Nokea
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.
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The primary health care provider prescribes adalimumab. The nurse would prepare to administer this drug by which route?
- A. Orally
- B. Intramuscularly
- C. Subcutaneously
- D. Intravenously
Correct Answer: C
Rationale: Adalimumab, a DMARD, is administered by subcutaneous injection. Abatacept and infliximab are examples of DMARDs that are administered IV. Methotrexate, sulfasalazine, and leflunomide are examples of DMARDs that can be given orally.
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 client is receiving medication for gout. The nurse would include instructions about which of the following during the course of treatment?
- A. Taking drug on an empty stomach
- B. Using protection against sunlight
- C. Reporting any skin rash
- D. Wearing a brace to get out of bed
Correct Answer: C
Rationale: The nurse should instruct the client to report any skin rash. A rash should be monitored carefully because it may precede a serious adverse reaction, such as Stevens-Johnson syndrome. The nurse need not instruct the client to take the drug on an empty stomach, use protection against sunlight, or wear a brace to get out of bed. Clients with osteoporosis are asked to wear a brace to get out of bed. Clients taking medications for gout are asked to take it with food. These clients are also instructed to avoid driving or performing other hazardous tasks.
Which of the following would the nurse include in the teaching plan for a client who is being discharged with a prescription for alendronate? Select all that apply.
- A. Take the medication in the evening.
- B. Take the medication with 6 to 8 ounces of water.
- C. Remain upright for at least 30 minutes after administration.
- D. Wait 30 minutes before taking any other food or drink.
- E. Take a calcium supplement at the same time with the medication.
Correct Answer: B,C,D
Rationale: A nurse should include the following administration instructions to a client being discharged with a prescription for alendronate (Fosamax): take the medication in the morning with 6 to 8 ounces of water, remain upright for at least 30 minutes after administration, and do not take any other food, drink, medication, or supplement until at least 30 minutes after administration of the medication.
A nurse is caring for a client with a musculoskeletal disorder who is experiencing a significant impairment in the ability to ambulate due to pain. As a result, the client spends a majority of time in bed. Which of the following would the nurse most likely include in the client's plan of care?
- A. Changing the client's position every 2 hours
- B. Changing the bed linens every hour
- C. Encouraging the client to walk with assistance
- D. Encouraging the client to exercise with assistance
Correct Answer: A
Rationale: The nurse should change the client's position every 2 hours and inspect pressure sites for skin breakdown. The nurse need not change linens every hour. Once the client's condition improves, then encouraging ambulation with assistance and exercises would be appropriate.