Nursing Leadership And Management Musculoskeletal System ATI

A nurse is teaching a client who has a prescription for calcitonin-salmon about manifestations of hypercalcemia. Which of the following manifestations should the nurse include In the teaching?... • • Musce twitching INCORRECT The nurse should teach the client that muscle twitching is a manifestation of hypocalcemia. Fever INCORRECT The nurse should teach the client that fever is a manifestation of hypersensitivity to the drug. Nervousness INCORRECT The nurse should teach the client that nervousness is a manifestation of hypocalcemia. Vomiting CORRECT My Answer A nurse is caring for a client who is currently taking methotrexate for rheumatoid arthritis. The nurse should identify that which of the following is an adverse effect of this medication? Hypertension INCORRECT Methotrexate has many adverse effects that affect the central nervous, respiratory, dermatologic, and hematology systems; however, hypertension is not an adverse effect of methotrexate. Thrombocytopenia ~ CORRECT My Answer Methotrexate has many adverse effects that affect the central nervous, respiratory, dermatologic, and hematology systems, such as anemia, leukopenia, and thrombocytopenia. A nurse is teaching a client who has a prescription for prednisone and takes 1,500 mg/day of calcium carbonate to reduce the risk of osteoporosis. Which of the following information should the nurse include? (Select all that apply.) .... • Take the calcium tablets with food. *Drink 240 mL (8 oz) of water with the calcium tablets. *Chew calcium tablets before swallowing them. *Take the drugs 1 hr apart. *Divide the daily dosage of calcium into three 500-mg doses. •.................. A nurse is reacning a clent about menotrexare inerapy tor neumatola arenritis. wnicn or the rollowing intormation snould the nurse inciude! (Select all that apply.) .. ....................•о *Avoid being near people who are sick with a communicable illness. *Periodic laboratory tests are required. The drug's effects are immediate *Report bruising or petechiae. *Avoid drinking alcohol. CORRECT My Answer A nurse is teaching a client about raloxifene. Which of the following information should the nurse include? (Select all that apply.) • ... Perform a breast self-examination twice per month. *Increase physical activity by taking walks. *Use a contraceptive if there is any possibility of pregnancy. Take the drug on an empty stomach. *Increase intake of calcium and vitamin D. CORRECT My Answer Which of the following is a therapeutic action of raloxifene? • • Blocks the effects of estrogen on endometrial tissue INCORRECT Mimics the effects of estrogen on bone tissue CORRECT My Answer understanding of the teaching? • fwill take a birth control pill every day." CORRECT medication. A nurse is planning care for a client who has a new prescription for methotrexate. The nurse should plan to monitor the client for which of the following adverse effects? •• • .. .................... • Bone marrow depression • CORRECT My Answer The nurse should monitor the client for bone marrow depression, which is an adverse effect of folic acid analogs such as methotrexate. A nurse should instruct a client who is taking alendronate to monitor for which of the following adverse effects? (Select all that apply.) *Jaw pain Drowsiness *Blurred vision Tinnitus *Muscle pain → CORRECT My Answer A nurse is teaching a client who has a prescription for prednisone and takes 1,500 mg/day of calcium carbonate to reduce the risk of osteoporosis. Which of the following information should the nurse include? (Select all that apply.) -..................... Take the calcium tablets with food. *Drink 240 mL (8 oz) of water with the calcium tablets. *Chew calcium tablers before swallowing them. *Take the drugs 1 hr apart. *Divide the daily dosage of calcium into three 500-mg doses. CORRECT My Answer Which of the following is a therapeutic action of raloxifene? • Blocks the effects of estrogen on endometrial tissue INCORRECT Raloxifene mimics the effects of estrogen on endometrial tissue and blocks the effects of estrogen on breast tissue. Mimics the effects of estrogen on bone tissue • CORRECT My Answer Raloxifene mimics the effects of estrogen on bone tissue, minimizing or stopping bone loss. A nurse should instruct a client who is taking alendronate to monitor for which of the following adverse effects? (Select all that apply.) • 0. *Jaw pain Drows ness *Blurred vision Tinnitus *Muscle pain ~ CORRECT My Answer A nurse is caring for a client who is currently taking methotrexate for rheumatoid arthritis. The nurse should identify that which of the following is an adverse effect of this medication? Hypertension INCORRECT Methotrexate has many adverse effects that affect the central nervous, respiratory, dermatologic, and hematology systems; however, hypertension is not an adverse effect of methotrexate. Thrombocytopenia → CORRECT My Answer Methotrexate has many adverse effects that affect the central