Question 1

Which assessment should the nurse include in the treatment plan for a client receiving calcium intravenously (IV)?

Accepted Answer

When a client receives intravenous calcium, it is important for the nurse to assess the IV site for any signs of inflammation, infection, or infiltration. These complications can be detrimental to the client's health and may require immediate intervention. Serum glucose levels, serum potassium levels, and level of consciousness are not directly related to the administration of intravenous calcium.

Question 2

Which symptoms associated with an adverse effect of alendronate (Fosamax) should the nurse instruct the client to report?

Accepted Answer

Muscle spasms can indicate hypocalcemia, a potential adverse effect of alendronate, which should be reported.

Question 3

Which is a contributing factor to the symptoms of gout?

Accepted Answer

Gout is caused by the buildup of uric acid in the blood, which can lead to the formation of crystals in the joints, causing inflammation and pain. An increase in the excretion of uric acid (choice A) and a decrease in uric acid in the blood (choice D) would actually help prevent gout symptoms. Cartilage loss in the joints (choice C) may contribute to joint pain and stiffness, but it is not a direct cause of gout.

Question 4

Which statement made by a client supports their diagnosis of acute gouty arthritis?

Accepted Answer

Acute gouty arthritis attacks often occur at night, which is known as nocturnal attacks. The other statements do not support a diagnosis of gouty arthritis. Numbness in joints could suggest a nerve issue, muscle weakness could indicate a muscular or neurological problem, and morning stiffness is a common symptom of rheumatoid arthritis.

Question 5

Which describe the goals of pharmacotherapy for a client with rheumatoid arthritis? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Accepted Answer

The goals of pharmacotherapy for a client with rheumatoid arthritis include reducing pain (B), minimizing disability (D), and controlling inflammation (E). These objectives aim to improve the quality of life for the patient by managing symptoms and preventing the progression of the disease. Increasing rheumatoid factors (A) is not a goal, as rheumatoid factors are antibodies that are often elevated in individuals with rheumatoid arthritis, and their increase is associated with disease activity, not a treatment goal. Preventing fractures (C) is more directly related to conditions like osteoporosis, and while maintaining bone health is important in rheumatoid arthritis, it is not a primary goal of pharmacotherapy for the condition.

Question 6

Which pharmacological effects are used to prevent hyperuricemia for a client with gout? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Accepted Answer

To prevent hyperuricemia in a client with gout, the pharmacological effects of inhibiting the formation of uric acid, increasing the excretion of uric acid, and converting uric acid to a less toxic form can be used. Breaking down or eliminating uric acid does not necessarily prevent its accumulation, which is the primary concern in hyperuricemia.

Question 7

The nurse has completed medication education for a client prescribed allopurinol (Zyloprim). Which client statements indicate an understanding of the information? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Accepted Answer

Allopurinol is used to treat gout and certain types of kidney stones, and it can take a few days to weeks to see its full effect. Alcohol can exacerbate gout and interact negatively with allopurinol. A skin rash can be a sign of an allergic reaction to allopurinol, necessitating immediate contact with a healthcare provider. Taking the medication with food can help minimize gastrointestinal side effects. Crushing the medication is not mentioned as a specific concern for allopurinol, so D is not a correct statement in the context of general guidance for this medication.

Question 8

Which conditions should the nurse associate with the development of hypocalcemia despite normal dietary intake? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Accepted Answer

A) Malabsorption syndrome can lead to hypocalcemia because it interferes with the body's ability to absorb calcium from the diet.C) Chronic kidney disease can cause hypocalcemia due to the kidneys' reduced ability to convert vitamin D to its active form, which is necessary for calcium absorption.D) Excessive vomiting can lead to hypocalcemia by causing a loss of stomach acids, which in turn affects calcium absorption.E) Multiple blood transfusions can lead to hypocalcemia due to the citrate used in stored blood products binding with calcium, reducing its levels in the blood.

Question 9

Which statement should the nurse include in a client's education when discussing calcium supplementation?

Accepted Answer

Calcium should be taken with a meal to increase absorption and reduce gastrointestinal side effects such as constipation. Insomnia is not a common side effect of calcium supplementation. Vitamin D is often recommended to be taken along with calcium as it helps the body absorb calcium, so it should not be taken separately. Calcium should not be taken on an empty stomach as it may lead to gastrointestinal irritation.

