PN NCLEX-6th Edition, Musculoskeletal Pharmacology
A client is receiving a maintenance dose of oral dantrolene sodium (Dantrium) for the treatment of spasticity. The nurse reviews the medication record, expecting which dose to be prescribed? 1. 50 mg daily 2. 100 mg daily 3. 100 mg twice daily 4. 200 mg four times daily
100 mg twice daily
A client has just been given a prescription for methocarbamol (Robaxin), and the nurse reinforces instructions to the client. Which statement by the client indicates the need for further teaching? 1. "This medication can cause nasal congestion." 2. "The medication may turn the urine brown or green." 3. "Blurred vision is a common but unimportant effect." 4. "This medication is intended to relieve muscle spasms."
"Blurred vision is a common but unimportant effect."
The nurse reviews the medication history of a client admitted to the hospital and notes that the client is taking leflunomide (Arava). During data collection, the nurse asks which question to determine medication effectiveness? 1. "Do you have any joint pain?" 2. "Are you having any diarrhea?" 3. "Do you have frequent headaches?" 4. "Are you experiencing heartburn?"
"Do you have any joint pain?"
A client with rheumatoid arthritis has been taking aspirin (acetylsalicylic acid [ASA]) more frequently than prescribed because the arthritis has been causing more discomfort than usual. The client complains of joint pain and has an elevated temperature. The nurse is concerned about the possibility of aspirin toxicity and asks the client which question that may confirm this suspicion? 1. "Are you constipated?" 2. "Are you having any diarrhea?" 3. "Do you have any double vision?" 4. "Do you have any ringing in your ears?"
"Do you have any ringing in your ears?"
The nurse has given medication instructions to a client beginning therapy with carisoprodol (Soma). The nurse determines that the client understands the effects of the medication if the client makes which statement? 1. "I can expect muscle spasticity as a side effect." 2. "I need to avoid alcohol while taking this medication." 3. "I can drive on city streets, but should avoid highway driving." 4. "I can take a missed dose when remembered, regardless of when the next dose is due."
"I need to avoid alcohol while taking this medication."
The nurse has reinforced discharge instructions to a client with multiple sclerosis who is receiving baclofen (Lioresal). Which statement by the client indicates an understanding of the medication? 1. "I need to watch for urinary retention." 2. "I need to stop the medication if diarrhea occurs." 3. "If I develop fatigue, I need to notify the health care provider." 4. "I need to restrict my fluid intake while I take this medication."
"I need to watch for urinary retention."
The nurse is providing instructions to a client with a diagnosis of rheumatoid arthritis (RA) who is receiving aspirin (acetylsalicylic acid [ASA]) 5 g orally daily. Which statement by the client would indicate an understanding of the instructions? 1. "A slow pulse might indicate a reaction to the medication." 2. "If I have joint pain, I need to notify the health care provider." 3. "If I have discomfort with exercise, I need to stop the medication." 4. "I should notify the health care provider if I get any ringing in my ears."
"I should notify the health care provider if I get any ringing in my ears."
A client receives a prescription for methocarbamol (Robaxin), and the nurse reinforces instructions to the client regarding the medication. Which client statement should indicate a need for further teaching? 1. "My urine may turn brown or green." 2. "This medication is prescribed to help relieve my muscle spasms." 3. "If my vision becomes blurred, I don't need to be concerned about it." 4. "I need to call my doctor if I experience nasal congestion from this medication."
"If my vision becomes blurred, I don't need to be concerned about it."
A film-coated form of diflunisal has been prescribed for a client for the treatment of chronic rheumatoid arthritis. The client calls the clinic nurse because of difficulty swallowing the tablets. Which initial instruction should the nurse reinforce to the client? 1. "Crush the tablets and mix them with food." 2. "Open the tablet and mix the contents with food." 3. "Notify the health care provider for a medication change." 4. "Swallow the tablets with large amounts of water or milk."
"Swallow the tablets with large amounts of water or milk."
A client with acute muscle spasms has been taking baclofen. The client calls the clinic nurse because of continuous feelings of weakness and fatigue and asks the nurse about discontinuing the medication. The nurse should make which appropriate response to the client? 1. "You should never stop the medication." 2. "It is best that you taper the dose if you intend to stop the medication." 3. "It is okay to stop the medication if you think that you can tolerate the muscle spasms." 4. "Weakness and fatigue commonly occur and will diminish with continued medication use."
"Weakness and fatigue commonly occur and will diminish with continued medication use."
