Nokea
A patient is being seen in the clinic for rheumatoid arthritis. Which of the following statements would indicate that she may be developing a complication from her rheumatoid medication, chloroquine (Aralen)?
- A. I have to urinate all the time.'
- B. Sometimes I have blurred vision.'
- C. I have tingling and numbness in my arms and legs.'
- D. Sometimes I feel like I am losing my balance when I walk.'
Correct Answer: B
Rationale: Chloroquine (Aralen) can cause ocular toxicity with blurring of vision, color vision changes, corneal damage, and blindness. Increased urination and tingling and numbness are signs of hyperkalemia and hypokalemia. Loss of balance can be caused by auditory damage due to drug toxicity.
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A nurse is providing instructions to a client who has a new prescription for Albuterol and Beclomethasone inhalers for the control of asthma. Which of the following instructions should the nurse include in the teaching?
- A. Take the albuterol at the same time each day.
- B. Administer the albuterol inhaler prior to using the beclomethasone inhaler.
- C. Use beclomethasone if experiencing an acute episode.
- D. Avoid shaking the beclomethasone before us
Correct Answer: B
Rationale: Albuterol (bronchodilator) should be used before beclomethasone (steroid) to open airways for better steroid delivery.
A client with Crohn's disease is scheduled to receive an infusion of infliximab (Remicade). The nurse assisting in caring for the client should take which action to monitor the effectiveness of treatment?
- A. Monitoring the leukocyte count for 2 days after the infusion
- B. Checking the frequency and consistency of bowel movements
- C. Checking serum liver enzyme levels before and after the infusion
- D. Carrying out a Hematest on gastric fluids after the infusion is completed
Correct Answer: B
Rationale: The principal manifestations of Crohn's disease are diarrhea and abdominal pain. Infliximab (Remicade) is an immunomodulator that reduces the degree of inflammation in the colon, thereby reducing the diarrhea. Options 1, 3, and 4 are unrelated to this medication.
A patient with a history of opioid abuse will be discharged home with buprenorphine to help prevent relapse. Which product will the nurse anticipate the provider to order?
- A. Buprenex
- B. Suboxone
- C. Subutex
- D. Vivitrol
Correct Answer: A
Rationale: Buprenex is buprenorphine with low abuse potential for maintenance; Suboxone has naloxone added. Buprenex is an agonist-antagonist opioid that can be used for detoxification and maintenance therapy because it has a low potential for abuse.
When taken with aminoglycosides, platinum chemotherapy or cyclosporin increase the risk of
- A. Kidney damage
- B. Ototoxicity
Correct Answer: A
Rationale: Platinum chemotherapy (e.g., cisplatin) and cyclosporin both potentiate aminoglycoside nephrotoxicity, increasing kidney damage risk.
Which of the following has a strong anti-inflammatory effect:
- A. Prednisolone
- B. Triamcinolone
- C. Dexamethasone
- D. Prednisone
Correct Answer: C
Rationale: Dexamethasone has a strong anti-inflammatory effect due to its high glucocorticoid potency.