A nurse is providing teaching to a client who has chronic rheumatoid arthritis and a new prescription for hydroxychloroquine. The nurse should instruct the client to obtain which of the following diagnostic studies routinely?

Eye examination

Chest -ray

Pancreatic enzyme levels

Urinalysis screening

Answer and Explanation

The Correct Answer is A

When providing teaching to a client with chronic rheumatoid arthritis who is starting a new prescription for hydroxychloroquine, the nurse should instruct the client to obtain routine eye examinations. Hydroxychloroquine is an antimalarial and immunosuppressive medication commonly used to treat rheumatoid arthritis and other autoimmune conditions.

One of the potential side effects of hydroxychloroquine is ocular toxicity, particularly affecting the retina. Retinal toxicity can lead to vision changes or, in severe cases, irreversible damage to the eyes. Therefore, regular eye examinations are necessary to monitor for any signs of retinal toxicity and detect any visual changes early to prevent further complications.

The American Academy of Ophthalmology recommends that patients taking hydroxychloroquine undergo a baseline eye examination before starting the medication and annual eye examinations thereafter, especially after five years of continuous use.

Let's go through the other options:

B. Chest x-ray: A chest x-ray is not routinely required for monitoring clients taking hydroxychloroquine for rheumatoid arthritis. Hydroxychloroquine is not known to cause significant respiratory or pulmonary side effects.

C. Pancreatic enzyme levels: Monitoring pancreatic enzyme levels is not specifically related to hydroxychloroquine therapy. Pancreatic enzyme level testing is typically used to assess the function of the pancreas in conditions like pancreatitis or pancreatic insufficiency.

D. Urinalysis screening: While regular monitoring of kidney function is important for clients on long-term medication therapy, routine urinalysis screening is not specifically related to hydroxychloroquine use in clients with rheumatoid arthritis. Regular eye examinations are of higher priority due to the potential ocular toxicity associated with this medication.

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Correct Answer is C

Explanation

When assessing a client receiving ciprofloxacin, the nurse should prioritize reporting tendon pain when walking to the provider. Ciprofloxacin is a fluoroquinolone antibiotic that can rarely cause tendonitis or tendon rupture, particularly in the Achilles tendon. Tendon pain, especially when associated with difficulty walking, can be indicative of a serious adverse effect and requires immediate attention and evaluation by the provider.

Nausea and vomiting (A) are common side effects of ciprofloxacin but are typically not considered urgent or life-threatening. They can often be managed with supportive care measures and may not require immediate intervention.

Daytime drowsiness (B) is not typically associated with ciprofloxacin and may be unrelated to the medication. It should be assessed and reported if it persists or is severe, but it is not a priority finding specifically related to ciprofloxacin administration.

Photosensitivity (D) is a known side effect of ciprofloxacin, but it is not typically considered a priority finding unless it is severe or causing significant discomfort. Adequate sun protection measures can help manage photosensitivity.

Correct Answer is ["0.8"]

Explanation

To calculate the amount of morphine to administer, we can use the following formula:

Amount of medication (mL) = Desired dose (mg) / Concentration (mg/mL)

In this case, the desired dose is 8 mg and the concentration is 10 mg/mL.

Amount of medication (mL) = 8 mg / 10 mg/mL

Amount of medication (mL) = 0.8 mL

Therefore, the nurse should administer 0.8 mL of morphine.

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A nurse is providing teaching to a client who has chronic rheumatoid arthritis and a new prescription for hydroxychloroquine. The nurse should instruct the client to obtain which of the following diagnostic studies routinely?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who is receiving IV ciprofloxacin to treat a urinary tract infection. Which of the following findings should the nurse identify as the priority to report to the provider?

Correct Answer is C

Explanation

A nurse is preparing to administer morphine 8 mg IV intermittent bolus to a client. The amount available is morphine 10 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["0.8"]

Explanation

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