An adult client with muscle spasms is taking an oral maintenance dose of baclofen (Lioresal). The nurse reviews the medication record, expecting that which dose would be prescribed? 1. 15 mg 4 times a day 2. 25 mg 4 times a day 3. 30 mg 4 times a day 4. 40 mg 4times a day
15 mg 4 times a day
A client with rheumatoid arthritis is taking acetylsalicylic acid (aspirin) on a daily basis. Which medication dose should the nurse expect the client to be taking? 1. 1 g daily 2. 4 g daily 3. 325 mg daily 4. 1000 mg daily
4 g daily
A health care provider instructs a client with rheumatoid arthritis to take ibuprofen (Motrin IB). The nurse reinforces the instructions, knowing that the normal adult dose for this client is which? 1. 100 mg orally twice a day 2. 200 mg orally twice a day 3. 400 mg orally 3 times a day 4. 1000 mg orally 4 times a day
400 mg orally 3 times a day
Dantrolene sodium (Dantrium) is prescribed for a client experiencing flexor spasms, and the client asks the nurse about the action of the medication. The nurse responds knowing that which is the therapeutic action of this medication? 1. Depresses spinal reflexes 2. Acts directly on the skeletal muscle to relieve spasticity 3. Acts within the spinal cord to suppress hyperactive reflexes 4. Acts on the central nervous system (CNS) to suppress spasms
Acts directly on the skeletal muscle to relieve spasticity
Allopurinol (Zyloprim) has been prescribed for the client, and the client asks the nurse about the action of the medication. The nurse responds knowing that allopurinol has which action? 1. Allopurinol is used for the lysis of thrombi obstructing coronary arteries. 2. Allopurinol decreases sympathetic outflow from the central nervous system (CNS). 3. Allopurinol prevents calcium ion entry across cell membranes of the cardiac smooth muscle. 4. Allopurinol decreases uric acid production and reduces uric acid concentrations in both the serum and urine.
Allopurinol decreases uric acid production and reduces uric acid concentrations in both the serum and urine.
A licensed practical nurse (LPN) 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 LPN questions the prescription if which disorder is noted in the admission history? 1. Hypothyroidism 2. Chronic bronchitis 3. Recurrent pneumonia 4. Angle-closure glaucoma
Angle-closure glaucoma
The nurse is reinforcing discharge instructions to a client receiving baclofen. Which should the nurse include in the instructions? 1. Restrict fluid intake. 2. Avoid the use of alcohol. 3. Stop the medication if diarrhea occurs. 4. Notify the health care provider if fatigue occurs.
Avoid the use of alcohol.
A health care provider is planning to administer a skeletal muscle relaxant to a client with a spinal cord injury. The medication is going to be administered intrathecally. Which medication should the nurse expect to be prescribed and administered by this route? 1. Baclofen (Lioresal) 2. Chlorzoxazone (Paraflex) 3. Dantrolene sodium (Dantrium) 4. Cyclobenzaprine hydrochloride (Flexeril)
Baclofen (Lioresal)
A client has been taking indomethacin (Indocin) for gout and experiencing side/adverse effects. Which assessment should the nurse expect the health care provider to prescribe? 1. Monitoring for steatorrhea 2. Checking for occult blood 3. Checking the color of stool 4. Monitoring the pH of stool
Checking for occult blood
A health care provider prescribes auranofin (Ridaura) for a client with rheumatoid arthritis. Which data would indicate to the nurse that the client is experiencing toxicity related to the medication? 1. Joint pain 2. Constipation 3. Ringing in the ears 4. Complaints of a metallic taste in the mouth
Complaints of a metallic taste in the mouth
The nurse is caring for a client with Paget's disease of the bone. The nurse understands that the client is receiving calcitonin (Cibacalcin) to produce which effect? 1. Decrease bone reabsorption. 2. Increase bone metabolism. 3. Promote the urine excretion of calcium. 4. Decrease gastrointestinal absorption of calcium.
Decrease bone reabsorption.
