The patient underwent an allograft renal transplant 48 hours earlier and is showing signs of rejection. What drug would the nurse expect the physician to order?

Correct Answer: A

Rationale: The correct answer is A: Muromonab. Muromonab is a monoclonal antibody that targets T-lymphocytes and is used to treat acute rejection in organ transplant patients. It works by suppressing the immune response against the transplanted organ. In this case, the patient showing signs of rejection after an allograft renal transplant would benefit from Muromonab to prevent further rejection. Other choices are incorrect: B: Anakinra is an interleukin-1 receptor antagonist used for conditions like rheumatoid arthritis, not for transplant rejection. C: Mycophenolate is an immunosuppressant that prevents organ rejection by inhibiting T and B cell proliferation, but it is not typically used for acute rejection. D: Sirolimus is an mTOR inhibitor used for maintenance immunosuppression, not for acute rejection treatment.

Correct Answer: A

Rationale: The correct answer is A because it encourages open communication between the patient, nurse, and provider to ensure the best possible outcome for both the patient's health and desire to start a family. By discussing the desire to start a family with the provider, the risks associated with immune modulating medications can be assessed, and appropriate steps can be taken to minimize these risks. This approach allows for personalized care and decision-making based on the individual's specific situation. Choice B is incorrect because discontinuing immune modulating drugs without proper guidance can have negative consequences for the patient's health. Choice C is incorrect because while some immune modulating drugs may have teratogenic effects, not all drugs in this class are equally harmful. Choice D is incorrect as it presents a limited view that pregnancy is not an option without considering individual circumstances and medical advice.

Correct Answer: D

Rationale: The correct answer is D: Provide written and oral education about the use of antiretroviral therapy during pregnancy. This is the best action because antiretroviral therapy has been proven to significantly reduce the risk of perinatal transmission of HIV. By educating the patient about the importance and benefits of adhering to antiretroviral therapy during pregnancy, the nurse can help protect the fetus from contracting HIV. A: Providing contact information for an AIDS support group may be helpful, but it does not directly address preventing perinatal transmission. B: Educating the patient about the risks is important, but it is crucial to also provide actionable steps like antiretroviral therapy. C: Notifying the CDC is not within the nurse's scope of practice and may not directly benefit the patient in preventing perinatal transmission.

Correct Answer: A

Rationale: The correct answer is A: At the same laboratory at approximately the same time of day whenever possible. This is important for accurate comparison of CD4+ counts over time. Different labs or varying times can lead to inconsistent results. Choice B is incorrect as fasting is not necessary for CD4+ count testing. Choice C is incorrect because CD4+ count testing should be done before taking antiretroviral medications. Choice D is incorrect as consistency in time and lab location is crucial for reliable CD4+ count monitoring.

Correct Answer: C

Rationale: Rationale: 1. Posttransplant lymphoproliferative disorder (PTLD) is linked to Epstein-Barr virus (EBV). 2. EBV infects B cells and can lead to lymphoproliferative disorders, especially in immunocompromised individuals. 3. In transplant recipients, EBV reactivation can cause PTLD due to suppressed immune function. 4. Cytomegalovirus, Herpes simplex virus, and Human immunodeficiency virus are not typically associated with PTLD. Summary: - A: Cytomegalovirus is not the correct answer as it is not primarily linked to PTLD. - B: Herpes simplex virus does not cause PTLD; it mainly causes cold sores and genital herpes. - D: Human immunodeficiency virus can lead to AIDS-related lymphomas but is not the primary virus associated with PTLD.