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

Smoking is a known risk factor for the development of aspirin-induced ulcers. It can increase the risk of gastrointestinal bleeding and compromise the integrity of the gastric mucosa. Smoking can also impair the healing process and increase the risk of complications associated with ulcers.

While the other factors mentioned in the options may have their own health implications, smoking is specifically associated with an increased risk of aspirin-induced ulcers. Therefore, the nurse should identify the client's smoking habit as a risk factor for the development of an aspirin-induced ulcer.

A. Dabigatran B. Levothyroxine C. Isoproterenol D. Furosemide

Correct Answer is D

Explanation

Furosemide, a loop diuretic, is known to cause orthostatic hypotension as an adverse effect. It works by increasing urine output and reducing fluid volume, which can lead to a decrease in blood pressure when standing up, causing dizziness or lightheadedness.

Dabigatran (A) is an anticoagulant used to prevent blood clots and does not typically cause orthostatic hypotension as a side effect.

Levothyroxine (B) is a thyroid hormone replacement medication used to treat hypothyroidism. It does not usually cause orthostatic hypotension.

Isoproterenol (C) is a non-selective beta-adrenergic agonist that is primarily used for cardiac stimulation. It can cause tachycardia and palpitations, but orthostatic hypotension is not a common side effect.

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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 caring for a client who is starting to take aspirin 81 mg daily. Which of the following findings should the nurse identify as a risk factor for the client's development of an aspirin-induced ulcer?

Correct Answer is C

Explanation

A nurse is assessing a client who reports feeling dizzy while getting out of bed. The nurse suspects orthostatic hypotension related to a medication the client is taking Which of the following medications should the nurse identify as likely causing this adverse effect?

Correct Answer is D

Explanation

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