Musculoskeletal system ATI
A nurse is teaching about self - administering methotrexate to a client who has rheumatoid arthritis . Which of the following statements should the nurse make ?
"Drink a minimum of 2 liters of water per day to promote the drug's excretion" Methotrexate can cause 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 ?
Ibuprofen; it can take weeks for DMARDS to reach therapeutic levels and begin relieving joint inflammation and pain.
A nurse should identify that a client who has diabetes mellitus and is taking etanercept is at an increased risk for which of the following adverse effects ?
Infection
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" risk for systemic fungal infections and other opportunistic infections .
A nurse is teaching a client who has a new prescription for etanercept . Which of the following statements should the nurse make ?
" You should report signs of infection to your provider immediately;" susceptible to infections when taking DMARD Il medications.
A nurse is teaching a client about methotrexate therapy for rheumatoid arthritis . Which of the following information should the nurse include ? ( Select all that apply . )
Avoid being near people who are sick with a communicable illness, Periodic laboratory tests are required, Report bruising or petechiae, Avoid drinking alcohol .
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; adverse effect of folic acid analogs such as methotrexate
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 ?
Calf pain; risk of deep-vein thrombosis , which can lead to a pulmonary embolism or cerebrovascular accident .
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
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 . )
Drink 240 mL ( 8 02 ) 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 preparing to administer alendronate to a client who has osteoporosis . The nurse should recognize which of the following as an adverse effect of alendronate ?
Joint pain; and muscle pain, nausea, visual disturbances, esophagitis
A nurse is teaching a client about calcitonin - salmon intranasal spray to treat osteoporosis . Which of the following information should the nurse include ? ( Select all that apply . )
Report rash or itching, Prime the pump before the first dose, Report nasal irritation
A nurse is caring for a client who is taking etanercept for rheumatoid arthritis . The nurse should monitor the client for which of the following indications of a serious adverse reaction to the drug ?
Shortness of breath ; Etanercept can cause heart failure , manifesting as shortness of breath , cough , elevated blood pressure and heart rate , and pink - tinged sputum .
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 ?
Skin rash; can cause serious skin infections . Clients should report any rashes or blisters , can cause a serious as Stevens - Johnson syndrome or toxic epidermal necrolysis
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 ?
Thrombocytopenia; also effects central nervous , respiratory , dermatologic , and hematology systems , such as anemia , leukopenia
A nurse is teaching a client who has a prescription for calcium citrate about manifestations of hypercalcemia . Which of the following manifestations should the nurse include in the teaching?
Vomiting; The nurse should teach the client that hypercalcemia can occur when taking this drug. Manifestations of hypercalcemia include nausea , vomiting , flank pain lethargy , and deep bone pain .
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; contraindicated for administration to clients who have a history of exposure to tuberculosis
A nurse is teaching a client about raloxifene . Which of the following information should the nurse include ? ( Select all that apply . )
Increase physical activity by taking walks, Use a contraceptive, Increase intake of calcium and vitamin D.
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, Blurred vision, Muscle pain
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" Methotrexate is teratogenic to a fetus and is contraindicated during pregnancy.
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 ?
Black , tarry stools; can cause gastric intestinal ulceration , can lead to perforation and bleeding.
Alendronate is contraindicated for administration to clients who have which of the following conditions ?
inability to sit upright; Clients should drink 240 mL . ( 8 oz ) of water after taking the drug and sit upright or stand for at least 30 min to prevent esophagitis
A nurse is caring for a client 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 ?
skin testing to check the client for; nurse should perform skin testing to check for an allergy to salmon or fish protein , and have epinephrine , antihistamines , and resuscitation equipment available .
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; prevents the autoimmune response and subsequent inflammation of the joints .
Which of the following is a therapeutic action of raloxifene ?
Mimics the effects of estrogen on bone tissue; minimizing or stopping bone loss
