A patient will begin taking hydroxychloroquine (Plaquenil) for ...

[ARLKQ]

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 exam 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

Question 2

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

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Answer to Question 1

ANS: A
Hydroxychloroquine can cause retinal damage so an eye exam 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.

Answer to Question 2

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.

[ARLKQ]

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