The Musculoskeletal System
Prior to starting alendronate, the nurse should assess which of the following in the client?
Ability to swallow due to esophagitis and baseline vision
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
A nurse is teaching a client about methotrexate therapy for rheumatoid arthritis. Which of the following information should the nurse include?
Avoid being near people who are sick with a communicable illness, periodic lab testing is required, report bruising or petechiae, and avoid drinking alcohol
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 which can cause increase of gastric intestinal ulceration
A nurse is planning care for a client who has new prescription for methotrexate. The nurse should plan to monitor the client for which of the following adverse effects?
Bone marrow depression which is an adverse effect of folic acid
A primary care provider prescribes calcitonin salmon for a post-menopausal client. Knowing the adverse effects of calcitonin, you instruct the client to increase what?
Calcium and Vitamin D intake due to the risk for hypocalcemia due to increased excretion of calcium
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 due to increase risk of deep-vein thrombosis
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 osteoclast which are cells that cause bone reabsorption or bone loss
A nurse is teaching a client who has a prescription for prednisone and take 1,500 mg/day of calcium carbonate to reduce the risk of osteoporosis. Which of the following information should the nurse include?
Drink 8 oz of water with calcium tablets, chew calcium tablets before swallowing, take the drugs 1 hr apart, and divide the daily dosage of calcium into three 500 mg doses
A nurse is teaching about self-administration methotrexate to a client who has RA. 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
A nurse is caring for a client who has a new diagnosis of fibromyalgia. Which of the following medication should the nurse expect to administer to this client?
Duloxetine because it is a serotonin-norepinephrine reuptake
A client who has rheumatoid arthritis is taking methotrexate. Which of the following reduces toxicity from this drug?
Folic acid by taking at least 5 mg per week
A client is about to start taking raloxifene to treat osteoporosis. You advise the client to watch for which of the following adverse effects?
Hot flashes as well as leg cramps and pulmonary embolism
A nurse is providing teaching to a client who is taking raloxifene to prevent postmenopausal osteoporosis. The nurse should advise the client that which are adverse effects of this medication?
Hot flashes, Swelling or redness in calf from DVT, and shortness of breath
A nurse is teaching a client about ADRs 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 due to increase risk of infection
A nurse is teaching a client about methotrexate therapy for RA. Which of the following statements by the client indicates understanding of the teaching?
I will take a birth control pill every day because it is teratogenic to a fetus and is contraindicated during pregnancy
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 RA?
Ibuprofen because it is a NSAIDs analgesics which is often proscribed with methotrexate
Aledronate is contraindicated for admin to clients who have which of the following conditions?
Inability to sit upright or stand for 30 min due to increase risk for esophagitis
A nurse is caring for a client who has a prescription for etanercept. The nurse should identify that etanercept treats RA by which of the following actions?
Inactivation of tumor necrosis factor (TNF) preventing autoimmune response
A nurse is teaching a client about raloxifene. Which of the following information should should the nurse include?
Increase physical activity by taking walks, use a contraceptive if there is any possibility of pregnancy, and increase calcium and Vitamin D
What is the therapeutic action of raloxifene?
Mimics the effects of estrogen on bone tissue, minimizing or stopping bone loss
A client who is menopausal is taking a calcium supplement to prevent osteoporosis. You instruct the client to watch or which of the following indications of hypercalcemia?
Nausea as well as anorexia, vomiting, and constipation
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 and should not provide to someone who has current infection
A nurse is caring for a client taking etanercept. Which of the following adverse effects is most important to mention when educating this client?
Injection site reaction like itching, erythema, swelling, and pain
A nurse should instruct a client who is talking alendronate to monitor for which of the following adverse effects?
Jaw pain, blurred vision, and muscle pain
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 and muscle pain as well as nausea, visual disturbances, and esophagitis
A nurse is providing teaching for a client who has gout and a new prescription for allopurinol. For which of the adverse effects should the client be taught to monitor?
Nausea, Rash, and Increased gout pain
Which of the following drug are effective in disease prevention as well as treatment of osteoporosis?
Raloxifene and alendronate in prevention and treatment of postmenopausal osteoporosis
A nurse is teaching a client about calcitonin-salmon intranasal spray to treat osteoporosis. Which of the following information should the nurse include?
Report rash or itching, prime the pump before the first dose, report nasal irritation, and hold the pump horizontally
A nurse is caring for a client who is taking etanercept for rheumatoid arthritis. The should monitor the client for which of the following indications of a serious adverse reaction of the drug?
Shortness of breath due to the risk of heart failure
A nurse is teaching a client who is taking etanercept for RA. The nurse should instruct the client to monitor for which of the following indications of an adverse reaction to this drug?
Skin rash due to the increased risk of skin infections
A client is about to start therapy with methotrexate for rheumatoid arthritis. Knowing the adverse effects of methotrexate, you advise the client to watch for which of the following?
Sore throat because it causes suppression of the immune system and is a sign of infection
What do calcium supplements raise?
The calcium levels
What do Selective Estrogen Receptor Modulators mimics?
The effects of estrogen on the bones
What does calcitonin increase?
The excretion of calcium by the kidney
What do bisphosphonates reduce?
The number of osteoclasts
A nurse is caring for a client who is currently taking methotrexate for RA. The nurse should identify that which of the following is an adverse effect of this medication?
Thrombocytopenia like the CNS, respiratory, and etc.
A HCP prescribes etanercept to treat a client's RA. Prior to beginning the treatment, the client requires testing for which of the following?
Tuberculosis
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?
Use skin testing to check the client for allergies so they are not allergic to salmon or fish protein
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 as well as nausea, flank pain, lethargy, and deep bone pain
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 like fever, cough, malaise, weight loss, and dyspnea