A client with multiple sclerosis is receiving baclofen (Lioresal). The nurse monitoring this client should look for which outcome to indicate a primary therapeutic response from the medication? 1. Decreased nausea 2. Decreased muscle spasms 3. Increased muscle tone and strength 4. Increased range of motion of all extremities
Decreased muscle spasms
Baclofen (Lioresal) is prescribed for the client with multiple sclerosis. The nurse evaluates 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
Decreased muscle spasms
A client has a new medication prescription for allopurinol (Zyloprim). A practical nursing student co-assigned with the licensed practical nurse (LPN) states, "I know this is for gout, but how does it work?" In formulating a response, the LPN includes that allopurinol works in which manner? 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
Decreases uric acid production
A client with a history of spinal cord injury is beginning medication therapy with baclofen (Lioresal). The nurse who is providing medication information should caution the client about which side effect of this medication? 1. Drowsiness 2. Muscle pain 3. High blood pressure 4. Sensitivity to bright light
Drowsiness
A client with a history of spinal cord injury is receiving baclofen (Lioresal) for muscle spasms. The nurse determines that the client is experiencing a side effect of this medication if the client experiences which sign/symptom? 1. Muscle pain 2. Drowsiness 3. Hypertension 4. Photosensitivity
Drowsiness
A client with multiple sclerosis is receiving diazepam (Valium), a centrally acting skeletal muscle relaxant. Which data would indicate that the client is experiencing a side effect related to this medication? 1. Headache 2. Drowsiness 3. Urinary retention 4. Increased salivation
Drowsiness
The nurse is monitoring a client receiving baclofen for side effects related to the medication. Which should indicate that the client is experiencing a side effect? 1. Polyuria 2. Diarrhea 3. Drowsiness 4. Muscular excitability
Drowsiness
Cyclobenzaprine (Flexeril) is prescribed for a client to treat muscle spasms, and the nurse is reviewing the client's record. Which disorder would indicate a need to contact the health care provider regarding the administration of this medication? 1. Glaucoma 2. Emphysema 3. Hyperthyroidism 4. Diabetes mellitus
Glaucoma
A client is receiving diazepam (Valium) for its skeletal muscle relaxant effects. The nurse should monitor this client for which side effect of this medication? 1. Headache 2. Incoordination 3. Urinary retention 4. Increased salivation
Incoordination
A client with multiple sclerosis is receiving diazepam (Valium), and the home care nurse reinforces instructions to the client regarding the side effects of the medication. The nurse tells the client that which is a side effect of this medication? 1. Insomnia 2. Incoordination 3. Inability to urinate 4. Increased salivation
Incoordination
The nurse prepares to reinforce instructions to a client who is taking allopurinol (Zyloprim). The nurse should include which instruction in the plan? 1. Instruct the client to drink 3000 mL of fluid per day. 2. Instruct the client to take the medication on an empty stomach. 3. Inform the client that the effect of the medication will occur immediately. 4. Instruct the client that if swelling of the lips occurs, this is a normal expected response.
Instruct the client to drink 3000 mL of fluid per day.
The nurse is reviewing medications with the client receiving colchicine for the treatment of gout. The nurse determines that the medication is effective if the client reports a decrease in which? 1. Headaches 2. Blood glucose 3. Blood pressure 4. Joint inflammation
Joint inflammation
A licensed practical nurse (LPN) is reviewing laboratory results for a client taking dantrolene sodium (Dantrium). The LPN should suggest that the registered nurse notify the health care provider if which finding is noted on the laboratory report sheet? 1. Creatinine 0.6 mg/dL 2. Blood urea nitrogen 9 mg/dL 3. Platelet count 290,000 cells/mm3 4. Lactate dehydrogenase (LDH) 600 units/L
Lactate dehydrogenase (LDH) 600 units/L
A client experiencing spasticity because of a spinal cord injury has been prescribed dantrolene (Dantrium). Before administering the first dose, the nurse checks to see whether which baseline study has been done? 1. Liver function 2. Renal function 3. Otoscopic examination 4. Blood glucose measurements
Liver function
A client with a spinal cord injury has been experiencing discomfort because of spasticity, and dantrolene (Dantrium) is prescribed for the client. Before initiating therapy, the nurse anticipates that which testing will be prescribed? 1. Renal function studies 2. Liver function studies 3. Otoscopic examination 4. Blood pressure measurements
Liver function studies
A client with multiple sclerosis is receiving dantrolene (Dantrium) for relief of muscle spasticity. The nurse checks the results of which laboratory value periodically prescribed while the client is taking this medication? 1. Creatinine 2. Hematocrit level 3. Blood urea nitrogen 4. Liver function studies
Liver function studies
Dantrolene (Dantrium) is prescribed for a client with a spinal cord injury for discomfort resulting from spasticity. The nurse tells the client about the importance of follow-up and the need for which blood study? 1. Creatinine level 2. Sedimentation rate 3. Liver function studies 4. White blood cell count
Liver function studies
The nurse is reviewing the laboratory studies on a client receiving dantrolene sodium (Dantrium). Which laboratory test(s) would identify an adverse effect associated with the administration of this medication? 1. Creatinine 2. 3. Blood urea nitrogen 4. Hematological function tests
Liver function tests
The nurse is administering alendronate (Fosamax) to a client. Which nursing intervention is most important for the nurse to consider when giving this medication? 1. Make sure the medication is taken on a full stomach. 2. Make sure this medication is always taken at bedtime. 3. Make sure the medication is taken with just a sip of water. 4. Make sure the client remains upright for 30 minutes after taking the medication.
