Nokea
Which assessment finding would the nurse consider a likely adverse effect of the client's methotrexate (Rheumatrex) therapy?
- A. Constipation
- B. Arrhythmia
- C. Mouth sores
- D. Chest pain
Correct Answer: C
Rationale: Mouth sores (stomatitis) are a common adverse effect of methotrexate due to its impact on rapidly dividing cells, like those in the oral mucosa. The other symptoms are less commonly associated.
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The 84-year-old client is a resident in a long-term care facility. Which intervention should be implemented to help prevent complications secondary to osteoporosis?
- A. Keep the bed in the high position.
- B. Perform passive range-of-motion exercises.
- C. Turn the client every two (2) hours.
- D. Provide nighttime lights in the room.
Correct Answer: D
Rationale: Nighttime lights reduce fall risk, a major osteoporosis complication causing fractures. High beds increase fall risk, ROM does not prevent falls, and turning addresses skin integrity, not fractures.
The nurse is reviewing the serum laboratory results of the client with DM prior to surgical removal of pins used to stabilize a compound ankle fracture. Based on the results, which action should the nurse take?
- A. Notify the surgeon because the white blood cell count is elevated.
- B. Notify the anesthesiologist because multiple lab values are abnormal.
- C. Give potassium chloride 10 mEq in 100 mL NaCl per agency protocol.
- D. Continue to prepare the client for the scheduled pin removal surgery.
Correct Answer: A
Rationale: A. The elevated WBC indicates that the client may have an infection, which increases the risk of developing osteomyelitis. DM and a compound fracture also increase the client's risk for osteomyelitis.
The client diagnosed with osteoporosis asks the nurse, 'Why does smoking cigarettes cause my bones to be brittle?' Which response by the nurse is most appropriate?
- A. Smoking causes nutritional deficiencies, which contribute to osteoporosis.'
- B. Tobacco causes an increase in blood supply to the bones, causing osteoporosis.'
- C. Smoking low-tar cigarettes will not cause your bones to become brittle.'
- D. Nicotine impairs the absorption of calcium, causing decreased bone strength.'
Correct Answer: D
Rationale: Nicotine reduces calcium absorption, contributing to bone loss in osteoporosis. Nutritional deficiencies are secondary, blood supply does not increase, and low-tar cigarettes still harm bones.
Which of the following evening snacks would the nurse encourage for the client with immobility due to the fractured hip?
- A. An orange
- B. Rice cakes
- C. Peanut butter and celery
- D. Potato chips
Correct Answer: C
Rationale: Peanut butter and celery provide protein and healthy fats, supporting tissue repair and nutrition during immobility. Oranges offer vitamin C but less protein, while rice cakes and potato chips lack substantial nutritional value.
Which statement to the nurse indicates a good understanding by the client of the use of methotrexate and cyclosporine?
- A. I am having an exacerbation of symptoms so two medications are needed.
- B. Cyclosporine is given to enhance the effect of the methotrexate.
- C. Methotrexate and cyclosporine together decrease unwanted side effects.
- D. My symptoms are severe enough to indicate the use of two strong medications.
Correct Answer: D
Rationale: Severe symptoms justify the use of two potent immunosuppressive drugs.