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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
When a medication error occurs, the nurse should report the incident to the nurse manager or appropriate supervisor. It is essential to follow the facility's policies and procedures for reporting and managing medication errors. Prompt reporting allows for appropriate investigation, documentation, and implementation of necessary measures to prevent future errors.
Documenting that the pharmacy sent the incorrect medication (B) is not appropriate in this situation, as it does not address the nurse's role and responsibility in the error. Reporting the incident is the primary action required.
Contacting the provider to change the client's prescription (C) is not necessary in this case, as the error was related to the medication selection during administration, not an issue with the prescription itself.
Placing the unwrapped celecoxib back into the AMDS (D) is not appropriate. Once a medication has been removed from its packaging or container, it should not be returned to the dispensing system. Additionally, since it was the wrong medication for the client, it should not be administered.
Therefore, the nurse should primarily report the incident to the nurse manager or appropriate supervisor to ensure appropriate handling of the medication error.
Correct Answer is C
Explanation
Flumazenil is the antidote for diazepam, which is a benzodiazepine. Flumazenil is a selective antagonist that can reverse the sedative effects of benzodiazepines and is commonly used in cases of benzodiazepine overdose or to reverse sedation after procedures.
Naloxone (A) is the antidote for opioid overdose and would not be appropriate for reversing the effects of diazepam.
Atropine (B) is an anticholinergic medication used to increase heart rate and is not specific to the reversal of diazepam sedation.
Neostigmine (D) is a cholinesterase inhibitor used to reverse the effects of non-depolarizing neuromuscular blocking agents and is not indicated for reversing the effects of diazepam.
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