Nokea
A client is receiving anakinra. After administering the drug, the nurse would continue to assess the client for which of the following?
- A. Constipation
- B. Abdominal pain
- C. Retinal changes
- D. Pancytopenia
Correct Answer: D
Rationale: Due to the immunosuppressive properties of DMARD drugs, pancytopenia is an adverse effect of anakinra, a DMARD, and the client should be monitored for it closely. Administration of anakinra may also cause headache and irritation at the injection site, but not constipation, abdominal pain, or retinal changes.
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The nurse should screen clients carefully for medical conditions involving which of the following prior to the administration of colchicine? Select all that apply.
- A. Gastrointestinal disorders
- B. Pulmonary disorders
- C. Cardiac disorders
- D. Blood disorders
- E. Central nervous system disorders
Correct Answer: A,C,D
Rationale: Colchicine is contraindicated in clients with serious GI, renal, hepatic, or cardiac disorders and those with blood dyscrasias.
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 nurse is caring for a client with a musculoskeletal disorder who is experiencing a significant impairment in the ability to ambulate due to pain. As a result, the client spends a majority of time in bed. Which of the following would the nurse most likely include in the client's plan of care?
- A. Changing the client's position every 2 hours
- B. Changing the bed linens every hour
- C. Encouraging the client to walk with assistance
- D. Encouraging the client to exercise with assistance
Correct Answer: A
Rationale: The nurse should change the client's position every 2 hours and inspect pressure sites for skin breakdown. The nurse need not change linens every hour. Once the client's condition improves, then encouraging ambulation with assistance and exercises would be appropriate.
A client tells the nurse that she takes her prescribed medication immediately upon arising each morning and does not eat or drink anything for 30 minutes while she stays in an upright sitting position. The nurse determines that the client is adhering to the medication regimen because which drug has been prescribed?
- A. Methotrexate
- B. Allopurinol
- C. Risedronate
- D. Baclofen
Correct Answer: C
Rationale: The client is taking a bisphosphonate, which requires that it be taken upon arising in the morning with 6 to 8 ounces of water, with the client remaining in an upright position. Methotrexate (a DMARD), allopurinol (uric acid inhibitor), and baclofen (skeletal muscle relaxant) are taken with or immediately after meals to minimize gastric distress.