nervous, respiratory, dermatologic, and hematology systems, such as anemia, leukopenia. and thrombocytopenia. A nurse is teaching a client about raloxifene. Which of the following information should the nurse include? (Select all that apply.) Perform a breast self-examination twice per month. *Increase physical activity by taking walks. *Use a contraceptive if there is any possibility of pregnancy. Take the drug on an empty stomach. *Increase intake of calcium and vitamin D. CORRECT My Answer A nurse is planning care for a client who has a new prescription for methotrexate. The nurse should plan to monitor the client for which of the following adverse effects? CORRECT my Answer The nurse should mon tor the leat for bone marrow deoression, which is an adverse effect of folic acid analogs such as methotrexate A nurse is teaching a client who has a prescription for calcitonin-salmon about manifestations of hypercalcemia. Which of the following manifestations should the nurse include in the teaching? • Musde twitching INCORRECT Fever INCORRECT Nervousness INCORRECT Vomiting CORRECT (Select all that apply.) My Answer A nurse is reacning a chent adout menotreate cerapy tor neumatoia arenritis. vnicn or the tonowing intormation snoula tne nurse inciude? *Avoid being near people who are sick with a communicab'e illness. *Periodic laboratory tests are required. The drug's effects are immediate *Report bruising or petechiae. *Avoid drinking alcohol. CORRECT My Answer A nurse is teaching a client about methotrexate therapy for rheumatoid arthritis. Which of the following statements by the client indicates understanding of the teaching? ... "i will take a birth control pill every day." CORRECT Methotrexate is teratogenic to a fetus and is contraindicated during pregnancy. Therefore, a client of childbearing age should use birth control while on this medication. A nurse is teaching a client who is taking etanercept for rheumatoid arthritis. The nurse should instruct the client to monitor for which of the following indications of an adverse reaction to this drug? • ...o.... • Skin rash • CORRECT My Answer Etanercept can cause serious skin infections. Clents should immediately report any skin rashes or bllsters, because an infection can cause a serious reaction, such as Stevens-Johnson syndrome or toxic epidermal necrolysis A nurse is teaching a client about adverse effects of etanercept. Which of the following statements by the client indicates understanding of the teaching? i will need to get my blood drawn periodically while on this medication." ~ CORRECT My Answer Etanercept places the client at risk for systemic fungal infections and other opportunistic infections. Therefore, the client will need to have their CBC monitored periodically whie on this medication. A nurse is teaching a client about methotrexate. The nurse should inform the client to monitor for which of the following as an adverse effect of this drug? Muscle pain INCORRECT • Peripheral edema INCORRECT Black, tarry stools • CORRECT My Answer report either to the provider immediately. Alendronate is contraindicated for administration to clients who have which of the following conditions? Heart fallure INCORRECT Alendronate is not contraindicated for administration to a client who has heart failure. Clients who have heart fallure should not take etanercept. Fish protein allergy INCORRECT Alendronate is not contraindicated for administration to a dient who has a fish protein allergy. Cllents who have an allergy to fish protein or salmon should not take calcitonin-salmin. Inability to sit upright CORRECT My Answer Alendronate is contraindicated for administration to a client who cannot sit upright or stand for 30 min. Clients should drink 240 mL (8 oz) of water after taking the drug and sit upnight or stand for at least 30 min to prevent esophagitis. A nurse is teaching a client about raloxifene therapy to prevent osteoporosis. The nurse should instruct the client to monitor for which of the following indications of an adverse reaction to this drug? Loss of hair INCORRECT Raloxifene is unlikely to cause alopecia. Alopecia is a possible adverse effect of methotrexate. Numbness of the fingertips INCORRECT Raloxifene is unlikely to cause numbness of the fingertips. Numbness in fingertips can indicate hypoca cemia from calcitonin-salmon use. Call pain ~ CORRECT My Answer Raloxifene can increase the risk of deep-vein thrombosis, which can lead to a pulmonary embolism or cerebrovascular accident. Clients should avoid long periods of Inactivity and report any pain, redness, or swelling in the calf. A nurse is caring for a cilent who was diagnosed with postmenopausal osteoporosis. Which of the following actions should the nurse take prior to administering calcitonin-salmon to the client for the first time? • Checking the client's urine for sedimentation. INCORRECT hypercalcemia. Assess the cilent's liver function. INCORRECT Use skin testing to check the client for allergies, CORRECT My Answer antihistamines, and resuscitation