# A client with ANCA-associated vasculitis is receiving avacopan. Classify each finding by the medication-safety decision it supports.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522930&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

A client with ANCA-associated vasculitis is receiving avacopan. Classify each finding by the medication-safety decision it supports.

|  | Promptly interrupt and evaluate | Modify or clarify the interaction plan | Continue scheduled surveillance |
| --- | --- | --- | --- |
| New jaundice, dark urine, and rapidly rising bilirubin |  |  |  |
| Itraconazole was added while the existing avacopan schedule remains unchanged |  |  |  |
| Liver panel is scheduled every 4 weeks during the first 6 months |  |  |  |
| Fever, hypoxemia, and imaging consistent with serious pneumonia |  |  |  |
| Rifampin appears on the new medication list |  |  |  |
| Baseline HBsAg and anti-HBc results are documented for specialist review |  |  |  |

## Explanation

Avacopan requires scheduled liver surveillance, hepatitis B risk management, infection monitoring, and explicit CYP3A4 interaction decisions. Jaundice or a serious infection requires prompt interruption and evaluation rather than routine follow-up.

## In-depth explanation

Quick answer
Separate urgent toxicity, interaction modification, and planned surveillance.

Why this is correct
The C5a-receptor antagonist is used with standard vasculitis therapy and does not eliminate all glucocorticoid use. Its label connects hepatic injury, HBV reactivation, infection, and altered exposure from CYP3A4 modifiers to different nursing actions.

Easy analogy or mental picture
Build a medication-safety chain: identify the new cue, connect it to the drug mechanism or labeled limitation, stop preventable exposure, stabilize the client, and verify a measurable response.

Memory hook
Drug, urgent cue, protective action, and reassessment endpoint.

NCLEX decision rule
Choose the action that prevents the most immediate medication-related harm while preserving indicated treatment and required monitoring.

Why the other choices are wrong
Options that continue a suspect exposure, normalize a labeled danger cue, substitute an unauthorized dose, or delay escalation leave the client at risk.References
1DailyMed: TAVNEOS (avacopan)Baseline and serial liver testing, hepatitis B screening, serious-infection interruption, and CYP3A4 interaction management

## Clinical scenario

Medication-safety review
Verify indication, current assessment, dose and route, organ function, interactions, urgent toxicity cues, authorized action, and measurable follow-up.

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