Nokea
A client with osteoporosis is prescribed a selective estrogen receptor modifier (SERM) as treatment. The nurse would identify which drug as belonging to this class?
- A. Alendronate (Fosamax)
- B. Calcium gluconate
- C. Tamoxifen (Nolvadex)
- D. Raloxifene (Evista)
Correct Answer: D
Rationale: An example of a selective estrogen receptor modifier (SERM) is raloxifene (Evista). Alendronate is a bisphosphonate; calcium gluconate is an oral calcium preparation; tamoxifen is an antiestrogen agent.
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A client is experiencing symptoms that are suspected to be related to systemic lupus erythematosus. What cutaneous symptom occurs in about 50% of clients affected by this disease?
- A. Diffuse purplish lesions on the trunk
- B. Butterfly-shaped rash on the face over the bridge of the nose and cheeks
- C. Fluid-filled vesicles clustered on the cheeks, chin, and forehead
- D. Pustules scattered on the chest and back
Correct Answer: B
Rationale: A prominent sign for about half of the clients with SLE is a red, butterfly-shaped rash known as malar rash, on the face over the bridge of the nose and the cheeks. The word lupus means 'wolf.' The term may have been used as a description for the facial rash that, to some, resembled the mask of reddish-brown fur on a wolf. The other choices are not routinely seen with SLE.
In osteoporosis, which of the following is the most common complication?
- A. Diabetes
- B. Hypertension
- C. Compression fractures of the vertebrae
- D. Cardiac disease
Correct Answer: C
Rationale: In osteoporosis, loss of bone substance exceeds bone formation. The total bone mass and density is reduced, resulting in bones that become progressively porous, brittle, and fragile. Compression fractures of the vertebrae are common. Diabetes, hypertension, and cardiac disease may occur in response to the aging process but are not the result of osteoporosis.
A client is diagnosed with systemic lupus erythematosus (SLE). Which action would be most appropriate for the nurse to use to evaluate the client's stage of disease?
- A. Observe the client's gait.
- B. Review the client's medical record.
- C. Inspect the client's mouth.
- D. Ausculate the client's lung sounds.
Correct Answer: B
Rationale: The nurse evaluates the stage of SLE and plans appropriate interventions by reviewing the medical record and diagnostic findings of the client. The stage of the disease cannot be established by observing the client's gait, inspecting the client's mouth, or auscultating the client's lung sounds.
A client has been diagnosed with temporomandibular disorder and has not been able to eat. What is an appropriate action for the nurse to take?
- A. Have the client's food pureed
- B. Have the client placed on a liquid diet.
- C. Have the client eat soft rather than coarse food.
- D. Give the client clear liquids as well as intravenous fluids.
Correct Answer: C
Rationale: The nurse modifies the diet to include soft rather than coarse food, which is easier to chew. The nurse also provides nutritional liquid supplements and assists the client to acquire skills that control pain, such as using a bite guard during sleep. The client does not require pureed food or clear liquids. Pureed and clear liquids are not warranted because these are too extreme and may interfere with nutrition.
The nurse is discussing the new medication that a client will be taking for treatment of rheumatoid arthritis. Which disease-modifying antirheumatic drug (DMARD) will the nurse educate the client about?
- A. Methotrexate
- B. Celecoxib
- C. Methylprednisolone
- D. Mercaptopurine azathioprine
Correct Answer: A
Rationale: Methotrexate is a DMARD that reduces the amount of joint damage and slows the damage to other tissues as well. Celecoxib is a nonsteroidal anti-inflammatory drug (NSAID). Methylprednisolone is a steroid to reduce pain and inflammation and slow joint destruction. Mercaptopurine azathioprine is a cytotoxic drug.