Saunders- Musculoskeletal Meds

Acetylsalicylic acid (ASA), or aspirin, has been prescribed for a client with rheumatoid arthritis, and the nurse provides instructions to the client about the medication. Which statement by the client indicates the need for further teaching?

1. "I should not crush or break the enteric-coated form of aspirin." 2. "I need to take this medication on an empty stomach for it to work." 3. "It may take 1 to 3 weeks for a therapeutic anti-inflammatory effect to occur." 4. "I should call my health care provider (HCP) if I experience stomach pain that will not go away." 2. "I need to take this medication on an empty stomach for it to work."

A client is to receive a prescription for methocarbamol (Robaxin). The nurse provides instructions to the client about the medication. Which client statement would indicate a need for further education?

1. "My urine may turn brown or green." 2. "I might get some nasal congestion from this medication." 3. "This medication is prescribed to help relieve my muscle spasms." 4. "If my vision becomes blurred, I don't need to be concerned about it." 4. "If my vision becomes blurred, I don't need to be concerned about it."

A client with a history of spinal cord injury is beginning medication therapy with baclofen (Lioresal). The nurse determines that the client understands the side effects of the medication if the client makes which statement?

1. "The medication may make me drowsy." 2. "The medication can cause high blood pressure." 3. "The medication may cause me to have some muscle pain." 4. "The medication may increase my sensitivity to bright light." 1. "The medication may make me drowsy."

A client with muscle spasms is taking an oral maintenance dose of baclofen (Lioresal). Which represents a safe maintenance dose for this medication?

1. 15 mg four times daily 2. 25 mg four times daily 3. 30 mg four times daily 4. 40 mg four times daily 1. 15 mg four times daily

Acetylsalicylic acid (ASA), or aspirin, has been prescribed for a client with rheumatoid arthritis. The nurse tells the client that a blood test to assess the serum aspirin level will be done periodically. Which is the therapeutic serum level for an antiarthritic effect?

1. 5 to 10 mg/dL 2. 10 to 20 mg/dL 3. 20 to 30 mg/dL 4. 30 to 40 mg/dL 3. 20 to 30 mg/dL

Oral dantrolene sodium (Dantrium) has been prescribed to a client for the treatment of spasticity. The nurse understands that the usual maintenance adult dosage of this medication is which dosage?

1. 50 mg daily 2. 100 mg daily 3. 100 mg twice daily 4. 200 mg four times daily 3. 100 mg twice daily

A client tentatively diagnosed with gout has received a prescription for colchicine. The nurse understands that colchicine is which type of medication?

1. Analgesic that relieves pain 2. Anti-inflammatory agent specific for gout 3. Nonsteroidal anti-inflammatory drug (NSAID) 4. Osmotic diuretic that facilitates the removal of uric acid 2. Anti-inflammatory agent specific for gout

A nurse is collecting data from a client and notes that the client is taking acetylsalicylic acid (ASA), or aspirin, 5 g daily in divided doses. The nurse determines that this medication has been prescribed to treat which condition?

1. Backache 2. Muscle aches 3. Frequent headaches 4. Rheumatoid arthritis 4. Rheumatoid arthritis

The health care provider is planning to administer a skeletal muscle relaxant to a client with a spinal cord injury. The medication will be administered intrathecally (within the spinal column). Which medication should the nurse expect to be prescribed and administered by this route?

1. Baclofen (Lioresal) 2. Chlorzoxazone (Parafon Forte) 3. Dantrolene sodium (Dantrium) 4. Cyclobenzaprine hydrochloride (Amrix) 1. Baclofen (Lioresal)

Dantrolene (Dantrium) is prescribed for a client with spinal cord injury for discomfort caused by spasticity. Which laboratory measure should the nurse monitor while the client is taking this medication?

1. Creatinine 2. Sedimentation rate 3. Liver function studies 4. White blood cell count 3. Liver function studies

A nurse is reviewing laboratory results for a client taking dantrolene sodium (Dantrium). The nurse should notify the health care provider (HCP) if which finding is noted on the laboratory report sheet?

1. Creatinine level 0.6 mg/dL 2. Platelet count 290,000 cells/mm3 3. Blood urea nitrogen (BUN) level 9 mg/dL 4. Lactic dehydrogenase (LDH) level 600 units/L 4. Lactic dehydrogenase (LDH) level 600 units/L

A film-coated form of diflunisal, a nonsteroidal anti-inflammatory medication, has been prescribed for a client to treat chronic rheumatoid arthritis. The client calls the clinic nurse because of difficulty swallowing the tablets. Which instruction should the nurse provide to the client?

