Exam 4 Pharm Practice Questions And Correct Answers |
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Question 1
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.
Correct Answer: D
Rationale A: Incorrect. This option is not supported by the source explanation. The correct answer is D,
because 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.
Rationale B: Incorrect. This option is not supported by the source explanation. The correct answer is D,
because 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.
Rationale C: Incorrect. This option is not supported by the source explanation. The correct answer is D,
because 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.
Rationale D: Correct. 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.
Question 2
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
Correct Answer: C
Rationale A: Incorrect. This option is not supported by the source explanation. The correct answer is C,
because 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.
Rationale B: Incorrect. This option is not supported by the source explanation. The correct answer is C,
because 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.
Rationale C: Correct. 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.
Rationale D: Incorrect. This option is not supported by the source explanation. The correct answer is C,
because 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.
Question 3
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
Correct Answer: A
Rationale A: Correct. 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.
Rationale B: Incorrect. This option is not supported by the source explanation. The correct answer is A,
because 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.
Rationale C: Incorrect. This option is not supported by the source explanation. The correct answer is A,
because 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.
Rationale D: Incorrect. This option is not supported by the source explanation. The correct answer is A,
because 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.
Question 4
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.
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
Correct Answer: C
Rationale A: Incorrect. This option is not supported by the source explanation. The correct answer is C,
because 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.
Rationale B: Incorrect. This option is not supported by the source explanation. The correct answer is C,
because 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.
Rationale C: Correct. 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.
Rationale D: Incorrect. This option is not supported by the source explanation. The correct answer is C,
because 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.
Question 5
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.
Correct Answer: C
Rationale A: Incorrect. This option is not supported by the source explanation. The correct answer is C,
because leflunomide is contraindicated during pregnancy. Patients desiring pregnancy must follow a
threestep protocol that includes stopping the drug, taking cholestyramine to chelate the leflunomide, and
ensuring that leflunomide drug levels are below 20 μg/L before getting pregnant. Leflunomide is
teratogenic and is not safe during pregnancy. Plasma levels of leflunomide may take 2 years to drop
without using cholestyramine. It is not correct to stop taking leflunomide without following the protocol.
Rationale B: Incorrect. This option is not supported by the source explanation. The correct answer is C,
because leflunomide is contraindicated during pregnancy. Patients desiring pregnancy must follow a
threestep protocol that includes stopping the drug, taking cholestyramine to chelate the leflunomide, and
ensuring that leflunomide drug levels are below 20 μg/L before getting pregnant. Leflunomide is
teratogenic and is not safe during pregnancy. Plasma levels of leflunomide may take 2 years to drop
without using cholestyramine. It is not correct to stop taking leflunomide without following the protocol.
Rationale C: Correct. Leflunomide is contraindicated during pregnancy. Patients desiring pregnancy must
follow a threestep protocol that includes stopping the drug, taking cholestyramine to chelate the
leflunomide, and ensuring that leflunomide drug levels are below 20 μg/L before getting pregnant.
Leflunomide is teratogenic and is not safe during pregnancy. Plasma levels of leflunomide may take 2
years to drop without using cholestyramine. It is not correct to stop taking leflunomide without following
the protocol.
Rationale D: Incorrect. This option is not supported by the source explanation. The correct answer is C,
because leflunomide is contraindicated during pregnancy. Patients desiring pregnancy must follow a
threestep protocol that includes stopping the drug, taking cholestyramine to chelate the leflunomide, and
ensuring that leflunomide drug levels are below 20 μg/L before getting pregnant. Leflunomide is
teratogenic and is not safe during pregnancy. Plasma levels of leflunomide may take 2 years to drop
without using cholestyramine. It is not correct to stop taking leflunomide without following the protocol.
Question 6
A patient is beginning therapy with oral methotrexate [Rheumatrex] for rheumatoid arthritis. The nurse will
teach this patient about the importance of:
A. having routine renal and hepatic function tests.
B. limiting folic acid consumption.
C. reporting alopecia and rash.
D. taking the medication on a daily basis.
Correct Answer: A
Rationale A: Correct. Periodic tests of renal and liver function are mandatory for patients taking
methotrexate. Patients taking methotrexate should take folic acid supplements. Alopecia and rash are not
worrisome side effects. Methotrexate is taken once weekly.
Rationale B: Incorrect. This option is not supported by the source explanation. The correct answer is A,
because periodic tests of renal and liver function are mandatory for patients taking methotrexate. Patients
taking methotrexate should take folic acid supplements. Alopecia and rash are not worrisome side effects.
Methotrexate is taken once weekly.
