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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Free Nursing Study Resources

Correct Answer is ["18.8"]

Explanation

To calculate the rate at which the IV pump should deliver dopamine, we can follow these steps:

Step 1: Convert the weight of the client from pounds to kilograms.

220 lb ÷ 2.2 = 100 kg (rounded to the nearest whole number)

Step 2: Calculate the total dose of dopamine per minute.

5 mcg/kg/min × 100 kg = 500 mcg/min

Step 3: Convert the dose from micrograms (mcg) to milligrams (mg).

500 mcg/min ÷ 1000 = 0.5 mg/min

Step 4: Determine the infusion rate in milliliters per hour (mL/hr).

The total volume of the solution is 250 mL.

The total dose of dopamine is 400 mg.

So, the infusion rate is (0.5 mg/min ÷ 400 mg) × 250 mL = 0.3125 mL/min.

Step 5: Convert the infusion rate from mL/min to mL/hr.

0.3125 mL/min × 60 min/hr = 18.75 mL/hr (rounded to the nearest tenth).

Therefore, the nurse should set the IV pump to deliver 18.8 mL/hr (rounded to the nearest tenth).

A. Report the incident to the nurse manager. B. Document that the pharmacy sent the incorrect medication. C. Contact the provider to change the client's prescription. D. Place the unwrapped celecoxib back into the AMDS

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.

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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

Correct Answer is ["18.8"]

Explanation

A nurse accidently removes celecoxib from an automated medication dispensing system (AMDS) instead of citalopram and almost administers the wrong medication to a client. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

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