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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.
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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.
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.
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 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.
The primary health care provider prescribes adalimumab. The nurse would prepare to administer this drug by which route?
- A. Orally
- B. Intramuscularly
- C. Subcutaneously
- D. Intravenously
Correct Answer: C
Rationale: Adalimumab, a DMARD, is administered by subcutaneous injection. Abatacept and infliximab are examples of DMARDs that are administered IV. Methotrexate, sulfasalazine, and leflunomide are examples of DMARDs that can be given orally.