Module 9

The nurse is giving a dose of bethanechol to a postoperative patient. The nurse is aware that contraindications to bethanechol include which of these? (Select all that apply.)

Peptic ulcer Hyperthyroidism Cardiac disease

The nurse knows that antimalarial drugs are used to treat patients with infections caused by which microorganism

Plasmodium spp

A nurse suspects a client who has myasthenia gravis is experiencing a myasthenic crisis. Which of the following interventions should the nurse take?

Prepare the client for mechanical ventilation The client who is experiencing a myasthenic crisis is at risk for loss of adequate respiratory function. The nurse should closely monitor the client's respiratory status and prepare for possible mechanical ventilation.

A nurse is contributing to the plan of care for clients who have rheumatoid arthritis. Which of the following plans incorporates integrative health.

Provide massage therapy and corticosteroid medications to clients Integrative health combines complementary therapies and conventional medicine in an integrative manner to treat illness, relieve pain, and promote health

A patient has a new order for glatiramer acetate. The patient has not had an organ transplant. The nurse knows that the patient is receiving this drug for which

Relapse-remitting multiple sclerosis

A nurse is caring for a female client who has rheumatoid arthritis and a new prescription for methotrexate. The client tells the nurse she is planning a pregnancy. Which of the following instructions should the nurse give the client.

The medication should be discontinued 3 months prior to a planned pregnancy Methotrexate should be discontinued 3 months prior to planning a pregnancy because of the risk of birth defects

When the nurse is teaching about antigout drugs, which statement by the nurse is accurate?

"Colchicine is best taken on an empty stomach."

Prevention of organ rejection in a patient who had an organ transplant

"I can stop this medication if I have severe adverse effects."

A nurse is completing discharge instructions with a client following an acute onset of gout. Which of the following client statements indicates an understanding of the treatment regimen.

"I will limit my alcohol intake" A client who has gout should limit alcohol consumption, which is known to cause a gouty attack by inhibiting excretion of uric acid and leading to its buildup. However, clients should be encouraged to increase their fluid intake to help prevent formation of urinary stones.

During a teaching session for a patient receiving an immunosuppressant drug, the nurse will include which statement?

"It is important to use some form of contraception during treatment and for up to 12 weeks after the end of therapy."

A nurse is caring for a client who is taking naproxen following an exacerbation of rheumatoid arthritis. Which of the following statements by the client requires further discussion by the nurse?

"Ive been taking an antacid to help with indigestion" NSAIDs, like naproxen, can cause serious adverse gastrointestinal reactions such as ulceration, bleeding, and perforation. Warning manifestations such as nausea or vomiting, gastrointestinal burning, and blood in the stool reported by the client require further investigation by the nurse. The client might be taking an antacid because he is experiencing one or more of these manifestations

A nurse is teaching with a client about taking high doses of oral glucocorticoids for an extended period of time to treat rheumatoid arthritis. Which of the following instructions should the nurse include in the teaching

"Monitor for compression fractures of the back and neck" High-dose, long-term use of glucocorticoids can result in bone loss in the back and neck within weeks of starting the medication. Clients experience an increase in parathyroid hormone, which causes calcium to move out of the bones can result in fractures.

Which teaching is appropriate for a patient who is taking an inhaled glucocorticoid for asthma?

"Rinse your mouth thoroughly after taking the medication."

The family of a patient who has recently been diagnosed with Alzheimer's disease is asking about a new drug prescribed to treat this disease. The patient's wife says, "I'm so excited that there are drugs that can cure this disease! I can't wait for him to start treatment." Which reply from the nurse is appropriate?

"These drugs do not cure Alzheimer's disease. Let's talk about what the physician said to expect with this drug therapy"

A mother calls the clinic to ask what medication to give her 5-year-old child for a fever during a bout of chickenpox. The nurse's best response would be:

"You can use children's dosages of acetaminophen or ibuprofen, but aspirin is not recommended."

When monitoring for a therapeutic response to prednisone, the nurse will look for which potential outcomes? (Select all that apply.)

*Decreased inflammation *Prevention of organ rejection in a patient who had an organ transplant

During long-term corticosteroid therapy, the nurse will monitor the patient's laboratory results for adverse effects, such as: (Select all that apply.)

*Decreased serum potassium levels *Increased sodium levels *Hyperglycemia

When giving metronidazole, the nurse implements appropriate administration techniques, including which of these? (Select all that apply.)

*Giving oral forms with food *Giving oral forms with food *Obtaining ordered specimens before starting the medication

During long-term corticosteroid therapy, the nurse will monitor the patient for Cushing's syndrome, which is manifested by which of these? (Select all that apply.)

*Hirsutism *Bruising *Muscle atrophy

During therapy with azathioprine, the nurse must monitor for which adverse effects? (Select all that apply.)

*Liver toxicity *Thrombocytopenia

The nurse recognizes that manifestations of nonsalicylate NSAID toxicity include which of these? (Select all that apply.)

*Nausea and vomiting *Numbness *Drowsiness

When assessing a patient who is to begin therapy with an immunosuppressant drug, the nurse recognizes that such drugs should be used cautiously in patients with which condition(s)? (Select all that apply.)

*Pregnancy *Renal failure *Liver failure

A 49-year-old patient has been admitted with possible chronic salicylate intoxication after self-treatment for arthritis pain. The nurse will assess for which symptoms of salicylate intoxication? (Select all that apply)

*Tinnitus *Headache *Nausea

A nurse is preparing to administer PO medication to a client who has myasthenia gravis. Which of the following actions should the nurse take prior to administering the clients medication?