1. Crush the tablets and mix with food. 2. Open the tablet and mix the contents with food. 3. Swallow the tablets with large amounts of water or milk. 4. Notify the health care provider (HCP) for a medication change. 3. Swallow the tablets with large amounts of water or milk.

A client with multiple sclerosis is receiving baclofen (Lioresal). The nurse assessing the client monitors for which finding as an indication of a primary therapeutic response to the medication?

1. Decreased nausea 2. Decreased muscle spasms 3. Increased muscle tone and strength 4. Increased range of motion of all extremities 2. Decreased muscle spasms

A client with a new medication prescription for allopurinol (Zyloprim) asks the nurse, "I know this is for gout, but how does it work?" In formulating a response, the nurse understands that which is the action of allopurinol?

1. Decreases uric acid production 2. Reduces the production of fibrinogen 3. Lowers the risk of sulfa crystal formation in the urine 4. Prevents influx of calcium ions during cell depolarization 1. Decreases uric acid production

Dantrolene sodium (Dantrium) is prescribed for the client experiencing flexor spasms. The nurse monitors the client, knowing that which is the therapeutic action of this medication?

1. Depresses spinal reflexes 2. Acts on the central nervous system to suppress spasms 3. Acts directly on the skeletal muscle to relieve spasticity 4. Acts within the spinal cord to suppress hyperactive reflexes 3. Acts directly on the skeletal muscle to relieve spasticity

A client newly diagnosed with gout has been prescribed allopurinol (Zyloprim). The nurse would be concerned if the client was also currently taking which medication?

1. Digoxin (Lanoxin) 2. Warfarin (Coumadin) 3. Adenosine (Adenocard) 4. Ergonovine maleate (Ergotrate) 2. Warfarin (Coumadin)

A client is taking large doses of acetylsalicylic acid (aspirin) for rheumatoid arthritis. Which assessment finding indicates that the client is experiencing ototoxicity as a result of the medication?

1. Dizziness, sore throat, and purpura 2. GI bleeding, ecchymosis, and dizziness 3. Gastrointestinal (GI) upset and dizziness 4. Tinnitus, hearing loss, dizziness, and ataxia 4. Tinnitus, hearing loss, dizziness, and ataxia

The nurse notes that a client has been taking colchicine. The nurse assesses the client for which finding that is an indication for the use of this medication?

1. Double vision 2. Difficulty urinating 3. Migraine headaches 4. Joint inflammation and pain 4. Joint inflammation and pain

Allopurinol (Zyloprim) is prescribed for a client and the nurse provides medication instructions to the client. Which instruction should the nurse provide?

1. Drink 3000 mL of fluid a day. 2. Take the medication on an empty stomach. 3. The effect of the medication will occur immediately. 4. Any swelling of the lips is a normal expected response. 1. Drink 3000 mL of fluid a day.

A client with gout has begun to take allopurinol (Zyloprim). The home health nurse provides which instruction to the client when using the medication?

1. Drink at least 8 glasses of fluid every day. 2. Take the medication one hour before eating. 3. Put ice on the upper and lower lips if they swell. 4. Use an antihistamine lotion if an itchy rash develops. 1. Drink at least 8 glasses of fluid every day.

Etanercept (Enbrel) is prescribed for a client with rheumatoid arthritis. The nurse should monitor the client for which adverse effect of the medication following administration?

1. Dyspnea 2. Headache 3. Dizziness 4. Abdominal discomfort 1. Dyspnea

A clinic nurse is performing an assessment on a client with rheumatoid arthritis who has been taking acetylsalicylic acid (aspirin) for the disorder. The nurse assesses the client for signs of aspirin toxicity. Which finding should alert the nurse to the possibility of toxicity?

1. Fever and signs of hyperventilation 2. Constipation and abdominal bloating 3. Client complaint of visual disturbances 4. A decreased respiratory rate and client complaint of diarrhea 1. Fever and signs of hyperventilation

Cyclobenzaprine hydrochloride (Flexeril) is prescribed for a client for muscle spasms and the nurse is reviewing the client's record. Which disorder, if noted in the record, would indicate a need to contact the health care provider about the administration of this medication?

1. Glaucoma 2. Emphysema 3. Hypothyroidism 4. Diabetes mellitus 1. Glaucoma

A client with osteoarthritis is receiving diclofenac sodium (Voltaren). The nurse would be concerned about the administration of this medication if the client's history and physical included a diagnosis of which condition?

