Prep Quiz #6- Musculoskeletal drugs

A patient with rheumatoid arthritis is experiencing sudden vision changes. Which medication found in the patient's medication list can cause retinal damage?

Hydroxychloroquine (Plaquenil)

The nurse is teaching a patient how to self-administer triptan injections for migraine headaches. Which statement by the patient indicates that he needs further teaching?

"I will take this medication regularly to prevent a migraine headache from occurring."

The nurse is teaching a patient who is taking colchicine for the treatment of gout. Which instruction will the nurse include during the teaching session?

"The drug will be discontinued when symptoms are reduced."

A patient with gout who has increasingly frequent acute gouty attacks will begin receiving allopurinol [Zyloprim] and colchicine. The nurse will include which statement when teaching the patient about this drug regimen?

"You will take both drugs initially and then stop taking the colchicine."

A patient is to receive filgrastim (Neupogen) 5 mcg/kg/day. The patient weighs 198 pounds. Identify how many micrograms of medication will this patient receive each day.

450 mcg

A patient will be receiving aldesleukin [IL-2] (Proleukin), 600,000 IU/kg every 8 hours for 14 doses. The patient weighs 220 pounds. Identify how many IU of medication will this patient receive per dose.

60 million (60,000,000) IU

A patient is receiving instructions regarding the use of caffeine for migraine headaches. The nurse shares that caffeine should be used with caution if which of these conditions is present?

A history of peptic ulcers

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.

An increased range of motion in the affected joints 3 months into therapy Control of symptoms during periods of emotional stress Normal white blood cell, platelet, and neutrophil counts Radiological findings that show no progression of joint degeneration

A client with gout has begun to take allopurinol. The nurse informs the client that which medication may also be necessary during the beginning phase of medication therapy with allopurinol? Select all that apply.

Colchicine Indomethacin Naproxen

TT is a 55-year-old female who has been diagnosed with postmenopausal osteoporosis. She has a past medical history of ethanol abuse, alcoholic liver disease, erosive esophagitis, and hypothyroidism. Which of the following would be the primary reason oral bisphosphonates should be used with caution in this patient?

Erosive esophagitis.

The nurse notes in a patient's medication history that the patient is taking allopurinol (Zyloprim). Based on this finding, the nurse interprets that the patient has which disorder?

Gout

Colchicine is especially useful in treating an acute attack of gout because it achieves which of the following?

Impairs leukocyte migration

A 48-year-old man is diagnosed with gout. Allopurinol is useful in treating gout because of which of the following property?

It decreases the production of uric acid.

A client with rheumatoid arthritis is receiving Hydroxychloroquine (Plaquenil) in the recent months. The nurse tells the client to visit which of the following while on the treatment?

Ophthalmologist

A 64-year-old male presents with signs and symptoms of an acute gouty flare. His doctor wishes to treat him accordingly to improve his symptoms. Which of the following strategies would be the LEAST likely to acutely improve his gout symptoms and pain?

Probenecid

A 17 year-old high school athlete with a history of asthma comes to your clinic seeking a preventative medication for migraine headaches. Which of the following would be contraindicated?

Propranolol (Inderal)

VS is a 70-year-old female who is being started on ibandronate once monthly for the treatment of osteoporosis. Which of the following is important to communicate to this patient?

Remain upright for at least 60 minutes after taking this medication.

A client has just been prescribed with Methotrexate (Trexall) for the treatment of rheumatoid arthritis who did not respond to any other treatment. An important reminder for the client is to?

Strict hand washing.

Jane is a 67 year-old woman with a history of mild hypertension and classic angina pectoris. She is seeking treatment for migraine headaches of moderate intensity. Her headaches are preceeded by bilateral light flashes and dizziness that last about 10 minutes prior to the onset of pain. Her headaches are also frequently accompanied by photophobia, severe nausea and occasional vomiting. What medication would be contraindicated for acute treatment of Jane's headaches?

Sumatriptan

A 23 year old woman with a history of depression comes to your clinic seeking relief for a severe migraine headache that began 20 minutes ago. She is currently taking the SSRI (selective serotonin repute inhibitor) Citalopram for her depression and an estrogen/progesterone combined oral contraceptive. What medication would you avoid using for her acute treatment?

Sumatriptan (Imitrex)

A patient will begin taking hydroxychloroquine [Plaquenil] for rheumatoid arthritis. The patient is currently taking high-dose NSAIDs and methotrexate. What will the nurse teach the patient?

That an eye exam is necessary at the beginning of therapy with this drug

A 44-year-old man is suffering from recurrent gouty arthritis. His serum uric acid level is elevated, and you prescribe allopurinol. Within 1 week of the allopurinol, he develops a painful episode that "feels like gout." Which of the following is the best explanation?

The patient likely developed acute gout as a result of mobilization of the urate from joints and tissues.

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

Tinnitus, hearing loss, dizziness, and ataxia

A patient has had three gouty flare-ups in the past year. Which drug class will the nurse expect the provider to order for this patient?

Urate-lowering drugs

The nurse is caring for a client with a diagnosis of gout. Which laboratory value would the nurse expect to note in the client?

Uric acid level of 9.0 mg/dL

A patient with gout has been treated with allopurinol (Zyloprim) for 2 months. The nurse will monitor laboratory results for which therapeutic effect?

decreased uric acid levels