Nokea
The nurse is caring for a patient in a long-term care facility who takes multiple medications and has developed acute gouty arthritis. Which of the following medications should not be given until the health care provider has been consulted?
- A. Serratiopeptidase
- B. Famotidine
- C. Oxycodone
- D. Hydrochlorothiazide
Correct Answer: D
Rationale: Diuretic use increases uric acid levels and can precipitate gout attacks. The other medications are safe to administer.
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The nurse is planning care for a patient who has osteoarthritis. Which of the following medications should the nurse anticipate being prescribed for the patient?
- A. Adalimumab
- B. Prednisone
- C. Capsaicin cream
- D. Sulphasalazine
Correct Answer: C
Rationale: Capsaicin cream blocks the transmission of pain impulses and is helpful for some patients in treating OA. The other medications would be used for patients with RA.
The nurse is reviewing laboratory data for a patient who is taking methotrexate to treat rheumatoid arthritis. Which of the following information is most important to communicate to the health care provider?
- A. The blood glucose is 4.2 mmol/L.
- B. The rheumatoid factor is positive.
- C. The white blood cell (WBC) count is 1.5 x 10^9/L.
- D. The erythrocyte sedimentation rate is elevated.
Correct Answer: C
Rationale: Bone marrow suppression is a possible adverse effect of methotrexate, and the patient's low WBC count places the patient at high risk for infection. The elevated erythrocyte sedimentation rate and positive rheumatoid factor are expected in rheumatoid arthritis. The blood glucose is normal.
The nurse is caring for a young adult patient with urethritis and knee pain who has been diagnosed with reactive arthritis. Which of the following medications should the nurse include in the teaching plan?
- A. Anakinra
- B. Etanercept
- C. Doxycycline
- D. Methotrexate
Correct Answer: C
Rationale: Reactive arthritis associated with urethritis is usually caused by infection with Chlamydia trachomatis and treatment with doxycycline. The other medications are used for persistent inflammatory problems such as rheumatoid arthritis.
The nurse is caring for a patient with dermatomyositis who is receiving long-term prednisone therapy. Which of the following findings is most important to report to the health care provider?
- A. The blood glucose is 6.2 mmol/L.
- B. The patient has painful hematuria.
- C. The patient has an increased appetite.
- D. Acne is noted on the back and face.
Correct Answer: B
Rationale: Corticosteroid use is associated with increased risk for infection, so the nurse should report the urinary tract symptoms immediately to the health care provider. The increase in blood glucose, increased appetite, and acne also are adverse effects of corticosteroid use, but do not need diagnosis and treatment as rapidly as the probable urinary tract infection.
The nurse is conducting patient teaching with a patient who has systemic lupus erythematosus and is prescribed hydroxychloroquine. Which of the following information should the nurse include in the teaching plan?
- A. Has a rapid therapeutic response.
- B. Vision assessment every 6-12 months
- C. Does not prevent flare-ups of symptoms.
- D. Can only be administered intravenously.
Correct Answer: B
Rationale: Fundoscopic and visual field examinations must be performed by an ophthalmologist every 6-12 months when patients are on hydroxychloroquine. Hydroxychloroquine is often used to treat fatigue and moderate skin and joint problems. Unlike the rapid response noted with corticosteroids, effects of antimalarial therapy may not be noticed for several months. Flares may also be prevented with these drugs.