1. Graves' disease 2. Peptic ulcer disease 3. Coronary artery disease 4. Benign prostatic hypertrophy 2. Peptic ulcer disease

A client with multiple sclerosis is receiving diazepam (Valium), a centrally acting skeletal muscle relaxant. Which finding, if noted during the nursing assessment, would indicate that the client is experiencing a side effect of this medication?

1. Headache 2. Drowsiness 3. Urinary retention 4. Increased salivation 2. Drowsiness

The home health nurse is reviewing medications with a client receiving colchicine for the treatment of gout. The nurse evaluates that the medication is effective if the client reports a decrease in which measure?

1. Headaches 2. Blood glucose 3. Blood pressure 4. Joint inflammation 4. Joint inflammation

Acetylsalicylic acid (ASA), or aspirin, has been prescribed for a client, and the client asks the nurse about the side effects of the medication. The nurse responds that which is an occasional side effect of ASA?

1. Heartburn 2. Muscle aches 3. Constipation 4. Burning on urination 1. Heartburn

A nurse is reviewing the medical record of a newly assigned client and notes that the client is receiving cyclobenzaprine hydrochloride (Flexeril) for the treatment of muscle spasms. The nurse questions the prescription if which disorder is noted in the admission history?

1. Hypothyroidism 2. Chronic bronchitis 3. Recurrent pneumonia 4. Angle-closure glaucoma 4. Angle-closure glaucoma

What should the nurse anticipate when evaluating for the effects of raloxifene (Evista) in an older client?

1. Increased bone density 2. Relief of leg cramps and tenderness 3. A decrease in severity of hot flashes 4. A resumption of the menstrual cycle 1. Increased bone density

Baclofen (Lioresal) is prescribed for the client with multiple sclerosis. The nurse determines that the medication is having the intended effect if which finding is noted in the client?

1. Increased muscle tone 2. Increased range of motion 3. Decreased muscle spasms 4. Decreased local pain and tenderness 3. Decreased muscle spasms

A nurse is assigned to care for a client with multiple sclerosis who is receiving an intravenous (IV) dose of methocarbamol (Robaxin). The nurse monitors the client knowing that which is an expected side effect?

1. Insomnia 2. Excitability 3. Hypertension 4. Dark green-colored urine 4. Dark green-colored urine

The nurse gives a dose of diazepam (Valium) to an assigned client. What is the most important action to be taken by the nurse before leaving the room?

1. Instituting safety measures 2. Closing the curtains in the room 3. Lowering the volume on the television set 4. Giving the client the remote control for the television set 1. Instituting safety measures

A client who has rheumatoid arthritis has begun treatment with anakinra (Kineret) and has received the first injection. What finding would indicate that the health care provider (HCP) should be notified and that the medication should be discontinued?

1. Irritation and erythema at the injection site 2. Concurrent therapy with a tumor necrosis factor inhibitor 3. No relief of arthritic symptoms during the first week of treatment 4. White blood cell count of 12,000 cells/mm3 and a temperature of 99.9° F 4. White blood cell count of 12,000 cells/mm3 and a temperature of 99.9° F

A client is admitted to the hospital, and the nurse notes that the client is taking acetylsalicylic acid (ASA), or aspirin, to treat a chronic rheumatoid disorder. The nurse should monitor the client for which sign or symptom that indicates a toxic effect of the medication?

1. Jaundice 2. Peripheral edema 3. Ringing in the ears 4. Bilateral lung crackles 3. Ringing in the ears

The home health nurse is providing dietary instructions to a client who is taking probenecid (Benemid) for the treatment of gout. Which food should the nurse instruct the client to continue to eat?

1. Liver 2. Shrimp 3. Scallops 4. Spinach 4. Spinach

The nurse asks a nursing student about the uses of the medication dantrolene (Dantrium). The nursing student correctly states that dantrolene is used to manage hypermetabolism of skeletal muscle that occurs in which condition?

1. Low back pain 2. General anesthesia 3. Malignant hyperthermia 4. Hyperplasia of the prostate 3. Malignant hyperthermia

A client is receiving baclofen (Lioresal) for muscle spasms because of a spinal cord injury. Which side/adverse effect related to this medication should the nurse monitor the client for?

1. Muscle pain 2. Hypertension 3. Slurred speech 4. Photosensitivity 3. Slurred speech

Colchicine (Colcrys) is prescribed for a client with a diagnosis of gout. The nurse reviews the client's record, knowing that this medication would be used with caution in which disorder?