100% Pass Guaranteed | Graded A+
Question 1
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.
Correct Answer: D
Rationale A: Incorrect. This option is not supported by the source explanation. The correct answer is D,
because 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.
Rationale B: Incorrect. This option is not supported by the source explanation. The correct answer is D,
because 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.
Rationale C: Incorrect. This option is not supported by the source explanation. The correct answer is D,
because 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.
Rationale D: Correct. 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.
Question 2
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
Correct Answer: C
Rationale A: Incorrect. This option is not supported by the source explanation. The correct answer is C,
because 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.
Rationale B: Incorrect. This option is not supported by the source explanation. The correct answer is C,
because 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.
Rationale C: Correct. 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.
Rationale D: Incorrect. This option is not supported by the source explanation. The correct answer is C,
because 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.
Question 3
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
Correct Answer: A
Rationale A: Correct. 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.
Rationale B: Incorrect. This option is not supported by the source explanation. The correct answer is A,
because 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.
Rationale C: Incorrect. This option is not supported by the source explanation. The correct answer is A,
because 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.
Rationale D: Incorrect. This option is not supported by the source explanation. The correct answer is A,
because 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.
Question 4
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.
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
Correct Answer: C
Rationale A: Incorrect. This option is not supported by the source explanation. The correct answer is C,
because 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.
Rationale B: Incorrect. This option is not supported by the source explanation. The correct answer is C,
because 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.
Rationale C: Correct. 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.
Rationale D: Incorrect. This option is not supported by the source explanation. The correct answer is C,
because 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.
Question 5
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.
Correct Answer: C
Rationale A: Incorrect. This option is not supported by the source explanation. The correct answer is C,
because leflunomide is contraindicated during pregnancy. Patients desiring pregnancy must follow a
threestep protocol that includes stopping the drug, taking cholestyramine to chelate the leflunomide, and
ensuring that leflunomide drug levels are below 20 μg/L before getting pregnant. Leflunomide is
teratogenic and is not safe during pregnancy. Plasma levels of leflunomide may take 2 years to drop
without using cholestyramine. It is not correct to stop taking leflunomide without following the protocol.
Rationale B: Incorrect. This option is not supported by the source explanation. The correct answer is C,
because leflunomide is contraindicated during pregnancy. Patients desiring pregnancy must follow a
threestep protocol that includes stopping the drug, taking cholestyramine to chelate the leflunomide, and
ensuring that leflunomide drug levels are below 20 μg/L before getting pregnant. Leflunomide is
teratogenic and is not safe during pregnancy. Plasma levels of leflunomide may take 2 years to drop
without using cholestyramine. It is not correct to stop taking leflunomide without following the protocol.
Rationale C: Correct. Leflunomide is contraindicated during pregnancy. Patients desiring pregnancy must
follow a threestep protocol that includes stopping the drug, taking cholestyramine to chelate the
leflunomide, and ensuring that leflunomide drug levels are below 20 μg/L before getting pregnant.
Leflunomide is teratogenic and is not safe during pregnancy. Plasma levels of leflunomide may take 2
years to drop without using cholestyramine. It is not correct to stop taking leflunomide without following
the protocol.
Rationale D: Incorrect. This option is not supported by the source explanation. The correct answer is C,
because leflunomide is contraindicated during pregnancy. Patients desiring pregnancy must follow a
threestep protocol that includes stopping the drug, taking cholestyramine to chelate the leflunomide, and
ensuring that leflunomide drug levels are below 20 μg/L before getting pregnant. Leflunomide is
teratogenic and is not safe during pregnancy. Plasma levels of leflunomide may take 2 years to drop
without using cholestyramine. It is not correct to stop taking leflunomide without following the protocol.
Question 6
A patient is beginning therapy with oral methotrexate [Rheumatrex] for rheumatoid arthritis. The nurse will
teach this patient about the importance of:
A. having routine renal and hepatic function tests.
B. limiting folic acid consumption.
C. reporting alopecia and rash.
D. taking the medication on a daily basis.
Correct Answer: A
Rationale A: Correct. Periodic tests of renal and liver function are mandatory for patients taking
methotrexate. Patients taking methotrexate should take folic acid supplements. Alopecia and rash are not
worrisome side effects. Methotrexate is taken once weekly.
Rationale B: Incorrect. This option is not supported by the source explanation. The correct answer is A,
because periodic tests of renal and liver function are mandatory for patients taking methotrexate. Patients
taking methotrexate should take folic acid supplements. Alopecia and rash are not worrisome side effects.
Methotrexate is taken once weekly.
