Holland/Adams/Brice, Core Concepts in Pharmacology 5th Edition Test Bank
Chapter 36

Question 1

Type: MCMA

A client is admitted with hypocalcemia. What are possible causes of hypocalcemia? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Parathyroidectomy
2. Hypertension
3. Vitamin D deficiency
4. Heart failure
5. Malabsorption disorder

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 606

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 36-2 Explain the importance of treating hypocalcemia.

Question 2

Type: MCSA

The nurse is assessing a client who is diagnosed with hypocalcemia. What findings does the nurse anticipate?

1. Hypertension and tachycardia
2. Muscle weakness and bone pain
3. Bleeding problems or bruising
4. Muscle twitching or tremors

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 606

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 36-2 Explain the importance of treating hypocalcemia.

Question 3

Type: MCMA

The nurse is providing teaching to a client who is at risk for osteoporosis. Which risk factors are considered modifiable? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Postmenopausal age
2. High alcohol or caffeine consumption
3. Lack of vitamin D or calcium in the diet
4. Physical inactivity
5. Gender

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 609

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 36-4 Explain drug treatments for weak and fragile bones such as osteoporosis and Paget disease.

Question 4

Type: MCSA

The nurse is caring for a client with Paget disease. This client is considered to be late in the progression of the disease. Which disorders is this client at risk for developing?

1. Glaucoma, diabetes mellitus, and arthritis
2. Rheumatoid arthritis, epilepsy, and cardiac irregularities
3. Arthritis, kidney stones, and heart disease
4. Arthritis, endometrial cancer, and hypertension

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 614

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 36-4 Explain drug treatments for weak and fragile bones such as osteoporosis and Paget disease.

Question 5

Type: MCSA

The nurse is caring for a client who is receiving sodium hyaluronate (Hyalgan) injections. What should the nurse include in the medication teaching?

1. Continue with all activities following injection, so as not to cause stiffness
2. Increase ROM to joint for better dispersal of the medication
3. No weight bearing on the joint following injection
4. Avoid strenuous exercise for 48 hours after injection

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 615

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 36-5 Explain drug treatments directly related to weak bones and joints such as osteoarthritis, rheumatoid arthritis, and gout.

Question 6

Type: MCSA

A client is taking colchicine for gouty arthritis. What should the nurse include in the medication teaching for this client regarding adverse reactions?

1. GI upset is common.
2. The client should be monitored for signs of bleeding.
3. Skin rashes are common.
4. The client should call the physician if there is no improvement in gout symptoms.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 618

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 36-5 Explain drug treatments directly related to weak bones and joints such as osteoarthritis, rheumatoid arthritis, and gout.

Question 7

Type: MCSA

The nurse is caring for a client with arthritis. The client would like to explore the use of an inexpensive natural alternative to anti-inflammatory drugs. Which remedy would the nurse recommend?

1. Chondroitin
2. Glucosamine sulfate
3. Echinacea
4. Black cohosh

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 615

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 36-5 Explain drug treatments directly related to weak bones and joints such as osteoarthritis, rheumatoid arthritis, and gout.

Question 8

Type: MCMA

A client has been prescribed a PO vitamin D supplement. Which supplement does the nurse anticipate will be administered? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Calcitriol (Calcijex)
2. Calcium gluconate (Kalcinate)
3. Doxercalciferol (Hectorol)
4. Ergocalciferol (Deltalin)
5. Alendronate (Fosamax)

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Page Number: 608

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 36-3 Describe the pharmacologic management of disorders caused by calcium and vitamin D deficiency such as osteomalacia and rickets.

Question 9

Type: MCSA

A client asks the nurse to explain why a prescription for calcitriol (Calcijex) has been given when vitamin D is available without a prescription. What is the best response by the nurse?

1. “There is no difference between the two.”
2. “This will allow you to buy vitamin D and pay your co-payment.”
3. “You don’t need to fill the prescription. You can buy the over-the-counter vitamin D.”
4. “Calcitriol (Calcijex) is the active form of vitamin D, and the over-the-counter calcium is not the same.”

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Page Number: 608

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 36-3 Describe the pharmacologic management of disorders caused by calcium and vitamin D deficiency such as osteomalacia and rickets.

Question 10

Type: MCMA

The nurse explains to the female client the risk factors for osteoporosis. What risk factors should the nurse include in the teaching session? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Postmenopausal status
2. Excessive vitamin D or calcium in the diet
3. Tobacco use
4. High alcohol consumption
5. High caffeine consumption

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Page Number: 609

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 36-4 Explain drug treatments for weak and fragile bones such as osteoporosis and Paget disease.

Question 11

Type: MCMA

The nurse is caring for a woman with osteoporosis. Based on this diagnosis, the nurse teaches the woman that she is at risk for fractures to occur in which locations? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Hips
2. Spine
3. