Nokea
Which instructions should the nurse reinforce for the patient before the initiation of the hydroxychloroquine to treat joint inflammation from systemic lupus erythematosus(SLE)?
- A. Report mouth ulcerations.
- B. Get a chest x-ray.
- C. Get an eye examination.
- D. Take prophylaxis for malaria.
Correct Answer: C
Rationale: An eye examination should be completed before starting the drug and an eye examination should be done every 6 months while on the drug, because the drug can damage the retina and lead to blindness. Gold salts may cause mouth ulcerations. Hydroxychloroquine administration does not require monitoring of the chest x-ray because it does not cause lung damage. Hydroxychloroquine is also prescribed for malaria prophylaxis. This patient is taking the medication as an anti-inflammatory agent for SLE.
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Which is a vital function muscles perform when they contract?
- A. Absorb uric acid
- B. Maintenance of posture
- C. Motion
- D. Store minerals
- E. Production of heat
- F. To assist in return of venous blood to the left side of the heart
Correct Answer: B,C,E
Rationale: The vital functions muscles perform when they contract are maintenance of posture, motion, and production of $85 \%$ of body heat. Muscles do not absorb uric acid, store minerals. Venous blood is returned to the right side of the heart.
Which instruction will the nurse reinforce for a patient who is taking alendronate?
- A. Take drug with any meal.
- B. Take drug first thing in the morning.
- C. Drink at least $5 \mathrm{oz}$ of milk before taking drug.
- D. Take drug with an antacid to avoid heartburn.
Correct Answer: B
Rationale: Alendronate should be taken on an empty stomach first thing in the morning with $6 \mathrm{oz}$ of water, accompanied by no other medication. The patient should remain upright for 30 minutes after a dose to minimize risk of esophageal irritation.
Certain foods may increase the pain associated with gout. Which foods have the highest concentration of purines?
- A. Brain, liver, kidney
- B. Lettuce, corn, potatoes
- C. Beef, pork, chicken
- D. Fruits and fruit juices
Correct Answer: A
Rationale: Foods high in purines, such as brain, kidney, liver, and heart should be avoided, as well as alcohol. Lettuce, meat that does not include organ meats, and fruits do not have a high concentration of purines.
The nurse explains to a patient who has had a hip replacement that warfarin is prescribed for which reason?
- A. increase the red blood cells.
- B. reduce the threat of hemorrhage.
- C. prevent formation of emboli.
- D. help stabilize the prosthesis.
Correct Answer: C
Rationale: Warfarin is a standard postsurgical drug to prevent the formation of emboli. Warfarin does not increase red blood cells. The risk of hemorrhage is higher when an anticoagulant is taken. Warfarin does not help stabilize the prosthesis.
Which foods should the home health nurse suggest for the patient with osteoporosis to help slow the disease?
- A. Leafy green vegetables
- B. Foods high in sodium
- C. Tea and coffee
- D. Vitamin A
Correct Answer: A
Rationale: To slow the bone loss, a patient with osteoporosis should eat green leafy vegetables, such as spinach and turnip greens, foods low in sodium, and avoid caffeine. Vitamin D helps with the absorption of calcium and stimulates bone formation.