Nokea
A client is receiving hydroxychloroquine for a musculoskeletal disorder. Which of the following adverse reactions is irreversible and needs to be reported by the nurse?
- A. Easy bruising
- B. Skin rash
- C. Fever
- D. Visual changes
Correct Answer: D
Rationale: The nurse needs to report complaints of visual changes in a client receiving hydroxychloroquine, because irreversible retinal damage may occur. Although easy bruising, skin rash, and fever are adverse reactions of the drug, they are not irreversible.
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A client is prescribed probenecid and several other medications. When reviewing the client's medication record, the nurse determines that the client is at risk for possible toxicity if which of the following is also prescribed? Select all that apply.
- A. Phenobarbital (Luminal)
- B. Valproic acid (Depakote)
- C. Diazepam (Valium)
- D. Diclofenac (Voltaren)
- E. Acyclovir (Zovirax)
Correct Answer: A,C,D,E
Rationale: Probenecid (Benemid) increases the serum levels of the following medications, placing the client at risk for toxicity: penicillins, cephalosporins, acyclovir, rifampin, sulfonamides, barbiturates (phenobarbital), benzodiazepines (diazepam), and NSAIDs (diclofenac).
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).
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.
A nurse caring for a client with gout should monitor the client's fluid intake and output, as increased urinary output is needed to excrete uric acid. The nurse would encourage the client to achieve an intake of how much fluid per day?
- A. 1000 mL
- B. 1500 mL
- C. 2000 mL
- D. 3000 mL
Correct Answer: D
Rationale: A client with gout is encouraged to drink at least 3000 mL of fluid per day to promote uric acid excretion.
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.