Question 10

Which testing should the nurse instruct the client receiving hydroxychloroquine sulfate (Plaquenil) to do on a regular basis?

Accepted Answer

The nurse should instruct the client receiving hydroxychloroquine sulfate (Plaquenil) to have regular eye exams as this medication has potential retinal toxicity.

Question 11

Which assessment findings should the nurse anticipate for the client that has overdosed on vitamin D? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Accepted Answer

The answer of Which assessment findings should the nurse anticipate...

Question 12

Which is an important function of calcium?

Accepted Answer

Calcium plays a crucial role in regulating nerve transmission by its involvement in neurotransmitter release and muscle contraction.

Question 13

Which should the nurse plan to administer to a client to restore their calcium balance?

Accepted Answer

Calcium absorption and utilization is facilitated by vitamin D. Hence, calcium supplements and vitamin D are the best choice to restore calcium balance in a client. Milk products also contain calcium, but it may not be suitable for all clients, especially those with lactose intolerance or allergies. Dark green, leafy vegetables and potassium can also contribute to calcium intake but may not be sufficient to restore calcium balance in a deficient client.

Question 14

Which is the next step in the process of vitamin D activation after the dietary products are consumed?

Accepted Answer

After dietary products are consumed, cholecalciferol (vitamin D3) is synthesized in the skin or absorbed from the diet, which is the first step in the activation process of vitamin D.

Question 15

The nurse has provided education for a client prescribed (Fosamax). Which statements made by the client indicate an understanding of the information? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Accepted Answer

A) "I cannot lie down for at least 30 minutes after taking the prescription." - This is correct, as taking Fosamax while lying down can increase the risk of side effects.
C) "I should call my healthcare provider if I experience heartburn." - This is correct, as heartburn can be a side effect of Fosamax and may need to be addressed by a healthcare provider.
D) "I must take this with a full glass of water." - This is correct, as Fosamax should be taken with a full glass of water and not any other type of liquid, such as milk. 
B and E are incorrect. Milk should not be taken with Fosamax as it may interfere with its absorption, and while Fosamax can be taken with or without food, it should not be taken with calcium supplements or antacids.

Question 16

Which is the nurse's primary concern for a client with a low calcium level?

Accepted Answer

A low calcium level (hypocalcemia) can lead to neuromuscular irritability and potentially cause seizures. Bone fractures may be a concern for individuals with low calcium over a prolonged period of time, but seizures are the immediate concern. Hypoglycemia and depression are not related to low calcium levels.

Question 17

Which assessment is the best to determine the effectiveness of bisphosphonate therapy for a client with osteoporosis?

Accepted Answer

A bone density scan is the most accurate assessment to determine the effectiveness of bisphosphonate therapy for a client with osteoporosis. It measures the bone mineral density in various areas of the body and can detect any improvements or declines in bone density over time. The absence of fractures or bone pain may indicate some level of success, but cannot accurately measure the actual bone density and strength. Normal serum calcium levels are not specific to osteoporosis and may not necessarily indicate the effectiveness of bisphosphonate therapy.

Question 18

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

Accepted Answer

Calcium carbonate, which is a common form of calcium supplement, should be taken with food to enhance absorption. Taking it on an empty stomach may decrease the effectiveness of the supplement.

Question 19

Which describes the mechanism of action of selective estrogen receptor modulators (SERMs)? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Accepted Answer

The answer of Which describes the mechanism of action of...

Question 20

Which information should the nurse include in the education for the parent of a child with rickets?

Accepted Answer

Spending at least 20 minutes a day in sunlight is important for the child to receive adequate vitamin D. However, it is important to note that sun exposure should be balanced with the risk of skin cancer and sunburn. Other choices are incorrect: dairy products are a good source of vitamin D and should not be avoided; both brand name and generic vitamin D are effective; and vitamin D can be taken with food if needed to prevent stomach upset.

Quiz 48: Drugs for Bone and Joint Disorders

Which assessment should the nurse include in the treatment plan for a client receiving calcium intravenously (IV) ?