Q/EXP CONTAINS PHARM Q GOUT **REVIEW** PRACTICE
WEEK 5
A nurse is teaching a client who has RA about taking methotrexate. Which of the
following information should the nurse include?
A: Drink 2 to 3 L of water per day.
R: Methotrexate can cause renal toxicity. The client should drink 2 to 3 L of water per
day to promote excretion of the medication.
A nurse in a medical clinic is providing teaching to an older adult client who has
OA that is affecting her knees. Which of the following client statements indicates
an understanding of the teaching?
A: "I can use either heat or ice to help relieve my discomfort"
R: The nurse should reinforce that different treatment modalities, such as heat or cold
therapy, can be tried to determine which one is more effective for the client. Heat
application can help with muscle relaxation in the area around the affected joint. The
application of cold numbs nerve endings and decreases joint inflammation.
A nurse in the ED is caring for a client who is bleeding profusely from a deep
laceration on his left lower forearm. After observing standard precautions, which
of the following actions should the nurse perform first?
A: Apply direct pressure over the wound.
R: The greatest risk to the client is injury from hemorrhage. Therefore, the first action
the nurse should take is to apply firm pressure with a thick, dry dressing material directly
over the wound to stop bleeding.
A nurse is caring for a client who returns to the nursing unit from recovery room
after a sigmoid colon resection for adenocarcinoma. The client had an episode of
intraoperative bleeding. Which finding indicates to the nurse that the client may
be developing hypovolemic shock?
A: Increase in the heart rate from 88 to 110/min
R: Hypovolemic shock is a condition in which the heart is unable to supply enough
,blood to the body because of blood loss or inadequate blood volume. In an effort to
compensate for this, the heart rate increases steadily. In the first stage of shock
(compensatory), the heart rate is > 100/min. As shock progresses, the heart rate
continues to accelerate to more than 150/min. In the final (irreversible or refractory)
stage, the heart rate becomes very erratic and may develop asystole.
A nurse is caring for a client who is taking naproxen following an exacerbation of
RA. Which of the following statements by the client requires further discussion
by the nurse?
A: "I've been taking antacids to help with indigestion"
R: NSAIDs, like naproxen, can cause serious adverse gastrointestinal reactions such as
ulceration, bleeding, and perforation. Warning manifestations such as nausea or
vomiting, gastrointestinal burning, and blood in the stool reported by the client require
further investigation by the nurse. The client might be taking an antacid because he is
experiencing one or more of these manifestations.
A nurse is teaching a client who has RA about self-care strategies for managing
the disease. Which of the following activities should the nurse include in the
teaching?
A: Press water from a sponge rather than wringing it.
R: The nurse should instruct the client to modify fine motor activities, such as wringing
out a sponge, by using larger joints or body surfaces, such as the palm of the hand, to
substitute for smaller ones.
A nurse is teaching a client who is starting to take methotrexate to treat RA.
Which of the following instructions should the nurse include in the teaching?
A: Drink at least 2 liters of water daily
R: The client should drink 2 to 3 L of water per day because methotrexate can cause
kidney damage. Adequate hydration optimizes drug excretion and helps prevent renal
damage.
A nurse is caring for a client who has RA and tells the nurse that she wears a
copper bracelet to help her feel better. Which of the following responses should
the nurse take?
, A: "Yes, I understand that you feel better wearing your bracelet"
R: The nurse illustrates the therapeutic communication technique of accepting. The
nurse demonstrates the knowledge that the bracelet is harmless for the client and
shows respect for the client's beliefs.
A nurse is caring for a client who has liver cirrhosis with ascites, bleeding
esophageal varies, and portal hypertension. The nurse recognizes which of the
following lab findings as indicating the client GI tract is digesting and absorbing?
A: Elevated blood urea nitrogen (BUN)
R: As the body digests blood, BUN rises. An elevated BUN is an indication of GI
bleeding.
A nurse is caring for a female client who has RA and asks the nurse if it is safe
for her to take aspirin. The nurse should recognize which of the following
findings in the clients history is a contraindication to this medication?
A: History of gastric ulcers
R: Aspirin is contraindicated for clients who have a history of gastrointestinal bleeding
and peptic ulcer disease because it impedes platelet aggregation. An adverse effect of
aspirin is gastric bleeding.
A nurse is teaching a client who has RA about increasing physical rest as part of
her treatment plan. Which of the following outcomes of this intervention should
the nurse document as a goal for this client?
A: Reduced joint stress
R: Rheumatoid arthritis in an autoimmune disease in which the cartilage and bone of
the joints are destroyed resulting in increased pain and limited range of motion. The
nurse should instruct the client that rest reduces stress on the joints and can be an
effective intervention for relieving pain associated with rheumatoid arthritis.
A nurse is caring for a client who has a GI bleeding. Which of the following
actions should the nurse take first?
A: Assess orthostatic blood pressure
R: Using the nursing process, the first action the nurse should take is to assess the
client by measuring the client's orthostatic blood pressure. This action determines if the
client is hypovolemic and establishes a baseline for further measurements.