Make sure the client remains upright for 30 minutes after taking the medication.
Auranofin (Ridaura) has been prescribed for a client with rheumatoid arthritis. The nurse who is collecting data 2 weeks later interprets that the client may be experiencing the signs of medication toxicity based on what data collection findings? Select all that apply. 1. Reports loss of appetite 2. Observes several mouth lesions 3. Notes a rash noted on trunk and neck 4. Reports a metallic taste in the mouth 5. Notes purplish blotches on the skin
Observes several mouth lesions Notes a rash noted on trunk and neck Reports a metallic taste in the mouth Notes purplish blotches on the skin
The nurse notes that meloxicam (Mobic) is prescribed for a client. The nurse anticipates the client to have which diagnosis? 1. Pneumonia 2. Osteoarthritis 3. Heart failure 4. Chronic kidney disease
Osteoarthritis
Baclofen (Lioresal) is prescribed for a client with a spinal cord injury who is experiencing muscle spasms, and the nurse prepares a list of the associated side effects of the medication and reviews the list with the client. Which side effect identified by the client indicates a need for further teaching? 1. Tremors 2. Slurred speech 3. Nasal congestion 4. Photosensitivity
Photosensitivity
Colcrys (colchicine) is prescribed for a client with a diagnosis of gout. The nurse reviews the client's medical history in the health record, knowing that the medication would be contraindicated in which disorder? 1. Myxedema 2. Renal failure 3. Hypothyroidism 4. Diabetes mellitus
Renal failure
The nurse is caring for a client with gout who is taking colchicine (Colcrys). The client has been instructed to restrict the diet to low-purine foods. Which food should the nurse instruct the client to avoid while taking this medication? 1. Spinach 2. Scallops 3. Potatoes 4. Ice cream
Scallops
A licensed practical nurse (LPN) is told that baclofen (Lioresal) is prescribed for an assigned client. The LPN questions the registered nurse about the health care provider's prescription if which condition is noted on the client problem list? 1. Seizure disorder 2. Hyperthyroidism 3. Diabetes mellitus 4. Coronary artery disease
Seizure disorder
The nurse is reviewing the record of a client who has been prescribed baclofen. Which disorder should alert the nurse to contact the health care provider? 1. Seizure disorders 2. Hyperthyroidism 3. Diabetes mellitus 4. Coronary artery disease
Seizure disorders
A client is receiving baclofen (Lioresal) for muscle spasms caused by a spinal cord injury. The nurse monitors the client, knowing that which is a side effect of this medication? 1. Muscle pain 2. Hypertension 3. Slurred speech 4. Photosensitivity
Slurred speech
In monitoring a client's response to disease-modifying antirheumatic drugs (DMARDs), which findings should the nurse interpret as 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 nonprogression 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 injection is given 6. A low-grade temperature upon rising in the morning that remains throughout the day
Symptom control during periods of emotional stress Normal white blood cell, platelet, and neutrophil counts Radiological findings that show nonprogression of joint degeneration An increased range of motion in the affected joints 3 months into therapy
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 reinforce? 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.
Take the medication with a full glass of water after rising in the morning.
Alendronate (Fosamax) is prescribed for a client with osteoporosis. The nurse should reinforce instructing the client taking this medication to do which? 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.
Take the medication with a full glass of water after rising in the morning.