equipment available. A nurse is preparing to administer alendronate to a client who has osteoporosis. The nurse should recognize which of the following as an adverse effect of alendronate? • Venous thromboemboli INCORRECT Raloxifene, not alendronate, can cause deep vein thrombosis, which can lead to a pulmonary embolism or cerebrovascular accident. Clients who take raloxifene should avoid sitting for long periods of time and monitor for redness or swelling in the calf. Ventricular dysrhythmias INCORRECT Alendronate can cause atrial fibrillation in rare instances. It is unlikely to cause ventricular dysrhythmias. Breast cancer INCORRECT Alendronate is unlikely to cause breast cancer. Estrogen plus progestin therapy increases the risk of breast cancer. Joint pain| ~ CORRECT My Answer Alendronate can cause joint and muscle pain. Clients can treat joint pain with analgesics. Other adverse effects of this drug include nausea, visual disturbances, and esophagitis nurse make? A nurse is teaching about self-administering methotrexate to a client who has rheumatoid arthritis. Which of the following statements should the nurse make ? "Use a nonsteroidal anti-inflammatory drug to reduce toxicity." INCORRECT NSAIDs can increase methotrexate toxicity. NSAiDs are often prescribed concurrently with DMARDs, such as methotrexate, during the initial treatment of rheumatoid arthritis because it can take a long period of time for DMARDs to take effect. NSAIDs are discontinued once DMARD therapeutic levels are reached. "Take it with food to reduce gastric irritation." INCORRECT Clients should take methotrexate on an empty stomach to increase bioavailability. "Drink 2 to 3 liters of water per day to promote the drug's excretion." ~ CORRECT My Answer Methotrexate can cause kidney damage. Adequate hydration optimizes drug excretion and helps prevent kidney damage. Clients can also take sodium bicarbonate tablets to increase urine alkalinity and reduce the drug precipitation that can lead to kidney damage. A nurse is caring for a client who has a prescription for methotrexate. Which of the following drugs would likely be prescribed in conjunction during the initial treatment for rheumatoid arthritis? • Aspirin. INCORRECT Aspirin can increase the risk for methotrexate toxicity when administered concurrently. Salicylates INCORRECT My Answer Salicylates can increase the risk for methotrexate toxicity when administered concurrently. • Suifonylureas | INCORRECT Sulfonylureas can increase the risk for methotrexate toxicity when administered concurrently. • Ibuprofen CORRECT NSAID analgesics, such as ibuprofen, are often prescribed along with methotrexate during the initial course of treatment for rheumatoid arthritis. It can take weeks for DMARDs to reach therapeutic levels and begin relieving joint inflammation and pain, so ibuprofen can be administered concurrently to help make the client more comfortable while waiting for methotrexate's therapeutic effects. A nurse is teaching a client about methotrexate therapy for rheumatoid arthritis. Which of the following statements by the client indicates understanding of the teaching? • • • Twill take a birth control pill every day." CORRECT medication. Methotrexate is teratogenic to a fetus and is contraindicated during pregnancy. Therefore, a client of childbearing age should use birth control while on this A nurse is caring for a client who has a new prescription for etanercept. Which of the following actions should the nurse take? • • • Administer a tuberculin skin test prior to starting the medication. CORRECT My Answer Etanercept is contraindicated for administration to clients who have a history of exposure to tuberculosis. Therefore, the nurse should administer a tuberculin skin test priop to starting the mediation A nurse is caring for a client who has a prescription for etanercept. The nurse should identify that etanercept treats rheumatoid arthritis by which of the following actions? • • • • • Inactivation of tumor necrosis factor CORRECT Etanercept directly binds to the tumor necrosis factor (TNF), preventing the attachment of TNF onto the cell's surface. This prevents the autoimmune response and subsequent inflammation of the joints. A nurse is caring for a client who is taking alendronate to treat postmenopausal osteoporosis. The nurse should explain to the client that alendronate increases bone mass by which of the following actions? Decreases activity of osteoclasts • CORRECT My Answer Osteoclasts are ceils that cause bone resorption or bone loss. Alendronate reduces the activity of osteoclasts, reduting bone loss and increasing bone mass. Which of the following is a therapeutic action of raloxifene? • Blocks the effects of estrogen on endometrial issue INCORRECT Reloxifene mimics the effects of estrogen on endometrial tissue and blocks the effects of estrogen on breast tissue © Mimics the effects of estrogen on bone tissue CORRECT Raloxifene mimics the effects of estrogen on bone tissue, minimizing or stopping bone loss.