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Exam 4 Pharm Practice Questions with100% Verified
Answers UPDATED!!!
596. A patient about to begin therapy with etanercept has a
positive tuberculin skin test. A chest radiograph is negative. The
nurse will expect this patient to:
a. begin taking antituberculosis drugs at the beginning of
treatment with etanercept.
b. have periodic chest radiographs during treatment with
etanercept.
c. have regular monitoring of symptoms to detect active
tuberculosis.
d. undergo tuberculosis treatment prior to beginning
etanercept treatment. - ANSWER ANS: D
Since tuberculosis (TB) in a patient taking etanercept is often
extrapulmonary and disseminated, it is important to test all
patients for TB. Those who test positive for latent TB should be
treated for TB before etanercept treatment is begun. It is not
correct to begin TB treatment concurrently with etanercept
treatment. Latent TB must be treated and not monitored.
597. A child who has juvenile idiopathic arthritis and who has
been taking methotrexate [Rheumatrex] will begin a course of
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abatacept [Orencia]. What will the nurse include when teaching
the child's family about this drug?
a. That abatacept and methotrexate must both be taken to be
effective
b. To continue getting vaccinations during therapy with
abatacept
c. That signs of infection may warrant immediate
discontinuation of abatacept
d. That a tumor necrosis factor (TNF) antagonist may be added
if this therapy is not effective - ANSWER ANS: C
Abatacept suppresses immune function and can increase the
risk of serious infection. Parents should report any signs of
infection, which may warrant discontinuation of abatacept.
Abatacept may be taken alone. Abatacept may blunt the
effectiveness of vaccines, and vaccines should be up to date
prior to therapy and may need to be delayed until 3 months
after therapy. Live vaccines should be avoided. Abatacept
should not be given with TNF antagonists because of the
increased risk of serious infections.
598. A patient will begin taking hydroxychloroquine [Plaquenil]
for rheumatoid arthritis. The patient is currently taking high-
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dose NSAIDs and methotrexate. What will the nurse teach the
patient?
a. That an eye examination is necessary at the beginning of
therapy with this drug
b. That the dose of NSAIDs may be decreased when beginning
hydroxychloroquine
c. To obtain tests of renal and hepatic function while taking this
drug
d. To stop taking methotrexate when starting
hydroxychloroquine - ANSWER ANS: A
Hydroxychloroquine can cause retinal damage so an eye
examination is necessary at the onset of treatment as well as
every 6 months during treatment. Patients taking other drugs
should continue to take those when beginning treatment with
hydroxychloroquine since full therapeutic effects take months
to develop. Renal and hepatic toxicity are not concerns. The
drug is usually combined with methotrexate.
599. A patient will begin taking etanercept [Enbrel] for severe
rheumatoid arthritis. The patient has been taking methotrexate
[Rheumatrex]. The patient asks if the etanercept is stronger
than the methotrexate. The nurse will tell the patient that
etanercept __ methotrexate.
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a. has synergistic effects with
b. helps reduce adverse effects associated with
c. is better at delaying progression of joint damage than
d. has fewer adverse effects than - ANSWER ANS: C
Etanercept has been shown to reduce symptoms in patients
with moderate to severe RA who have not responded to
methotrexate. It does not have synergistic effects with
methotrexate or reduce adverse effects of methotrexate. It has
many adverse effects.
600. A patient with rheumatoid arthritis is taking leflunomide
[Arava] and an oral contraceptive. She tells the nurse she would
like to get pregnant. What will the nurse tell her?
a. That leflunomide is not dangerous during the first trimester
of pregnancy.
b. That plasma levels of leflunomide will drop rapidly when she
stops taking it.
c. To ask her provider about an 11-day course of
cholestyramine.
d. To stop taking leflunomide when she stops using
contraception. - ANSWER ANS: C
Exam 4 Pharm Practice Questions with100% Verified
Answers UPDATED!!!
596. A patient about to begin therapy with etanercept has a
positive tuberculin skin test. A chest radiograph is negative. The
nurse will expect this patient to:
a. begin taking antituberculosis drugs at the beginning of
treatment with etanercept.
b. have periodic chest radiographs during treatment with
etanercept.
c. have regular monitoring of symptoms to detect active
tuberculosis.
d. undergo tuberculosis treatment prior to beginning
etanercept treatment. - ANSWER ANS: D
Since tuberculosis (TB) in a patient taking etanercept is often
extrapulmonary and disseminated, it is important to test all
patients for TB. Those who test positive for latent TB should be
treated for TB before etanercept treatment is begun. It is not
correct to begin TB treatment concurrently with etanercept
treatment. Latent TB must be treated and not monitored.
597. A child who has juvenile idiopathic arthritis and who has
been taking methotrexate [Rheumatrex] will begin a course of
, Page |2
abatacept [Orencia]. What will the nurse include when teaching
the child's family about this drug?
a. That abatacept and methotrexate must both be taken to be
effective
b. To continue getting vaccinations during therapy with
abatacept
c. That signs of infection may warrant immediate
discontinuation of abatacept
d. That a tumor necrosis factor (TNF) antagonist may be added
if this therapy is not effective - ANSWER ANS: C
Abatacept suppresses immune function and can increase the
risk of serious infection. Parents should report any signs of
infection, which may warrant discontinuation of abatacept.
Abatacept may be taken alone. Abatacept may blunt the
effectiveness of vaccines, and vaccines should be up to date
prior to therapy and may need to be delayed until 3 months
after therapy. Live vaccines should be avoided. Abatacept
should not be given with TNF antagonists because of the
increased risk of serious infections.
598. A patient will begin taking hydroxychloroquine [Plaquenil]
for rheumatoid arthritis. The patient is currently taking high-
, Page |3
dose NSAIDs and methotrexate. What will the nurse teach the
patient?
a. That an eye examination is necessary at the beginning of
therapy with this drug
b. That the dose of NSAIDs may be decreased when beginning
hydroxychloroquine
c. To obtain tests of renal and hepatic function while taking this
drug
d. To stop taking methotrexate when starting
hydroxychloroquine - ANSWER ANS: A
Hydroxychloroquine can cause retinal damage so an eye
examination is necessary at the onset of treatment as well as
every 6 months during treatment. Patients taking other drugs
should continue to take those when beginning treatment with
hydroxychloroquine since full therapeutic effects take months
to develop. Renal and hepatic toxicity are not concerns. The
drug is usually combined with methotrexate.
599. A patient will begin taking etanercept [Enbrel] for severe
rheumatoid arthritis. The patient has been taking methotrexate
[Rheumatrex]. The patient asks if the etanercept is stronger
than the methotrexate. The nurse will tell the patient that
etanercept __ methotrexate.
, Page |4
a. has synergistic effects with
b. helps reduce adverse effects associated with
c. is better at delaying progression of joint damage than
d. has fewer adverse effects than - ANSWER ANS: C
Etanercept has been shown to reduce symptoms in patients
with moderate to severe RA who have not responded to
methotrexate. It does not have synergistic effects with
methotrexate or reduce adverse effects of methotrexate. It has
many adverse effects.
600. A patient with rheumatoid arthritis is taking leflunomide
[Arava] and an oral contraceptive. She tells the nurse she would
like to get pregnant. What will the nurse tell her?
a. That leflunomide is not dangerous during the first trimester
of pregnancy.
b. That plasma levels of leflunomide will drop rapidly when she
stops taking it.
c. To ask her provider about an 11-day course of
cholestyramine.
d. To stop taking leflunomide when she stops using
contraception. - ANSWER ANS: C