An older client with rheumatoid arthritis has been instructed by the health care provider to take ibuprofen (Motrin IB) 300 mg orally 4 times daily. How would the nurse reading the medication prescription interpret the prescribed dosage? 1. The normal adult dosage 2. An unusual dosage for this diagnosis 3. Higher than the normal adult dosage 4. Lower than the normal adult dosage
The normal adult dosage
The client has been on treatment for rheumatoid arthritis for 3 weeks. During the administration of etanercept, it is most important for the nurse to collect which data? 1. The injection site for itching and edema 2. The white blood cell counts and platelet counts 3. A metallic taste in the mouth, with a loss of appetite 4. Whether the client is experiencing fatigue and joint pain
The white blood cell counts and platelet counts
The client has been on treatment for rheumatoid arthritis for 3 weeks. Which is most important for the nurse to check during the administration of etanercept (Enbrel)? 1. The injection site for itching and edema 2. The white blood cell counts and platelet counts 3. A metallic taste in the mouth and a loss of appetite 4. Whether the client is experiencing fatigue and joint pain
The white blood cell counts and platelet counts
A client has been started on cyclobenzaprine (Flexeril) for the management of muscle spasms in the cervical spine. The client is experiencing drowsiness, dizziness, and dry mouth. The nurse interprets these signs/symptoms as which response? 1. These are the common side effects of this medication. 2. These effects represent an allergic reaction to the medication. 3. These effects are related to the problem with the cervical spine. 4. These effects are dose-related; the client should cut the medication dose in half.
These are the common side effects of this medication.
The nurse is reviewing the health care provider's prescriptions for an adult client who has been admitted to the hospital following a back injury. Carisoprodol (Soma) is prescribed for the client to relieve the muscle spasms; the health care provider has prescribed 350 mg to be administered 4 times a day. The nurse reviews the medication and determines what about the dosage? 1. This is the normal adult dosage. 2. This is a lower than normal dosage. 3. This is a higher than normal dosage. 4. This dosage requires further clarification.
This is the normal adult dosage.
A client is admitted to the hospital with complaints of back spasms. The client states, "I have been taking 2 or 3 aspirin every 4 hours for the past week, and it hasn't helped my back." Aspirin intoxication is suspected. Which complaint would indicate aspirin intoxication? 1. Tinnitus 2. Constipation 3. Photosensitivity 4. Abdominal cramps
Tinnitus
A client is taking large doses of acetylsalicylic acid (aspirin) for rheumatoid arthritis. The nurse tells the client to report which signs and symptoms of ototoxicity? 1. Dizziness, tinnitus, purpura 2. GI bleeding, ecchymosis, tinnitus 3. Tinnitus, hearing loss, dizziness, ataxia 4. Gastrointestinal (GI) upset, hematuria, dizziness
Tinnitus, hearing loss, dizziness, ataxia
A client has been prescribed cyclobenzaprine (Flexeril) in the treatment of painful muscle spasms accompanying a herniated intervertebral disk. The nurse should withhold the medication and question the prescription if the client had which concurrent prescriptions to take? 1. Ibuprofen (Advil) 2. Furosemide (Lasix) 3. Valproic acid (Depakene) 4. Tranylcypromine (Parnate)
Tranylcypromine (Parnate)
A client has been prescribed cyclobenzaprine (Flexeril) in the treatment of painful muscle spasms accompanying a herniated intervertebral disk. The nurse should withhold the medication and question the prescription if the client has concurrent prescriptions of which medication? 1. Ibuprofen (Motrin) 2. Furosemide (Lasix) 3. Valproic acid (Depakene) 4. Tranylcypromine (Parnate)
Tranylcypromine (Parnate)
A client is being given a transcutaneous electrical nerve stimulation (TENS) unit to use for relief of chronic pain. Which instructions should the nurse reinforce to the client about the TENS unit? Select all that apply. 1. Using this unit will help relieve the pain. 2. Hospitalization is required for this treatment. 3. The unit works after attaching electrodes to the skin. 4. The unit needs to be prescribed by the health care provider. 5. The unit will decrease the amount of pain medication needed. 6. The electrodes attached to the unit are placed on the skin around the area of pain.
Using this unit will help relieve the pain. The unit works after attaching electrodes to the skin. The unit needs to be prescribed by the health care provider. The unit will decrease the amount of pain medication needed. The electrodes attached to the unit are placed on the skin around the area of pain.
A client with osteoarthritis is receiving diclofenac sodium (Voltaren). The licensed practical nurse (LPN) reviewing the client's medication prescription sheet should verify the prescription with the registered nurse (RN) if which other medication is listed? 1. Primidone (Mysoline) 2. Warfarin (Coumadin) 3. Vitamin C supplement 4. Calcium carbonate (Tums)
Warfarin (Coumadin)
The nurse is providing care to a client diagnosed with multiple sclerosis and prescribed baclofen (Lioresal). Which information should the nurse plan to reinforce in the client instructions? 1. Watch for urinary retention as a side effect. 2. Stop taking the medication if diarrhea occurs. 3. Notify the health care provider if fatigue occurs. 4. Restrict fluid intake while taking this medication.
Watch for urinary retention as a side effect.
