Nokea
A nurse is providing care to a client with arthritis in several large weight-bearing joints who is receiving NSAID therapy. Which nursing diagnosis would be most likely?
- A. Risk for Unstable Blood Glucose Levels
- B. Impaired Gas Exchange
- C. Risk for Imbalanced Body Temperature
- D. Impaired Physical Mobility
Correct Answer: D
Rationale: The client has arthritis and is receiving NSAID therapy most likely for pain relief and reduction of inflammation. The affected joints would interfere with the client's mobility. Therefore, Impaired Physical Mobility would be most appropriate. There is no indication that the client has diabetes, respiratory problems, or fever. Therefore, the other nursing diagnoses would be inappropriate.
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After teaching a client receiving NSAID therapy about the drug, the nurse determines that the teaching was successful when the client identifies the need to notify the primary health care provider for which of the following? Select all that apply.
- A. Skin rash
- B. Visual disturbances
- C. Edema
- D. Chest pain
- E. Diarrhea
Correct Answer: A,B,C,D,E
Rationale: The client should notify the primary health care provider if any of the following adverse reactions occur: skin rash, itching, visual disturbances, weight gain, edema, diarrhea, black stools, nausea, vomiting, chest or leg pain, numbness, or persistent headache.
A nurse is reviewing the medical record of a client who is diagnosed with migraine headaches. The history also reveals that the client has phenylketonuria. Which of the following would the nurse least expect to be prescribed as treatment for the client's migraine headaches? Select all that apply.
- A. Rizatriptan (Maxalt)
- B. Almotriptan (Axert)
- C. Eletriptan (Relpax)
- D. Sumatriptan (Imitrex)
- E. Zolmitriptan (Zomig)
Correct Answer: A,E
Rationale: Rizatriptan (Maxalt) and zolmitriptan (Zomig) are not used as treatment for migraines in a client with phenylketonuria because both medications contain phenylalanine.
A client is prescribed tolmetin to be taken at home. The nurse would instruct the client to monitor for which of the following? Select all that apply.
- A. Dark, tarry stools
- B. Jaundice
- C. Hot, dry, flushed skin
- D. Increased urine output
- E. Unusual or prolonged bleeding
Correct Answer: A,C,E
Rationale: The nurse should instruct the client or caregiver to monitor for dark, tarry stools; hot, dry, flushed skin; decreased urine output, and unusual or prolonged bleeding.
The nurse would question an order for a selective serotonin agonist as treatment for a migraine headache for a client with which condition? Select all that apply.
- A. Diabetes
- B. Uncontrolled hypertension
- C. Angina
- D. Hyperlipidemia
- E. Transient ischemic attacks
Correct Answer: B,C,E
Rationale: 5-HT agonists should not be used in patients with ischemic heart disease (such as angina or myocardial infarction), transient ischemic attacks (TIA), uncontrolled hypertension, or those patients taking monoamine oxidase inhibitor (MAOI) antidepressants.
A nurse caring for a client who is receiving an NSAID for fever reduction documents a decrease in urinary output for the patient. Which of the following would the nurse most likely determine as the reason for the patient's condition?
- A. Prolonged immobility
- B. Reduced intake of fibrous food
- C. Intake of food with antacids
- D. Prolonged temperature elevation
Correct Answer: D
Rationale: If temperature elevation is prolonged while on NSAID therapy, hot, dry, flushed skin and a decrease in urinary output may develop; consequently, dehydration can occur. Prolonged immobility, reduced intake of fibrous food, and intake of food with antacids do not cause a decrease in urinary output.