The nurse, working with a nursing student, is caring for a patient who is to receive interleukins. The student nurse asks you what happens physiologically when a patient receives interleukins. What is the nurse's best response?

Correct Answer: B

Rationale: The correct answer is B: The patient has increases in the number of natural killer cells. Interleukins are a type of cytokine that play a key role in the immune response, including stimulating the production and activity of natural killer cells. Natural killer cells are important in fighting infections and cancer. Therefore, when a patient receives interleukins, it leads to an increase in the number of natural killer cells, enhancing the immune response. Choice A is too vague and does not provide specific information about the physiological effects of interleukins. Choice C is incorrect as interleukins actually increase cytokine activity. Choice D is incorrect as flu-like symptoms are a common side effect of interleukin therapy, but it is not the primary physiological effect of interleukins on the immune system.

Correct Answer: A

Rationale: Step-by-step rationale for the correct answer A: Anakinra (Kineret): 1. Anakinra is an interleukin-1 receptor antagonist used to treat RA by reducing inflammation. 2. It does not suppress the immune system globally, making it safer for a patient with a recent liver transplant. 3. Anakinra can effectively treat RA without compromising the patient's immune system post-transplant. Summary of why other choices are incorrect: B: Adalimumab (Humira) is a tumor necrosis factor (TNF) inhibitor commonly used for RA but poses a risk of immunosuppression post-liver transplant. C: Sirolimus (Rapamune) is an mTOR inhibitor used as an immunosuppressant post-transplant but is not typically prescribed for RA. D: Cyclosporine (Sandimmune) is a calcineurin inhibitor used as an immunosuppressant post-transplant, but it is not indicated

Correct Answer: D

Rationale: The correct answer is D. The nurse should educate the patient about the continued need for medications and ongoing monitoring because an undetectable viral load does not mean the medication stopped working. It indicates treatment success but does not signify a cure. The patient still needs to adhere to the medication regimen to maintain the viral load suppression and prevent resistance. Rescheduling the clinic visit (B) or immediate action (A) is not necessary based solely on this result. Simply congratulating the patient (C) without providing further information on the importance of medication adherence and monitoring would be inadequate. Therefore, choice D is the best response to ensure the patient understands the significance of continuing treatment.

Correct Answer: D

Rationale: The correct answer is D: Infection. When transplant drugs are administered with another immunosuppressant, the immune system is further suppressed, increasing the risk of infections. This is because the body's ability to fight off harmful pathogens is compromised. Nausea and vomiting (A), edema (B), and anemia (C) are not directly related to the interaction of transplant drugs with other immunosuppressants. Infection is the most critical concern due to the weakened immune response.

Correct Answer: B

Rationale: Basiliximab is a monoclonal antibody that can cause cytokine release syndrome, characterized by flu-like symptoms such as chills. This occurs due to the rapid release of cytokines in response to the antibody, leading to systemic inflammatory response. Coughing, tremors, and weakness are not typically associated with cytokine release syndrome. Therefore, the correct answer is B (Chills).