Deck 75: Pharmacotherapy of Bone and Joint Disorders

Question 1

The client is admitted with a diagnosis of type 2 diabetes mellitus, tuberculosis, and rheumatoid arthritis.Which of the following orders should the nurse question for this client?
1)Etanercept (Enbrel)
2)Minocycline (Minocin)
3)Sulfasalazine (Azulfidine)
4)Hydroxychloroquine (Plaquenil)

Answer 1

1

Question 2

A client has been diagnosed with rheumatoid arthritis, and the health care provider has ordered hydroxychloroquine (Plaquenil).To encourage compliance, the nurse should advise the client to expect the effects of this drug to begin within:
1)7 days.
2)3-6 weeks.
3)3-6 months.
4)6--9 months.

Answer 2

3

Question 3

The secretion of calcitonin is increased when the client experiences:
1)Hypercalcemia.
2)Hypocalcemia.
3)Hypothyroidism.
4)Hyperthyroidism.

Answer 3

1

Question 4

Approximately 50% of the calcium in the body participates in intracellular functions such as influencing neuromuscular activity and blood coagulation, and is:
1)Bound to albumin.
2)Nonionized.
3)Complexed.
4)Ionized.

Question 5

Which symptom is critical for the nurse to monitor for when a client is admitted with hypoparathyroidism?
1)Decreased peristalsis
2)Vomiting
3)Weakness
4)Tetany

Question 6

The mechanism of action for disease-modifying antirheumatic drugs (DMARDs)is to:
1)Provide rapid relief of symptoms.
2)Encourage the client to be more active.
3)Prevent the need for orthopedic surgery.
4)Reduce damage and delay disease progression.

Question 7

In the prevention of osteoporosis, it is important to maintain a normal serum calcium level because:
1)Calcium ions assist in blood clotting.
2)Calcium influences contraction of skeletal muscle.
3)Appropriate nerve conduction depends upon adequate calcium level.
4)The support provided by bones is important for the structural integrity of the body.

Question 8

A client experiencing symptoms of rheumatoid arthritis has hydroxychloroquine (Plaquenil)ordered.The client should be cautioned to:
1)Take this drug with an antacid to decrease stomach distress.
2)Report blurred vision or decreased reading ability immediately.
3)Continue with a glass of red wine before dinner to reduce cardiovascular risk.
4)Expose skin to sunlight for at least 20 minutes every day to help with bone formation.

Question 9

Encouraging outdoor play will help the child reduce the risk of osteomalacia because:
1)Exposure of the skin to ultraviolet light will enhance activation of parathyroid hormone.
2)Exercise will help increase osteoblastic activity to maintain calcium in the bone.
3)Ultraviolet light from the sun increases the level of an inactive form of vitamin D.
4)Play increases renal perfusion, which helps to activate vitamin D.

Question 10

Which pathophysiological process is most likely if the client has a serum calcium level of 12.0 mg/dL?
1)Chronic renal disease
2)Hypoparathyroidism
3)Metastatic bone tumor
4)Osteomalacia

Question 11

Which question is most important for the nurse to ask the client who has been diagnosed with osteoporosis?
1)"What would you estimate your cholesterol intake to be?"
2)"How many dairy products do you consume per day?"
3)"How much weight have you gained in the last year?"
4)"Does someone in your household smoke?"

Question 12

The nurse is teaching a client about taking risedronate (Actonel)for her osteoporosis.Which of the following statements made by the client indicates a need for further teaching?
1)"I will take the medication first thing in the morning, with water."
2)"I can return to bed while I wait for the medication to work."
3)"I will wait at least 30 minutes before eating."
4)"I will report difficulties with heartburn."

Question 13

Which factor predisposes a client to hypocalcemia?
1)Malignancy
2)Osteoporosis
3)Renal disease
4)Cardiac damage

Question 14

Osteoarthritis is best treated with low-impact exercises and:
1)High-dose anti-inflammatory doses of aspirin.
2)Glucosamine and chondroitin agents.
3)Acetaminophen.
4)Opioid analgesics.

Question 15

The recommended dietary allowance for calcium in the normal healthy adult is:
1)200-600 mg per day.
2)800-1,200 mg per day.
3)1,600-2,000 mg per day.
4)2,400-2,800 mg per day.

Question 16

Normally, serum calcium level is maintained by:
1)Folic acid and thyroxine.
2)Vitamin C and prolactin.
3)Vitamin D and parathormone.
4)Vitamin B₁₂ and aldosterone.

Question 17

A client with osteoporosis has been prescribed raloxifene (Evista).Which question should the nurse ask to determine the client's risks for complications with this drug?
1)"Have you ever had any broken bones?"
2)"Have you ever had esophageal or ulcer disease?
3)"Have you ever had or been treated for blood clots?"
4)"Do you have a history of abnormal breast biopsies?"

Question 18

A client has been prescribed allopurinol (Zyloprim)for gout.The purpose of this medication is to:
1)Reduce the formation of uric acid.
2)Help the body excrete excess uric acid.
3)Prevent the joint damage associated with this disease.
4)Relieve the inflammation caused by this disease process.

Question 19

What is the priority nursing diagnosis for a client with osteoporosis?
1)Injury, risk for related to loss of bone calcium
2)Infection, risk for related to impaired host defenses
3)Activity Intolerance related to inadequate nutrition and anemia
4)Constipation related to side effects of calcium replacement therapy

Question 20

A calcium supplement has been added to a client's drug regimen.The nurse should advise the client to:
1)Decrease intake of dairy products to prevent hypercalcemia.
2)Increase consumption of fruits and vegetables high in vitamin C.
3)Increase consumption of lean meats for additional protein intake.
4)Avoid taking calcium supplements with bran or whole-grain cereal.