Nokea
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.
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A nurse is caring for a client who is receiving cyclobenzaprine. The nurse would expect to assess which of the following as indicating the therapeutic effect of the drug?
- A. Reduction of muscle spasm
- B. Prevention of convulsion
- C. Relief from anxiety
- D. Relief from nervous disorder
Correct Answer: A
Rationale: Cyclobenzaprine affects muscle tone, thereby causing reduction of muscle spasm. Administration of cyclobenzaprine does not result in prevention of convulsion, relief from anxiety, or relief from nervous disorder.
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 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 client is receiving alendronate for osteoporosis. The client has informed the nurse that she has also been taking aspirin. Which of the following interactions should the nurse monitor for in this client?
- A. Increased risk of GI bleeding
- B. Decreased effects of bisphosphonate
- C. Increased level of sedation
- D. Increased risk of rash
Correct Answer: A
Rationale: Interaction of aspirin with a bisphosphonate drug causes increased risk of GI bleeding, which requires monitoring. Interaction of a uric acid inhibitor with barbiturates and benzodiazepines causes an increased level of sedation. Interaction of a uric acid inhibitor with ampicillin causes increased risk of rash. Interaction of calcium supplements or antacids with bisphosphonates decreases the effects of bisphosphonates.
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.