1. Myxedema 2. Kidney disease 3. Hypothyroidism 4. Diabetes mellitus 2. Kidney disease

Auranofin (Ridaura) has been prescribed for a client with rheumatoid arthritis. The nurse provides instructions to the client about the medication and tells the client to notify the health care provider (HCP) if which occurs?

1. Nausea 2. Diarrhea 3. Loss of appetite 4. Metallic taste in the mouth 4. Metallic taste in the mouth

Diclofenac (Voltaren) is prescribed for a client with osteoarthritis. Which medication, if noted on the client's record, would alert the nurse to consult with the health care provider?

1. Phenytoin (Dilantin) 2. Primidone (Mysoline) 3. Acetaminophen (Tylenol) 4. Warfarin sodium (Coumadin) 4. Warfarin sodium (Coumadin)

The nurse is analyzing the laboratory studies on a client receiving dantrolene sodium (Dantrium). Which laboratory test would identify an adverse effect associated with the administration of this medication?

1. Platelet count 2. Creatinine level 3. Liver function tests 4. Blood urea nitrogen level 3. Liver function tests

The nurse overhears the health care provider (HCP) tell a client with rheumatoid arthritis that the condition needs to be treated with gold therapy. The nurse interprets that the HCP is referring to which medication?

1. Prednisone 2. Pentostatin (Nipent) 3. Auranofin (Ridaura) 4. Fludarabine (Fludara) 3. Auranofin (Ridaura)

A client has been administered cyclobenzaprine (Flexeril) for the management of muscle spasms in the cervical spine. The client is experiencing drowsiness, dizziness, and dry mouth. How should the nurse interpret these findings?

1. Represent an allergic reaction to the medication 2. Are related to the problem with the cervical spine 3. Are the most common side effects of this medication 4. Are dose related, so the client should cut the medication dose in half 3. Are the most common side effects of this medication

The nurse is preparing discharge instructions for a client receiving baclofen. Which instruction should be included in the teaching plan?

1. Restrict fluid intake. 2. Avoid the use of alcohol. 3. Stop the medication if diarrhea occurs. 4. Notify the health care provider (HCP) if fatigue occurs. 2. Avoid the use of alcohol.

Dantrolene (Dantrium) is prescribed for a client experiencing discomfort caused by spasticity. In providing instructions to the client regarding the medication, what should the nurse emphasize?

1. Return to the clinic in 1 month for an eye examination. 2. Expect that periodic liver function studies will be required. 3. Return to the clinic weekly for blood pressure measurements. 4. Expect that the medication may take 8 weeks to begin to have an effect. 2. Expect that periodic liver function studies will be required.

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.

1. Symptom control during periods of emotional stress 2. Normal white blood cell, platelet, and neutrophil counts 3. Radiological findings that show no progression of joint degeneration 4. An increased range of motion in the affected joints 3 months into therapy 5. Inflammation and irritation at the injection site 3 days after the injection is given 6. A low-grade temperature on rising in the morning that remains throughout the day 1. Symptom control during periods of emotional stress 2. Normal white blood cell, platelet, and neutrophil counts 3. Radiological findings that show no progression of joint degeneration 4. An increased range of motion in the affected joints 3 months into therapy

The nurse is administering an intravenous dose of methocarbamol (Robaxin) to a client with multiple sclerosis. For which side/adverse effect should the nurse monitor?

1. Tachycardia 2. Rapid pulse 3. Bradycardia 4. Hypertension 3. Bradycardia

Alendronate (Fosamax) is prescribed for a client with osteoporosis and the nurse is providing instructions on administration of the medication. Which instruction should the nurse provide?

1. Take the medication at bedtime. 2. Take the medication in the morning with breakfast. 3. Lie down for 30 minutes after taking the medication. 4. Take the medication with a full glass of water after rising in the morning. 4. Take the medication with a full glass of water after rising in the morning.

A nurse is teaching a client who will be discharged on alendronate (Fosamax) about the medication. Which should be included in the teaching plan? Select all that apply.

1. Take the medication at the same time. 2. Report musculoskeletal pain immediately. 3. Take the medication on an empty stomach. 4. Consume coffee when taking the medication. 5. Remain upright for 30 minutes following ingestion. 1. Take the medication at the same time. 3. Take the medication on an empty stomach. 5. Remain upright for 30 minutes following ingestion.

A client has been on treatment for rheumatoid arthritis for 3 weeks. During the administration of etanercept, which is most important for the nurse to assess?