Ask the client to take a few sips of water Clients who have myasthenia gravis, an autoimmune disorder, have weakness of the muscles of the face and throat, which increases the risk for aspiration. The nurse should check the client's ability to swallow before administering oral medication.

While at home, a patient took an accidental overdose of a cholinergic drug. He comes to the emergency department with severe abdominal cramping and bloody diarrhea. Which drug would the nurse expect to use to treat this patient?

Atropine

Before administering antiprotozoal drugs, the nurse will review which baseline assessment

Complete blood count

A nurse is caring for a client who has myasthenia gravis. The nurse should recognize that this disease is caused by which of the following types of hypersensitivities?

Cytotoxic The nurse should recognize myasthenia gravis as a cytotoxic hypersensitivity. Other examples of this hypersensitivity include autoimmune hemolytic anemia and Goodpasture's syndrome.

During a teaching session about antigout drugs, the nurse tells the patient that antigout drugs work by which mechanism?

Decreasing serum uric acid levels

A nurse is reinforcing teaching with a client who has a new prescription for colchicine orally to treat gout. The nurse should inform the client that which of the following findings is an adverse effect of colchicine?

Diarrhea The nurse should inform the client that gastrointestinal effects, including diarrhea, are an adverse effect of colchicine and are an indication of toxicity due to the medication. The nurse should instruct the client to discontinue the medication if these gastrointestinal effects occur

A nurse is teaching a client who has a new diagnosis of gout about managing the disorder. Which of the following instructions should the nurse include in the teaching?

Eat less liver, sardines, and shrimp Gout results from urate crystals in joint spaces. Potential causes include hyperuricemia due to an overproduction of uric acid and a decreased ability of the kidney to excrete excess uric acid. Uric acid is a product of purine metabolism. The client should reduce the amount of liver, sardines, and shrimp in his diet, as these substances are high in purines.

During drug therapy with basiliximab, the nurse monitors for signs of cytokine release syndrome, which results in which of these?

Fever, dyspnea, and general malaise

The nurse is teaching a patient about the possible adverse effects of donepezil for Alzheimer's disease. Which of these are possible adverse effects? (Select all that apply.)

GI upset Drowsiness Dizziness

A nurse is caring for a female client who has rheumatoid arthritis and asks the nurse if it is safe for her to take aspirin. The nurse should recognize which of the following findings in the clients history is a contraindication to this medication?

History of gastric ulcers Aspirin is contraindicated for clients who have a history of gastrointestinal bleeding and peptic ulcer disease because it impedes platelet aggregation. An adverse effect of aspirin is gastric bleeding.

The nurse must watch for symptoms of a cholinergic crisis when giving intravenous cholinergic drugs. Which of these are symptoms of a cholinergic crisis? (Select all that apply.)

Hypotension Syncope Dyspnea Abdominal cramping

When teaching a patient who has been prescribed a daily dose of prednisone, the nurse knows that the patient will be told to take the medication at which time of day to help reduce adrenal suppression?

In the morning

The nurse is reviewing cyclosporine and recognizes that this drug works by which mechanism of action?

Inhibiting activation of T-lymphocyte cells

The nurse is reviewing the use of bethanechol in a patient who is experiencing postoperative urinary retention. Which statement best describes the mechanism of action of bethanechol?

It causes increased bladder tone and motility.

The nurse is preparing to administer sirolimus and is aware that this drug has a black box warning for which possible condition?

Lymphoma

A nurse is caring for a client who has a suspected diagnosis of myasthenia gravis. The provider prescribes a Tensilon test. Which of the following findings indicates a positive test.

Muscle contractions become progressively stronger A positive Tensilon test is indicated by a 4 to 5 min period of improved muscle tone and strength.

Praziquantel is prescribed for a patient with a tapeworm infection. The nurse prepares to administer the medication by which route?

Oral

Which teaching point would be appropriate to include when the nurse is informing a patient about the adverse effects of antimalarials?

These medications may cause anorexia and abdominal distress.

The nurse is reviewing the orders for a newly admitted patient and sees an order for edrophonium. The nurse expects that this drug was ordered for which reason?

To aid in the diagnosis of myasthenia gravis

A nurse is teaching a client who has chronic tophaceous gout about his new prescription for allopurinol. The nurse should explain that the purpose of this medication is to reduce blood levels of which of the following substances.

Uric acid Hyperuricemia is the underlying cause of gout. Clients who have chronic gout develop tophi. The purpose of allopurinol is to reduce the synthesis of uric acid.

A nurse is caring for a client who has a new diagnosis of myasthenia gravis. For which of the following manifestations should the nurse monitor?

Weakness Generalized weakness of the diaphragmatic and intercostal muscles may produce respiratory distress or predispose the client to respiratory infections.

When a patient is receiving long-term NSAID therapy, which drug may be given to prevent the serious gastrointestinal adverse effects of NSAIDs?

misoprostol

The nurse is reviewing the medication history of a patient who is taking hydroxychloroquine. However, the patient's chart does not reveal a history of malaria or travel out of the country. The patient is most likely taking this medication for

rheumatoid arthritis

When teaching a patient about the potential drug interactions with antiprotozoal drugs, the nurse will include information about:

warfarin