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NUR 521 Advanced Pharmacology – complete Exam 4
Blueprint TEST BANK Practice Questions with correct
answers and Rationale 2026 University of
Alabama||Verified Exam!!!
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. - Answers-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.
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597. A child who has juvenile idiopathic arthritis and who
has been taking methotrexate [Rheumatrex] will begin a
course of 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 - Answers-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.
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598. A patient will begin taking hydroxychloroquine
[Plaquenil] for rheumatoid arthritis. The patient is currently
taking high-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 - Answers-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
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etanercept is stronger than the methotrexate. The nurse
will tell the patient that etanercept __ methotrexate.
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 - Answers-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.
NUR 521 Advanced Pharmacology – complete Exam 4
Blueprint TEST BANK Practice Questions with correct
answers and Rationale 2026 University of
Alabama||Verified Exam!!!
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. - Answers-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.
,2|Page
597. A child who has juvenile idiopathic arthritis and who
has been taking methotrexate [Rheumatrex] will begin a
course of 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 - Answers-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.
,3|Page
598. A patient will begin taking hydroxychloroquine
[Plaquenil] for rheumatoid arthritis. The patient is currently
taking high-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 - Answers-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
, 4|Page
etanercept is stronger than the methotrexate. The nurse
will tell the patient that etanercept __ methotrexate.
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 - Answers-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.
