Prep Quiz #6 Musculoskeletal

The nurse notes in a patient's medication history that the patient is taking allopurinol (Zyloprim). Based on this finding, the nurse interprets that the patient has which disorder? Select one: a. osteoarthritis b. Systemic lupus erythematosus c. Gout d. rheumatoid arthritis

c. Gout

A patient is receiving instructions regarding the use of caffeine for migraine headaches. The nurse shares that caffeine should be used with caution if which of these conditions is present? a. A history of peptic ulcers b. Tension headache c. A history of kidney stones d. Asthma

a. A history of peptic ulcers

A 23 year old woman with a history of depression comes to your clinic seeking relief for a severe migraine headache that began 20 minutes ago. She is currently taking the SSRI (selective serotonin repute inhibitor) Citalopram for her depression and an estrogen/progesterone combined oral contraceptive. What medication would you avoid using for her acute treatment? a. Sumatriptan (Imitrex) b. Ergotamine (Ergomar) c. Morphine d. Topiramate (Topamax)

a. Sumatriptan (Imitrex)

A patient will begin taking hydroxychloroquine [Plaquenil] for rheumatoid arthritis. The patient is currently taking high-dose NSAIDs and methotrexate. What will the nurse teach the patient? Select one: a. That an eye exam is necessary at the beginning of therapy with this drug b. To stop taking methotrexate when starting hydroxychloroquine c. To obtain tests of renal and hepatic function while taking this drug d. That the dose of NSAIDs may be decreased when beginning hydroxychloroquine

a. That an eye exam is necessary at the beginning of therapy with this drug

In monitoring a client's response to disease-modifying antirheumatic drugs (DMARDs), which assessment findings would the nurse consider acceptable responses? Select all that apply. a. Inflammation and irritation at the injection site 3 days after the injection is given b. An increased range of motion in the affected joints 3 months into therapy c. A low-grade temperature on rising in the morning that remains throughout the day d. Normal white blood cell, platelet, and neutrophil counts e. Control of symptoms during periods of emotional stress f. Radiological findings that show no progression of joint degeneration

b. An increased range of motion in the affected joints 3 months into therapy d. Normal white blood cell, platelet, and neutrophil counts e. Control of symptoms during periods of emotional stress f. Radiological findings that show no progression of joint degeneration

A patient is taking ibuprofen 800 mg three times a day by mouth as treatment for OA. While taking a health history, the nurse finds out that the patient has a few beers on weekends. What concern would there be with the interaction of the alcohol and ibuprofen? a. Reduced anti-inflammatory effects of the NSAID b. Increased chance for GI bleeding c. Increased nephrotoxic effects d. Increased risk for falls

b. Increased chance for GI bleeding

A client with gout has begun to take allopurinol. The nurse informs the client that which medication may also be necessary during the beginning phase of medication therapy with allopurinol? Select all that apply. a. Oxycodone b. Indomethacin c. Hydromorphone d. Naproxen e. Colchicine

b. Indomethacin d. Naproxen e. Colchicine

A patient has had three gouty flare-ups in the past year. Which drug class will the nurse expect the provider to order for this patient? Select one: a. Glucocorticoids b. Urate-lowering drugs c. Nonsteroidal anti-inflammatory drugs d. Colchicine

b. Urate-lowering drugs

A patient with gout has been treated with allopurinol (Zyloprim) for 2 months. The nurse will monitor laboratory results for which therapeutic effect? Select one: a. Decreased prothrombin time b. decreased uric acid levels c. Decreased white blood cell count d. Increased hemoglobin and hematocrit levels

b. decreased uric acid levels

A nurse is providing teaching for a client who has gout and a new prescription for Allopurinol. For which of the following adverse reactions should the client be taught to monitor? Select all apply: Select one or more: a. insomnia b. increased gout pain c. nausea d. rash

b. increased gout pain c. nausea d. rash

A nurse is providing teaching to a client who has migraine headache and a new prescription for Ergotamine. For which of the following manifestations indicating a possible adverse reaction should the nurse instruct the client to stop taking the medication and notify the provider? Select all apply: Select one or more: a. visual disturbance b. numbness and tingling in fingers c. positive home pregnancy test d. muscle pain

b. numbness and tingling in fingers c. positive home pregnancy test d. muscle pain

