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. rheumatoid arthritis c. Gout d. Systemic lupus erythematosus

Gout

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. "This medication does not reduce the number of migraines I will have." b. "I will keep a journal to record the headaches I have and how the injections are working." c. "I will take this medication regularly to prevent a migraine headache from occurring." d. "I will take this medication when I feel a migraine headache starting."

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

The nurse is teaching a patient who is taking colchicine for the treatment of gout. Which instruction will the nurse include during the teaching session? Select one: a. "Fluids should be restricted while on colchicine therapy." b. "Take colchicine with meals." c. "The drug will be discontinued when symptoms are reduced." d. "Call your doctor if you have increased pain or blood in the urine."

"The drug will be discontinued when symptoms are reduced."

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. "Allopurinol reduces the likelihood of gouty episodes that usually occur with initial colchicine therapy." b. "The colchicine is given to enhance the effects of the allopurinol." c. "Allopurinol helps reduce the gastrointestinal side effects of colchicine." d. "You will take both drugs initially and then stop taking the colchicine."

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

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. Tension headache b. A history of kidney stones c. Asthma d. A history of peptic ulcers

A history of peptic ulcers

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. Normal white blood cell, platelet, and neutrophil counts b. An increased range of motion in the affected joints 3 months into therapy c. Inflammation and irritation at the injection site 3 days after the injection is given d. Control of symptoms during periods of emotional stress e. A low-grade temperature on rising in the morning that remains throughout the day f. Radiological findings that show no progression of joint degeneration

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

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. Lefluomide (Arava) b. Methylprednisolone (Medrol) c. Sulfasalazine (Azulfidine) d. Hydroxychloroquine (Plaquenil)

Hydroxychloroquine (Plaquenil)

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. Increased risk for falls b. Increased chance for GI bleeding c. Increased nephrotoxic effects d. Reduced anti-inflammatory effects of the NSAID

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. Naproxen b. Colchicine c. Indomethacin d. Hydromorphone e. Oxycodone

Naproxen, Colchicine, Indomethacin

A client with rheumatoid arthritis is receiving Hydroxychloroquine (Plaquenil) in the recent months. The nurse tells the client to visit which of the following while on the treatment? Select one: a. Ophthalmologist b. Pulmonologist c. Endocrinologist d. Dentist

Ophthalmologist

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. Propranolol (Inderal) b. Amitriptyline (Axert) c. Valproate (valproic acid) d. Topiramate (Topamax)

Propranolol (Inderal)

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. Get a daily source of sunlight during the day. d. Strict hand washing.

Strict hand washing.

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. Aspirin b. Acetaminophen c. Caffeine d. Propranolol e. Sumatriptan

Sumatriptan

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. Topiramate (Topamax) b. Sumatriptan (Imitrex) c. Morphine d. Ergotamine (Ergomar)

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. That the dose of NSAIDs may be decreased when beginning hydroxychloroquine d. To obtain tests of renal and hepatic function while taking this drug

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

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. Gastrointestinal upset and dizziness b. Gastrointestinal bleeding, ecchymosis, and dizziness c. Dizziness, sore throat, and purpura d. Tinnitus, hearing loss, dizziness, and ataxia

Tinnitus, hearing loss, dizziness, and ataxia

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. Urate-lowering drugs b. Colchicine c. Nonsteroidal anti-inflammatory drugs d. Glucocorticoids

Urate-lowering drugs

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. Phosphorus level of 3.1 mg/dL d. Uric acid level of 9.0 mg/dL

Uric acid level of 9.0 mg/dL

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 white blood cell count b. Increased hemoglobin and hematocrit levels c. Decreased prothrombin time d. decreased uric acid levels

decreased uric acid levels

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. reporting alopecia and rash. c. taking the medication on a daily basis. d. having routine renal and hepatic function tests.

having routine renal and hepatic function tests.