Question 1

The client receives alendronate (Fosamax) as treatment for osteoporosis. Which symptoms, caused by an adverse effect of the medication, does the nurse teach should be reported to the physician?

Accepted Answer

Alendronate can cause hypocalcemia, leading to symptoms like muscle spasms and facial twitching, which should be reported to the physician.

Question 2

The client has osteomalacia and the physician has ordered a treatment to restore calcium balance. What will the nurse plan to administer to the client?

Accepted Answer

Osteomalacia is a condition where the bones soften due to a lack of vitamin D, which is needed for calcium absorption and bone mineralization. Therefore, the treatment typically involves calcium supplements along with vitamin D to restore calcium balance and promote bone health. Dark green, leafy vegetables and milk products are good sources of calcium, but without vitamin D, the absorption of calcium will not be sufficient. Potassium is not directly involved in calcium balance and bone health.

Question 3

The nurse assesses the client might be experiencing toxicity from Colchicine. Which statement by the client would most likely confirm the nurse's suspicion?

Accepted Answer

Nausea, vomiting, and abdominal pain are the most common symptoms of Colchicine toxicity.

Question 4

The client's calcium level is low. What will be the nurse's primary concern?

Accepted Answer

Low calcium levels can lead to seizures as calcium plays an important role in nerve function and muscle contraction.

Question 5

The client has gout, and receives Colchicine . The nurse has completed medication education and evaluates that learning has occurred when the client makes which statement(s)? Select all that apply.

Accepted Answer

The answer of The client has gout, and receives Colchicine...

Question 6

The client takes etidronate disodium (Didronel) for osteoporosis. Which assessment is best in determining the effectiveness of the medication?

Accepted Answer

A bone density scan is the most accurate way to determine if etidronate disodium is effective in treating osteoporosis. This test measures bone mineral density and can detect changes over time, allowing healthcare providers to assess the effectiveness of the medication. While the absence of bone pain and normal serum calcium levels may be indications of improved bone health, they are not as reliable as a bone density scan. The absence of fractures is also a good indicator of improved bone health, but it may take a long time for this to occur, so it is not the best assessment for short-term effectiveness of the medication.

Question 7

The client receives alendronate (Fosamax) as treatment for osteoporosis. The nurse has completed medication education and evaluates learning has occurred when the client makes which statement(s)? Select all that apply.

Accepted Answer

A) This statement is incorrect. Calcium-rich foods or supplements can interfere with the absorption of alendronate, so it is recommended to wait at least 30 minutes before consuming them.
B) This statement is correct. Heartburn is a potential side effect of alendronate, and the healthcare provider should be notified if it occurs.
C) This statement is incorrect. Alendronate should be taken on an empty stomach, at least 30 minutes before the first food, beverage, or medication of the day.
D) This statement is correct. After taking alendronate, the client should remain upright for at least 30 minutes to avoid esophageal irritation.
E) This statement is correct. Alendronate must be taken with a full glass of water to ensure proper absorption and decrease the risk of esophageal irritation.

Question 8

The nurse administers calcium intravenously (IV) to the client. What will a key assessment of the nurse include?

Accepted Answer

When administering calcium intravenously, it is important to assess the IV site for signs of infiltration and phlebitis. While monitoring for peripheral edema, serum glucose levels, and serum potassium levels may also be important assessments in monitoring the client's overall condition, they are not directly related to administering calcium intravenously.

Question 9

The nurse teaches a class for college students about osteoporosis. What is the best information to include?

Accepted Answer

Prevention of osteoporosis begins in early adulthood through lifestyle measures such as adequate calcium and vitamin D intake, weight-bearing exercise, and avoiding smoking and excessive alcohol consumption.

Answer: A is partially correct, as medication can assist in preventing and halting bone loss, but it is not the only necessary measure.

Answer: B and D are incorrect as osteoporosis is not inevitable with aging, and men can also develop osteoporosis.

Question 10

The child has rickets, and is being treated at the clinic. In addition to taking vitamin D as prescribed, what is the best information the nurse can provide?

Accepted Answer

Sunlight is a natural source of vitamin D and spending at least 20 minutes a day in the sunlight can help increase vitamin D levels in the body. It is important to note that excessive exposure to sunlight can also lead to sunburn and skin damage, so it is important to balance sun exposure with protection measures such as wearing sunscreen and protective clothing. A and B are incorrect because brand name versus generic does not affect the efficacy of the medication and vitamin D should be taken with food for better absorption. C is incorrect because dairy products are a source of calcium, which can help improve bone health in individuals with rickets.

Question 11

The client has arthritis and has just learned that she is pregnant. What is the best instruction by the nurse?

Accepted Answer

Heat applications and splinting are considered safe and effective for managing arthritis discomfort during pregnancy, while ice baths may not be comfortable or safe for the fetus. Glucocorticoids and Hydroxychloroquine may not be safe during pregnancy and should be discussed with the healthcare provider.

Question 12

The client takes calcium supplements. What is the best instruction by the nurse?

Accepted Answer

Taking calcium supplements with a meal increases absorption and reduces the risk of gastrointestinal side effects. Adding Vitamin D enhances absorption, so it is also beneficial to look for a supplement that contains Vitamin D. Taking too many tablets at one time or on an empty stomach can lead to gastrointestinal side effects such as constipation or upset stomach.

Question 13

The client receives hydroxychloroquine sulfate (Gen -Hydroxychloroquine sulfate). Which test does the nurse tell the client should be done on a regular basis?

Accepted Answer

Hydroxychloroquine sulfate can cause retinopathy, which is why regular eye exams are necessary to monitor for any vision changes or damage to the retina. Serum glucose, serum potassium, and blood pressure may also need to be monitored for other health issues but they are not specifically related to hydroxychloroquine sulfate.

Question 14

The nurse has taught the client with osteoporosis about how to manage the illness. Which statement by the client indicates that she needs additional teaching?

Accepted Answer

Calcium supplements are best absorbed with food and not at bedtime. The client needs to be taught to take their calcium supplement with food.

Question 15

The client receives raloxifene (Evista)? Which other medication would the nurse hold and validate with the physician?

Accepted Answer

Raloxifene (Evista) is a selective estrogen receptor modulator (SERM) that is used to prevent and treat osteoporosis in postmenopausal women. It is also used to reduce the risk of invasive breast cancer in women at high risk. Raloxifene is contraindicated in women who are taking tamoxifen (Nolvadex), as the two medications can interact and increase the risk of blood clots. Therefore, the nurse would hold lisinopril (Zestril) and validate with the physician, as it is a medication that can interact with raloxifene.

Quiz 46: Drugs for Bone and Joint Disorders