A patient with gout who has increasingly frequent acute gouty attacks will begin receiving allopurinol [Zyloprim] and colchicine. The nurse will include which statement when teaching the patient about this drug regimen? Select one: a. "The colchicine is given to enhance the effects of the allopurinol." b. "Allopurinol reduces the likelihood of gouty episodes that usually occur with initial colchicine therapy." c. "You will take both drugs initially and then stop taking the colchicine." d. "Allopurinol helps reduce the gastrointestinal side effects of colchicine."

c. "You will take both drugs initially and then stop taking the colchicine."

A client has just been prescribed with Methotrexate (Trexall) for the treatment of rheumatoid arthritis who did not respond to any other treatment. An important reminder for the client is to? Select one: a. Pregnancy is not contraindicated with the use of the medication. b. Clay-colored stool is a normal response of the treatment c. Strict hand washing. d. Get a daily source of sunlight during the day.

c. Strict hand washing. -Clients taking Methotrexate are more likely to get infections or may worsen any current infections. Therefore. hand washing will help to prevent the spread of infection.

A client is taking large doses of acetylsalicylic acid (ASA) for rheumatoid arthritis. Which assessment findings indicate that the client is experiencing ototoxicity as a result of the medication? a. Dizziness, sore throat, and purpura b. Gastrointestinal bleeding, ecchymosis, and dizziness c. Tinnitus, hearing loss, dizziness, and ataxia d. Gastrointestinal upset and dizziness

c. Tinnitus, hearing loss, dizziness, and ataxia

The nurse is caring for a client with a diagnosis of gout. Which laboratory value would the nurse expect to note in the client? Select one: a. Calcium level of 9.0 mg/dL b. Potassium level of 4.1 mEq/L c. Uric acid level of 9.0 mg/dL d. Phosphorus level of 3.1 mg/dL

c. Uric acid level of 9.0 mg/dL

The nurse is teaching a patient how to self-administer triptan injections for migraine headaches. Which statement by the patient indicates that he needs further teaching? a. "I will keep a journal to record the headaches I have and how the injections are working." b. "I will take this medication when I feel a migraine headache starting." c. "This medication does not reduce the number of migraines I will have." d. "I will take this medication regularly to prevent a migraine headache from occurring."

d. "I will take this medication regularly to prevent a migraine headache from occurring."

A patient with rheumatoid arthritis is experiencing sudden vision changes. Which medication found in the patient's medication list can cause retinal damage? Select one: a. Methylprednisolone (Medrol) b. Lefluomide (Arava) c. Sulfasalazine (Azulfidine) d. Hydroxychloroquine (Plaquenil)

d. Hydroxychloroquine (Plaquenil) -This medication is a DMARD and can cause retinal damage. Therefore, the patient should be monitored for vision changes.

A 17 year-old high school athlete with a history of asthma comes to your clinic seeking a preventative medication for migraine headaches. Which of the following would be contraindicated? a. Amitriptyline (Axert) b. Valproate (valproic acid) c. Topiramate (Topamax) d. Propranolol (Inderal)

d. Propranolol (Inderal)

Jane is a 67 year-old woman with a history of mild hypertension and classic angina pectoris. She is seeking treatment for migraine headaches of moderate intensity. Her headaches are preceeded by bilateral light flashes and dizziness that last about 10 minutes prior to the onset of pain. Her headaches are also frequently accompanied by photophobia, severe nausea and occasional vomiting. What medication would be contraindicated for acute treatment of Jane's headaches? a. Caffeine b. Aspirin c. Acetaminophen d. Sumatriptan e. Propranolol

d. Sumatriptan

A patient is beginning therapy with oral methotrexate [Rheumatrex] for rheumatoid arthritis. The nurse will teach this patient about the importance of: a. limiting folic acid consumption. b. taking the medication on a daily basis. c. reporting alopecia and rash. d. having routine renal and hepatic function tests.

d. having routine renal and hepatic function tests.