Deck 47: Drugs for Bone and Joint Disorders

Question 1

The mechanism of action of selective estrogen receptor modulators (SERMs),such as raloxifene (Evista),is to
1)increase calcium levels in the bone.
2)slow bone resorption.
3)inhibit synthesis of microtubules.
4)increase bone mass and density.

Answer 1

4

Question 2

The nurse administers calcium intravenously (IV)to the client.What will a key assessment by the nurse include?
1)Assess the serum glucose levels.
2)Assess the intravenous (IV)site.
3)Assess the serum potassium levels.
4)Assess for peripheral edema.

Answer 2

2

Question 3

The client's calcium level is low.What will be the nurse's primary concern?
1)Seizures
2)Bone fractures
3)Hypoglycemia
4)Depression

Answer 3

1

Question 4

The client receives raloxifene (Evista).Which other medication would the nurse hold and validate with the physician?
1)Lisinopril (Prinivil)
2)Paroxetine (Paxil)
3)Atorvastatin (Lipitor)
4)Diphenhydramine (Benadryl)

Question 5

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?
1)"I will avoid drinking alcohol."
2)"I will walk for 30 minutes every day."
3)"I will take my calcium at bedtime."
4)"I will drink milk regularly."

Question 6

A client takes calcium three times a day in the form of supplements.The nurse will advise the client to take the drug
1)with tea or coffee.
2)on an empty stomach.
3)with zinc supplements.
4)with food.

Question 7

The client has arthritis and has just learned that she is pregnant.What is the best instruction by the nurse?
1)An ice bath to the affected joint will help with discomfort.
2)Hydroxychloroquine (Plaquenil)is the best medication for you.
3)You could try heat applications and splinting for discomfort.
4)Glucocorticoids are considered safe during pregnancy.

Question 8

The nurse assesses the client might be experiencing toxicity from colchicine.Which statement by the client would most likely confirm the nurse's suspicion?
1)"My joints hurt more."
2)"I have nausea,vomiting,and abdominal pain every day."
3)"I don't see as well as I used to,and my taste has changed."
4)"I wake up at night with muscle cramps."

Question 9

The nurse teaches a class for college students about osteoporosis.What is the best information to include?
1)Prevention of osteoporosis begins in early adulthood.
2)Medication is the primary treatment to prevent and halt bone loss.
3)Osteoporosis is an inevitable part of aging.
4)Men do not need to be concerned about osteoporosis.

Question 10

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?
1)Ringing of the ears
2)Hot and dry skin
3)Vision changes and photophobia
4)Muscle spasms and facial twitching

Question 11

The client receives hydroxychloroquine sulfate (Plaquenil).Which test does the nurse tell the client should be done on a regular basis?
1)Serum potassium
2)Eye exams
3)Serum glucose
4)Blood pressure

Question 12

A 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?
1)Avoid dairy products while taking vitamin D.
2)Be sure to take brand name,not generic,vitamin D.
3)Spend at least 20 minutes/day in the sunlight.
4)Take your vitamin D on an empty stomach.

Question 13

The symptoms of gout are due to
1)an increase in the excretion of uric acid.
2)buildup of uric acid in the blood.
3)cartilage loss in the joints.
4)a decrease in uric acid in the blood.

Question 14

An important function of calcium is to
1)regulate acid-base balance.
2)improve glucose absorption.
3)increase energy.
4)regulate nerve transmission.

Question 15

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 statements? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"I cannot lie down for at least 30 minutes after taking the medication."
2)"Milk will help with the absorption of this medication."
3)"I should call my doctor if I experience heartburn."
4)"I must take this with a full glass of water."
5)"The medication can be taken with or without food."

Question 16

The client has gout and receives allopurinol (Zyloprim).The nurse has completed medication education and evaluates that learning has occurred when the client makes which statements? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"It may take a few days or weeks for me to get the full effect of this medication."
2)"I should not drink alcohol while taking this drug."
3)"If I develop a skin rash I should contact the prescriber."
4)"I should not crush this medication."
5)"I should take this medication with food."

Question 17

The client takes calcium supplements.What is the best instruction by the nurse?
1)"This drug may cause insomnia."
2)"Take your calcium with a meal."
3)"It does not matter if Vitamin D is added."
4)"Take them on an empty stomach."

Question 18

Which of the following signs are common with hypocalcemia?
1)Bruising
2)Hypertension
3)Muscle wasting
4)Muscle spasms

Question 19

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?
1)Calcium supplements and dark green,leafy vegetables
2)Calcium supplements and milk products
3)Calcium supplements and potassium
4)Calcium supplements and vitamin D

Question 20

The client takes a bisphosphonate for osteoporosis.Which assessment is best in determining the effectiveness of the medication?
1)Normal serum calcium levels
2)Absence of fractures
3)Bone density scan
4)Absence of bone pain

Question 21

A client states,"I stopped taking my medications for osteoporosis.I couldn't see how they were helping me any." How should the nurse respond? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"The results from these medications are hard for you to see."
2)"It takes about 6 months to see any results."
3)"When did you stop taking the medications?"
4)"Were there any other reasons that you decided to discontinue the medications?"
5)"You are not helping us help you when you don't follow directions."

Question 22

During a medication history,the client states,"I take the calcium supplement called calcitriol." How should the nurse respond to this statement? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"Calcitriol is a vitamin D supplement."
2)"What other medications do you take?"
3)"You don't understand the medications you are taking."
4)"Do you also take a vitamin D supplement?"
5)"Do you take the prescription strength or over-the-counter?"

Question 23

A client has been prescribed denosumab (Prolia).What medication education should the nurse provide? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"I will give your medication in the form of an injection."
2)"You may feel more fatigued than usual when taking this drug."
3)"Be certain to keep your appointments for follow-up."
4)"Do not take any kind of calcium supplement or vitamin D supplement while taking this drug."
5)"We must monitor your cholesterol while you are taking this drug."

Question 24

A client is receiving therapy for gout.Which information should the nurse provide? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"You should not drink alcohol."
2)"You should increase intake of fatty fish like salmon and sardines."
3)"Take a vitamin C supplement while on your medication for gout."
4)"Increase your fluid intake to 2 to 4 liters each day."
5)"If your joint pain does not improve,let us know."

Question 25

A client who has osteoporosis says,"I am exercising more.I go to the gym once a week." How should the nurse respond? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"What kind of exercises are you doing"
2)"You should try to exercise three to five times a week."
3)"That is not enough."
4)"Is there somewhere that you can walk on the days you don't go to the gym?"
5)"Exercise will not improve your osteoporosis."