A patient with rheumatoid arthritis was not getting relief from methotrexate. So their physician added etanercept to their medications. The LPN reinforcing the teaching about the medication knows that the patient is:

A. More prone to infections while taking these medications: Etanercept is a tumor necrosis factor (TNF) inhibitor that suppresses the immune system to reduce inflammation in rheumatoid arthritis. Combined with methotrexate, immunosuppression is enhanced, increasing the patient’s susceptibility to bacterial, viral, and opportunistic infections, including reactivation of latent infections like tuberculosis. B. Less likely to get tuberculosis: TNF inhibitors actually increase the risk of reactivating latent tuberculosis because TNF is essential for containing Mycobacterium tuberculosis. Patients must be screened for TB prior to starting etanercept, making this statement inaccurate. C. Has an increased chance of kidney failure: Neither methotrexate nor etanercept is primarily nephrotoxic in standard doses. While monitoring of liver function and blood counts is essential, the risk of kidney failure is not significantly increased by these medications. D. More prone to developing psoriasis while taking these medications: TNF inhibitors like etanercept can rarely induce paradoxical psoriasis, but this is uncommon. The primary concern remains increased infection risk, which is more clinically significant in patient teaching.