Chapter 29: Skeletal Muscle, Bone, and Joint Disorder Drugs Introductory Clinical Pharmacology 12th Edition by Susan M Ford

Introductory Clinical Pharmacology 12th Edition by Susan M Ford 1. A nurse is teaching a client with gout the importance of getting adequate fluids. The nurse determines the session is successful when the client correctly plans to drink at least how much fluid each day? a. 1000 mL b. 1500 mL c. 2000 mL d. 3000 mL Answer: D Rationale: A client with gout is encouraged to drink at least 3000 mL of fluid per day to promote uric acid excretion. Question format: Multiple Choice Chapter: 29 Learning Objective: 5 Cognitive Level: Apply Client Needs: Physiological Integrity: Physiological Adaptation Integrated Process: Teaching/Learning Reference: p. 358, Readiness for Enhanced Fluid Balance 2. A client is receiving alendronate for osteoporosis. The client has informed the nurse that they have also been taking aspirin. Which interaction should the nurse monitor for in this client? a. Increased risk of GI bleeding b. Decreased effects of bisphosphonate c. Increased level of sedation d. Increased risk of rash Answer: A Rationale: Interaction of aspirin with a bisphosphonate drug causes increased risk of GI bleeding, which requires monitoring. Interaction of a uric acid inhibitor with barbiturates and benzodiazepines causes an increased level of sedation. Interaction of a uric acid inhibitor with ampicillin causes increased risk of rash. Interaction of calcium supplements or antacids with bisphosphonates decreases the effects of bisphosphonates. Question format: Multiple Choice Chapter: 29 Learning Objective: 3 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 355, Contraindications and Precautions 3. A nurse is caring for a client who is receiving cyclobenzaprine. The nurse would expect to assess which finding as indicating the therapeutic effect of the drug? a. Reduction of muscle spasm b. Prevention of seizure c. Relief from anxiety d. Relief from nervous disorder Answer: A Rationale: Cyclobenzaprine, a skeletal muscle relaxant, affects muscle tone, thereby causing reduction of muscle spasm. Antiepileptics are used to prevent seizures. Benzodiazepines are used for anxiety. There are a variety of nervous disorders, and they can be treated with amphetamines, analeptics, anorexiants, cholinesterase inhibitors, adrenergics, adrenergic blocking agents, cholinergics, cholinergic blocking agents, anti-Parkinson, and antiepileptics. Question format: Multiple Choice Chapter: 29 Learning Objective: 2 Cognitive Level: Understand Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 352, Skeletal Muscle Relaxants 4. The nurse is preparing to administer colchicine to a client who is in the initial phase of gout. Which disorder will the nurse be prepared to monitor the client for? a. Stomatitis b. Stevens–Johnson syndrome c. Bone marrow depression d. Exfoliative dermatitis Answer: C Rationale: The nurse needs to closely monitor the client for bone marrow depression, an adverse reaction of colchicine. Stomatitis, Stevens–Johnson syndrome, and exfoliative dermatitis are not adverse reactions of colchicine. Stomatitis is an adverse reaction of immunosuppressive drugs. Stevens–Johnson syndrome and exfoliative dermatitis are adverse reactions of allopurinol. Question format: Multiple Choice Chapter: 29 Learning Objective: 3 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 356, Gastrointestinal System Reactions 5. The nurse is teaching a client about the medication they are receiving as treatment for gout. The nurse determines the session is successful when the client correctly chooses which instruction as most important? a. Taking drug on an empty stomach b. Using protection against sunlight c. Reporting any skin rash d. Wearing a brace to get out of bed Answer: C Rationale: The nurse should instruct the client to report any skin rash. A rash should be monitored carefully because it may precede a serious adverse reaction, such as Stevens–Johnson syndrome. The nurse need not instruct the client to take the drug on an empty stomach, use protection against sunlight, or wear a brace to get out of bed. Clients with osteoporosis are asked to wear a brace to get out of bed. Clients taking medications for gout are asked to take it with food. These clients are also instructed to avoid driving or performing other hazardous tasks. Question format: Multiple Choice Chapter: 29 Learning Objective: 5 Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Integrated Process: Teaching/Learning Reference: p. 360, Educating the Client and Family 6. A client is receiving hydroxychloroquine for a musculoskeletal disorder. Which adverse reactions are irreversible and needs to be reported immediately? a. Easy bruising b. Skin rash c. Fever d. Visual changes