Nokea
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.
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A group of nursing students are reviewing information about drug therapy for rheumatoid arthritis. The students demonstrate understanding of the information when they identify which of the following as an example of a DMARD? Select all that apply.
- A. Infliximab
- B. Etanercept
- C. Ibandronate
- D. Zoledronic acid
- E. Carisoprodol
Correct Answer: A,B
Rationale: Infliximab and etanercept are examples of DMARDs. Ibandronate and zoledronic acid are examples of bone resorption inhibitors (bisphosphonates). Carisoprodol is a skeletal muscle relaxant.
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.
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.
Which of the following instructions should the nurse specifically stress when administering drugs used for muscle spasm and cramping?
- A. Take the drug with food.
- B. Stay upright for 30 minutes after taking the drugs.
- C. Avoid alcohol or other CNS depressants.
- D. Take the drug with 6 to 8 ounces of water.
Correct Answer: C
Rationale: The nurse should instruct the client to avoid alcohol or other CNS depressants when taking a drug for muscle spasms and cramping. The nurse should instruct clients taking drugs for osteoporosis to take them with 6 to 8 ounces of water and to stay upright for 30 minutes after taking drugs. The nurse should instruct clients with gout to take drugs for treating gout with food.
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).