WEEK 5
A nurse is teaching a client who has RA about taking methotrexate. Which of the
following information should the nurse include?
A: Drink 2 to 3 L of water per day.
R: Methotrexate can cause renal toxicity. The client should drink 2 to 3 L of water per
day to promote excretion of the medication.
A nurse in a medical clinic is providing teaching to an older adult client who has
OA that is affecting her knees. Which of the following client statements indicates
an understanding of the teaching?
A: "I can use either heat or ice to help relieve my discomfort"
R: The nurse should reinforce that different treatment modalities, such as heat or cold
therapy, can be tried to determine which one is more effective for the client. Heat
application can help with muscle relaxation in the area around the affected joint. The
application of cold numbs nerve endings and decreases joint inflammation.
A nurse in the ED is caring for a client who is bleeding profusely from a deep
laceration on his left lower forearm. After observing standard precautions, which
of the following actions should the nurse perform first?
A: Apply direct pressure over the wound.
R: The greatest risk to the client is injury from hemorrhage. Therefore, the first action
the nurse should take is to apply firm pressure with a thick, dry dressing material directly
over the wound to stop bleeding.
A nurse is caring for a client who returns to the nursing unit from recovery room
after a sigmoid colon resection for adenocarcinoma. The client had an episode of
intraoperative bleeding. Which finding indicates to the nurse that the client may
be developing hypovolemic shock?
A: Increase in the heart rate from 88 to 110/min
R: Hypovolemic shock is a condition in which the heart is unable to supply enough
,blood to the body because of blood loss or inadequate blood volume. In an effort to
compensate for this, the heart rate increases steadily. In the first stage of shock
(compensatory), the heart rate is > 100/min. As shock progresses, the heart rate
continues to accelerate to more than 150/min. In the final (irreversible or refractory)
stage, the heart rate becomes very erratic and may develop asystole.
A nurse is caring for a client who is taking naproxen following an exacerbation of
RA. Which of the following statements by the client requires further discussion
by the nurse?
A: "I've been taking antacids to help with indigestion"
R: NSAIDs, like naproxen, can cause serious adverse gastrointestinal reactions such as
ulceration, bleeding, and perforation. Warning manifestations such as nausea or
vomiting, gastrointestinal burning, and blood in the stool reported by the client require
further investigation by the nurse. The client might be taking an antacid because he is
experiencing one or more of these manifestations.
A nurse is teaching a client who has RA about self-care strategies for managing
the disease. Which of the following activities should the nurse include in the
teaching?
A: Press water from a sponge rather than wringing it.
R: The nurse should instruct the client to modify fine motor activities, such as wringing
out a sponge, by using larger joints or body surfaces, such as the palm of the hand, to
substitute for smaller ones.
A nurse is teaching a client who is starting to take methotrexate to treat RA.
Which of the following instructions should the nurse include in the teaching?
A: Drink at least 2 liters of water daily
R: The client should drink 2 to 3 L of water per day because methotrexate can cause
kidney damage. Adequate hydration optimizes drug excretion and helps prevent renal
damage.
A nurse is caring for a client who has RA and tells the nurse that she wears a
copper bracelet to help her feel better. Which of the following responses should
the nurse take?
, A: "Yes, I understand that you feel better wearing your bracelet"
R: The nurse illustrates the therapeutic communication technique of accepting. The
nurse demonstrates the knowledge that the bracelet is harmless for the client and
shows respect for the client's beliefs.
A nurse is caring for a client who has liver cirrhosis with ascites, bleeding
esophageal varies, and portal hypertension. The nurse recognizes which of the
following lab findings as indicating the client GI tract is digesting and absorbing?
A: Elevated blood urea nitrogen (BUN)
R: As the body digests blood, BUN rises. An elevated BUN is an indication of GI
bleeding.
A nurse is caring for a female client who has RA and asks the nurse if it is safe
for her to take aspirin. The nurse should recognize which of the following
findings in the clients history is a contraindication to this medication?
A: History of gastric ulcers
R: Aspirin is contraindicated for clients who have a history of gastrointestinal bleeding
and peptic ulcer disease because it impedes platelet aggregation. An adverse effect of
aspirin is gastric bleeding.
A nurse is teaching a client who has RA about increasing physical rest as part of
her treatment plan. Which of the following outcomes of this intervention should
the nurse document as a goal for this client?
A: Reduced joint stress
R: Rheumatoid arthritis in an autoimmune disease in which the cartilage and bone of
the joints are destroyed resulting in increased pain and limited range of motion. The
nurse should instruct the client that rest reduces stress on the joints and can be an
effective intervention for relieving pain associated with rheumatoid arthritis.
A nurse is caring for a client who has a GI bleeding. Which of the following
actions should the nurse take first?
A: Assess orthostatic blood pressure
R: Using the nursing process, the first action the nurse should take is to assess the
client by measuring the client's orthostatic blood pressure. This action determines if the
client is hypovolemic and establishes a baseline for further measurements.
