncontrolled hypertension o C. Concurrent folic acid therapy o D. History of strokes Answer: B Rationale: Darbepoetin alfa should not be used in patients with uncontrolled hypertension. 52. What condition is treated with interferons? o A. Chronic kidney disease o B. Multiple sclerosis o C. Pernicious anemia o D. Thrombocytopenia Answer: B  Rationale: Interferons are used to manage conditions like multiple sclerosis and some cancers. 53. What is a key side effect of colony-stimulating factors? o A. Bone pain o B. Cyanosis o C. Diarrhea o D. Pruritus Answer: A Rationale: Bone pain is a common adverse reaction due to increased bone marrow activity. 54. What is the primary use of antimetabolite drugs in chemotherapy? o A. Treating anemia o B. Targeting the cell cycle o C. Reducing nausea o D. Stimulating RBC production Answer: B Rationale: Antimetabolites are cell-cycle-specific drugs used to target cancer cells during division. 55. What nursing precaution is necessary for chemotherapy handling? o A. Double gloves and masks are sufficient. o B. Pregnant nurses should avoid handling chemotherapy drugs. o C. Only oral chemotherapy drugs require special precautions. o D. No special precautions are needed if in a liquid form. Answer: B Rationale: Pregnant nurses must avoid handling chemotherapy drugs due to teratogenic risks. 56. What adverse reaction requires immediate reporting in a chemotherapy patient? o A. Hair loss o B. Nausea o C. Temperature >100.4°F o D. Fatigue Answer: C Rationale: Fever may indicate infection and requires prompt medical intervention. 57. What should be done if extravasation occurs during IV chemotherapy? o A. Stop infusion immediately. o B. Flush the IV site with saline. o C. Switch to the other arm. o D. Apply a cold pack without discontinuing infusion. Answer: A Rationale: Extravasation of chemotherapy drugs requires immediate cessation of the infusion. 58. What anemia results from inadequate iron levels in the body? o A. Macrocytic anemia o B. Megaloblastic anemia o C. Iron-deficiency anemia  o D. Pernicious anemia Answer: C Rationale: Iron-deficiency anemia occurs when the body cannot produce sufficient hemoglobin due to low iron. 59. What method is best for administering iron supplements to minimize tooth staining? o A. Mix with milk and drink. o B. Use a straw with juice or water. o C. Take on a full stomach. o D. Administer via subcutaneous injection. Answer: B Rationale: Drinking iron through a straw prevents tooth staining. 60. Why is calcium avoided near the time of iron supplement intake? o A. It increases the risk of diarrhea. o B. It binds to iron, reducing absorption. o C. It leads to hypercalcemia. o D. It enhances the risk of constipation. Answer: B Rationale: Calcium interferes with iron absorption, so they should be taken at different times. 61. What is the main precaution for administering antivenoms? o A. Use only in patients without a fever. o B. Check for an allergy to equine serum. o C. Avoid administering with fluids. o D. Dilute with saline before use. Answer: B Rationale: Allergy to equine serum is a contraindication for antivenoms as it can cause severe hypersensitivity reactions. 62. What adverse reaction is commonly associated with interferons? o A. Hypercalcemia o B. “Flu-like symptoms” o C. Weight gain o D. Constipation Answer: B Rationale: Interferons often cause chills, fever, headache, and malaise resembling flu symptoms. 63. What monitoring is essential for colony-stimulating factors used in neutropenia? o A. Blood glucose levels o B. Absolute neutrophil count (ANC) o C. Serum calcium levels o D. Platelet aggregation Answer: B Rationale: Colony-stimulating factors are monitored by ANC to ensure effectiveness in treating neutropenia. 64. What is a major adverse reaction of thrombopoietin receptor agonists? o A. Vision disturbances (cataract formation)  o B. Severe nausea o C. Hyperkalemia o D. Alopecia Answer: A Rationale: Cataract formation is a potential side effect of thrombopoietin receptor agonists. 65. What type of immunity involves B cells and antibody production? o A. Cell-mediated immunity o B. Humoral immunity o C. Passive immunity o D. Innate immunity Answer: B Rationale: Humoral immunity involves B cells, which create antibodies to fight antigens. 66. Why should salicylates be avoided with the varicella vaccine? o A. They increase the risk of Reye’s syndrome. o B. They reduce the vaccine's effectiveness. o C. They cause excessive bleeding at the injection site. o D. They may lead to hypersensitivity reactions. Answer: A Rationale: The combination of salicylates and the varicella vaccine heightens the risk of Reye’s syndrome, especially in children. 67. What is the primary action of erythropoiesis-stimulating agents? o A. Stimulate platelet formation o B. Elevate serum iron levels o C. Promote red blood cell production o D. Reduce bone marrow activity Answer: C Rationale: Erythropoiesis-stimulating agents encourage the production of red blood cells. 68. Which adverse reaction is commonly associated with chemotherapy? o A. Increased appetite o B. Bone marrow suppression o C. Hyperpigmentation o D. Renal failure Answer: B Rationale: Bone marrow suppression is a frequent side effect of chemotherapy, affecting blood cell counts. 69. What is the ideal storage condition for vaccines? o A. Room temperature o B. Refrigerated with a backup plan for power outages o C. Frozen at -20°C o D. Store in a dry, dark cabinet Answer: B Rationale: Vaccines must be stored in a refrigerator, and a backup plan should be in place in case of power failure. 70. Which group is at increased risk of severe herpes zoster reoccurrence? o A. Adolescents o B. Older adults o C. Immunocompromised children o D. Pregnant women Answer: B Rationale: Older adults, especially those with a history of shingles, are at increased risk and should receive the recombinant zoster vaccine. 71. What precaution should be taken when administering vitamin B12 injections? o A. Use a Z-track method. o B. Administer via subcutaneous injection only. o C. Monitor for pulmonary edema. o D. Mix with folic acid before administration. Answer: C Rationale: Pulmonary edema can occur as an adverse reaction to vitamin B12 therapy. 72. What is the primary treatment for megaloblastic anemia? o A. Iron supplementation o B. Folic acid administration o C. Erythropoietin injections o D. Vitamin C tablets Answer: B Rationale: Folic acid is used to treat megaloblastic anemia caused by a dietary lack of folic acid. 73. What should be avoided within two hours of taking oral iron supplements? o A. Foods high in fiber o B. High-calcium meals o C. Vitamin B12 supplements o D. Antihistamines Answer: B Rationale: High-calcium meals interfere with iron absorption. 74. What is a contraindication for human immune globulin intravenous (IVIG)? o A. Older than 65 years of age o B. History of diabetes mellitus o C. Use of nephrotoxic drugs o D. All of the above Answer: D Rationale: IVIG is contraindicated for patients with diabetes, advanced age, or concurrent nephrotoxic drug use due to risks of renal failure. 75. What is the role of toxoids in immunization? o A. They neutralize toxins without invoking immune response. o B. They stimulate the body to produce antitoxins. o C. They prevent hypersensitive reactions. o D. They treat active infections. Answer: B Rationale: Toxoids are weakened toxins that stimulate the production of antitoxins in the body.