Nokea
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.
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A group of nursing students are reviewing information about drug therapy for rheumatoid arthritis. The students demonstrate understanding of the information when they identify which of the following as an example of a DMARD? Select all that apply.
- A. Infliximab
- B. Etanercept
- C. Ibandronate
- D. Zoledronic acid
- E. Carisoprodol
Correct Answer: A,B
Rationale: Infliximab and etanercept are examples of DMARDs. Ibandronate and zoledronic acid are examples of bone resorption inhibitors (bisphosphonates). Carisoprodol is a skeletal muscle relaxant.
Before administering dantrolene to a client, the nurse checks the client's medical history for possible contraindications for use. Which condition would the nurse identify as problematic? Select all that apply.
- A. Hypertension
- B. Atrial fibrillation
- C. Hepatic disease
- D. Diabetes
- E. Lactation
Correct Answer: C,E
Rationale: The use of dantrolene is contraindicated during lactation and in clients with active hepatic disease and muscle spasm caused by rheumatic disorders.
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.
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 nurse reviews a client's medical history for conditions that would contraindicate use of methotrexate. Which of the following would the nurse identify as a possible contraindication? Select all that apply.
- A. Hypertension
- B. Folate deficiency
- C. Vitamin B12 deficiency
- D. Diabetes
- E. Liver disease
Correct Answer: B,E
Rationale: The use of methotrexate is contraindicated in clients with known hypersensitivity to the drug and clients with renal insufficiency, liver disease, alcohol abuse, pancytopenia, or folate deficiency.