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 im-mediate discontinuation of abatacept
d. That a tumor necrosis factor (TNF) anta-gonist may be added if this therapy is not effective
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 vac-cines should be avoided. Abatacept should not be given with TNF antagonists because of the increased risk of serious infections.
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The perinatal nurse administers heparin as ordered to the postpartum woman with newly diagnosed deep vein thrombosis. The patient asks about the purpose of the medication. Which response by the nurse is best?
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a. Weight and abdominal girth b. Pulmonary function tests c. Bone density testing d. Abdominal ultrasound
Several nursing students have been discussing the benefits of joining a study group
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A patient taking a benzodiazepine says to the nurse, "I really like this pill because if I just take an extra one when I get very anxious, I always feel a lot better.". What is the nurse's best response?
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