Nokea
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.
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Before administering cyclobenzaprine, a nurse reviews a client's medical record. Which condition if found would alert the nurse to a possible contraindication for this drug? Select all that apply.
- A. Recent myocardial infarction
- B. Diabetes
- C. Hepatic disease
- D. Hypertension
- E. Hyperthyroidism
Correct Answer: A,E
Rationale: The use of cyclobenzaprine (Flexeril) is contraindicated in clients with a recent myocardial infarction, cardiac conduction disorders, hyperthyroidism, and known hypersensitivity to the drug and within 14 days of the administration of an MAOI.
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 would monitor a client closely for increased CNS depressant effects when a skeletal muscle relaxant is used concomitantly with which of the following? Select all that apply.
- A. Antihistamine
- B. Oral contraceptives
- C. Alcohol
- D. Opiates
- E. Antidiabetic medications
Correct Answer: A,C,D
Rationale: The concomitant use of skeletal muscle relaxants and antihistamines, alcohol, opiates, or sedatives can result in increased CNS depressant effects.
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 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.