1. The injection site for itching and edema 2. The white blood cell counts and platelet counts 3. Whether the client is experiencing fatigue and joint pain 4. Whether the client is experiencing a metallic taste in the mouth, and a loss of appetite 2. The white blood cell counts and platelet counts

The health care provider (HCP) has prescribed trolamine salicylate (Myoflex) topical cream for a client with a diagnosis of rheumatism who is complaining of muscular aches. Which should the nurse tell the client regarding this medication?

1. The medication will act as a local anesthetic. 2. The medication acts by decreasing muscle spasms. 3. The medication is prescribed to cause the skin to peel. 4. Apply a heating pad to the area after applying the medication. 1. The medication will act as a local anesthetic.

An older client with rheumatoid arthritis has been instructed by the health care provider to take ibuprofen (Motrin IB) 300 mg orally (PO) four times daily. The home care nurse reading the medication prescription knows that the instruction has been effective when the client states the instructed dose is which?

1. The normal adult dose 2. Higher than the normal adult dose 3. An unusual dosage for this diagnosis 4. Two times higher than the normal adult dose 1. The normal adult dose

The nurse is reviewing the health care provider's (HCP) prescriptions for an adult client who has been admitted to the hospital after a back injury. Carisoprodol (Soma) is prescribed for the client to relieve the muscle spasms. The HCP has prescribed 350 mg to be administered four times a day. Which should the nurse conclude?

1. The prescription is the normal adult dosage. 2. The prescription is lower than normal dosage. 3. The prescription is higher than normal dosage. 4. The dosage prescribed requires further clarification with the HCP. 1. The prescription is the normal adult dosage.

The home care nurse is visiting a client who sustained a severe muscle sprain to the back. Carisoprodol (Soma) is prescribed for the client. The nurse provides instructions to the client regarding the medication and should teach the client to take which measure?

1. To avoid driving until the reaction to the medication is known 2. To understand that muscle spasms will be reduced but the pain may increase 3. To limit alcohol consumption to two drinks daily while taking the medication 4. To try to avoid missing doses, but if a dose is missed to take it as soon as it is remembered 1. To avoid driving until the reaction to the medication is known

A client is seen in the hospital emergency department after injury to his right ankle. The client tells the nurse that he twisted his ankle while playing volleyball. The health care provider (HCP) has prescribed a topical analgesic cream for the injury. The nurse providing instruction about the medication should provide the client with which information?

1. To avoid hazardous activities while using the cream because it causes drowsiness 2. To apply the medication three times a day and place a heating pad on top of the area 3. That the medication contains a combination of medications, one of which is an analgesic 4. That the onset of headache indicates a systemic reaction and the HCP must be notified 3. That the medication contains a combination of medications, one of which is an analgesic

Dantrolene sodium (Dantrium) is prescribed for the client experiencing flexor spasms. The client asks the nurse how the medication is going to help. The nurse replies that this medication acts in which way?

1. To depress the spinal reflexes causing the spasms 2. Directly on the skeletal muscle to relieve the spasms 3. Within the spinal cord to suppress excess reflex activity 4. On the central nervous system (CNS) to suppress spasms 2. Directly on the skeletal muscle to relieve the spasms

A client with a diagnosis of rheumatoid arthritis is taking sulindac (Clinoril). The health care provider prescribes misoprostol (Cytotec) for the client. The nurse explains that this medication has been prescribed for which purpose?

1. To enhance the effects of the sulindac 2. To prepare the client for weaning off the sulindac 3. To prevent further development of arthritic nodules 4. To prevent gastric complications such as ulcer disease 4. To prevent gastric complications such as ulcer disease

The nurse is providing medication instructions to a client with multiple sclerosis receiving baclofen (Lioresal). Which information should the nurse include in the instructions?

1. Watch for urinary retention as a side effect. 2. Stop taking the medication if diarrhea occurs. 3. Restrict fluid intake while taking this medication. 4. Notify the health care provider (HCP) if fatigue occurs. 1. Watch for urinary retention as a side effect.

A client with muscle spasms in the lumbar area of the spine has been started on cyclobenzaprine (Flexeril). The nurse should monitor for which most frequent side effect of the medication?

1. Weakness 2. Confusion 3. Excitability 4. Drowsiness 4. Drowsiness

The nurse teaches the client with hypocalcemia to take calcium carbonate (Os-Cal) at which time?

1. With breakfast 2. At lunch time 3. Just before a meal 4. One hour after a meal 4. One hour after a meal

Calcium carbonate (Os-Cal) is prescribed for a client with hypocalcemia. How should the nurse instruct the client to take the medication?

1. With meals 2. Every 4 hours 3. Just before meals 4. 1 hour after meals 4. 1 hour after meals