Nokea
A client is receiving hydroxychloroquine. Which of the following adverse reactions should the nurse immediately report to the primary health care provider? Select all that apply.
- A. Diarrhea
- B. Tinnitus
- C. Fever
- D. Visual changes
- E. Nausea
Correct Answer: B,C,D
Rationale: The nurse should report any of the following adverse reactions to the physician immediately if observed in a client taking hydroxychloroquine (Plaquenil): skin rash, fever, cough, easy bruising, visual changes, tinnitus, or hearing loss.
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A client is receiving medication for gout. The nurse would include instructions about which of the following during the course of treatment?
- A. Taking drug on an empty stomach
- B. Using protection against sunlight
- C. Reporting any skin rash
- D. Wearing a brace to get out of bed
Correct Answer: C
Rationale: The nurse should instruct the client to report any skin rash. A rash should be monitored carefully because it may precede a serious adverse reaction, such as Stevens-Johnson syndrome. The nurse need not instruct the client to take the drug on an empty stomach, use protection against sunlight, or wear a brace to get out of bed. Clients with osteoporosis are asked to wear a brace to get out of bed. Clients taking medications for gout are asked to take it with food. These clients are also instructed to avoid driving or performing other hazardous tasks.
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 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.
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 be most important for the nurse to assess when administering a bisphosphonate to a client with Paget's disease?
- A. Altered renal function
- B. Increased skin rashes
- C. Serum calcium levels
- D. Hematology function
Correct Answer: C
Rationale: The nurse should monitor the serum levels of calcium before, during, and after bisphosphonate therapy, because bisphosphonates act primarily on the bone by inhibiting normal and abnormal bone resorption. These drugs are used cautiously in clients with renal function impairment but do not alter renal function. The nurse should monitor the client's renal function when allopurinol is administered and hematology function when methotrexate is administered.