Nokea
A client is receiving allopurinol. Which of the following would be most important for the nurse to include in the client's plan of care?
- A. Liberal fluid intake
- B. Moderate exercise
- C. Use of a brace or corset
- D. Avoidance of direct sunlight
Correct Answer: A
Rationale: When using uric acid inhibitors, such as allopurinol, the nurse should encourage liberal fluid intake and measure the client's intake and output. The client does not need to exercise or use braces or corsets; clients with osteoporosis may require a brace or corset when out of bed. The client need not avoid sunlight as uric acid inhibitors do not cause photosensitivity.
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After teaching a group of nursing students about the various drugs used to treat musculoskeletal conditions, the instructor determines that the teaching was successful when the students identify which of the following as being used to treat osteoporosis?
- A. DMARDs
- B. Bone resorption inhibitors
- C. Skeletal muscle relaxants
- D. Uric acid inhibitors
Correct Answer: B
Rationale: Bone resorption inhibitors are used to treat osteoporosis. Disease-modifying antirheumatic drugs (DMARDs) are used to treat rheumatoid arthritis. Uric acid inhibitors are used to treat gout. Skeletal muscle relaxants are used to alleviate muscle spasms and cramping.
A nurse monitors a client closely for methotrexate toxicity when the client is also prescribed which of the following? Select all that apply.
- A. Aspirin (Ecotrin)
- B. Cephalexin (Keflex)
- C. Sulfamethoxazole/trimethoprim (Septra)
- D. Ibuprofen (Motrin)
- E. Diclofenac (Voltaren)
Correct Answer: A,C,D,E
Rationale: The nurse should closely monitor the client for methotrexate toxicity when methotrexate is given with aspirin (Ecotrin), sulfa antibiotics (Septra), and NSAIDs (ibuprofen and diclofenac).
A client with which of the following would require the nurse to use caution when administering a skeletal muscle relaxant? Select all that apply.
- A. Cerebrovascular accident
- B. Diabetes
- C. Epilepsy
- D. Pregnancy
- E. Parkinsonism
Correct Answer: A,C,D,E
Rationale: Skeletal muscle relaxants are used with caution in clients with a history of cerebrovascular accident, cerebral palsy, parkinsonism, or epilepsy and during pregnancy and lactation.
After teaching a client receiving leflunomide, the nurse determines that the teaching was successful when the client identifies which of the following as a possible adverse reaction? Select all that apply.
- A. Alopecia
- B. Hypotension
- C. Diarrhea
- D. Nystagmus
- E. Hematuria
Correct Answer: A,C
Rationale: Adverse reactions to leflunomide include hypertension, alopecia, rash, nausea, and diarrhea.
Which of the following would the nurse include in the teaching plan for a client who is being discharged with a prescription for alendronate? Select all that apply.
- A. Take the medication in the evening.
- B. Take the medication with 6 to 8 ounces of water.
- C. Remain upright for at least 30 minutes after administration.
- D. Wait 30 minutes before taking any other food or drink.
- E. Take a calcium supplement at the same time with the medication.
Correct Answer: B,C,D
Rationale: A nurse should include the following administration instructions to a client being discharged with a prescription for alendronate (Fosamax): take the medication in the morning with 6 to 8 ounces of water, remain upright for at least 30 minutes after administration, and do not take any other food, drink, medication, or supplement until at least 30 minutes after administration of the medication.