Nokea
A nurse reviews a client's medical history for conditions that would contraindicate use of methotrexate. Which of the following would the nurse identify as a possible contraindication? Select all that apply.
- A. Hypertension
- B. Folate deficiency
- C. Vitamin B12 deficiency
- D. Diabetes
- E. Liver disease
Correct Answer: B,E
Rationale: The use of methotrexate is contraindicated in clients with known hypersensitivity to the drug and clients with renal insufficiency, liver disease, alcohol abuse, pancytopenia, or folate deficiency.
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A client is receiving anakinra. After administering the drug, the nurse would continue to assess the client for which of the following?
- A. Constipation
- B. Abdominal pain
- C. Retinal changes
- D. Pancytopenia
Correct Answer: D
Rationale: Due to the immunosuppressive properties of DMARD drugs, pancytopenia is an adverse effect of anakinra, a DMARD, and the client should be monitored for it closely. Administration of anakinra may also cause headache and irritation at the injection site, but not constipation, abdominal pain, or retinal changes.
After teaching a client receiving leflunomide, the nurse determines that the teaching was successful when the client identifies which of the following as a possible adverse reaction? Select all that apply.
- A. Alopecia
- B. Hypotension
- C. Diarrhea
- D. Nystagmus
- E. Hematuria
Correct Answer: A,C
Rationale: Adverse reactions to leflunomide include hypertension, alopecia, rash, nausea, and diarrhea.
A nurse should administer adalimumab (Humira) cautiously to a client with a history of which of the following? Select all that apply.
- A. Hepatitis A
- B. Diabetes
- C. Obesity
- D. Hepatitis B
- E. Hepatitis C
Correct Answer: B,C,D,E
Rationale: Adalimumab (Humira) is used with caution in clients with obesity, diabetes, and hepatitis B or C.
A client in the initial phase of gout is prescribed colchicine. After administering the drug, the nurse would continue to monitor the client for which of the following?
- A. Stomatitis
- B. Stevens-Johnson syndrome
- C. Bone marrow depression
- D. Exfoliative dermatitis
Correct Answer: C
Rationale: The nurse needs to closely monitor the client for bone marrow depression, an adverse reaction of colchicine. Stomatitis, Stevens-Johnson syndrome, and exfoliative dermatitis are not adverse reactions of colchicine. Stomatitis is an adverse reaction of immunosuppressive drugs. Stevens-Johnson syndrome and exfoliative dermatitis are adverse reactions of allopurinol.
The nurse should screen clients carefully for medical conditions involving which of the following prior to the administration of colchicine? Select all that apply.
- A. Gastrointestinal disorders
- B. Pulmonary disorders
- C. Cardiac disorders
- D. Blood disorders
- E. Central nervous system disorders
Correct Answer: A,C,D
Rationale: Colchicine is contraindicated in clients with serious GI, renal, hepatic, or cardiac disorders and those with blood dyscrasias.