exam 2
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Megan Meyer
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1.
MULTIPLE CHOICE QUESTION
45 sec • 2 pts
A nurse is providing teaching for a client newly prescribed methotrexate for rheumatoid arthritis. Which statement by the client indicates a need for further teaching?
“I’ll take my medication once a week.”
“I’ll increase my folic acid intake while taking this medication.”
“I can continue to drink a glass of wine each night.”
“I’ll call my provider if I develop a fever or sore throat.”
Answer explanation
The statement "I can continue to drink a glass of wine each night" indicates a need for further teaching. Methotrexate can interact with alcohol, increasing the risk of liver damage.
2.
MULTIPLE CHOICE QUESTION
45 sec • 2 pts
A nurse should monitor which laboratory value most closely in a client taking methotrexate?
Hemoglobin
Liver function tests
Serum sodium
Serum calcium
Answer explanation
Methotrexate can cause liver toxicity, so monitoring liver function tests is crucial to detect any potential damage early. Hemoglobin, serum sodium, and serum calcium are less directly affected by methotrexate.
3.
MULTIPLE CHOICE QUESTION
45 sec • 2 pts
A client taking hydroxychloroquine for rheumatoid arthritis should be instructed to:
Have regular eye examinations.
Avoid foods high in purine
Take the medication on an empty stomach.
Stop the medication if mild nausea occurs.
Answer explanation
Clients on hydroxychloroquine should have regular eye examinations due to the risk of retinal toxicity associated with long-term use of the medication.
4.
MULTIPLE CHOICE QUESTION
45 sec • 2 pts
Before initiating etanercept therapy for rheumatoid arthritis, which test should be completed?
Electrocardiogram (ECG)
Tuberculosis (TB) screening
Bone density scan
Pregnancy test
Answer explanation
Before starting etanercept for rheumatoid arthritis, TB screening is essential due to the risk of reactivation of latent tuberculosis. This test ensures patient safety and is a standard precaution for immunosuppressive therapies.
5.
MULTIPLE CHOICE QUESTION
45 sec • 2 pts
A nurse should question a prescription for infliximab in which client?
A client with osteoarthritis
A client with a history of tuberculosis
A client taking oral contraceptives
A client with mild hypertension
Answer explanation
Infliximab is an immunosuppressant that can reactivate latent tuberculosis. Therefore, a nurse should question its prescription for a client with a history of tuberculosis due to the increased risk of infection.
6.
MULTIPLE CHOICE QUESTION
45 sec • 2 pts
A client experiencing an acute gout attack is prescribed colchicine. Which finding requires the nurse’s immediate action?
Mild nausea
Diarrhea
Fatigue
Flushed skin
Answer explanation
Diarrhea is a common side effect of colchicine and can indicate toxicity. It requires immediate action to prevent dehydration and further complications, unlike mild nausea, fatigue, or flushed skin.
7.
MULTIPLE CHOICE QUESTION
45 sec • 2 pts
A nurse is teaching a client prescribed allopurinol for chronic gout. Which statement by the client indicates understanding?
“I should take this medication at the first sign of a gout flare."
“I need to drink plenty of water while taking this medication.”
“This medication is used to relieve pain during a gout attack."
“I will take aspirin if I get a headache.
Answer explanation
The correct statement is about drinking plenty of water, which helps prevent kidney stones and supports the excretion of uric acid while on allopurinol. The other statements are incorrect regarding the medication's use.
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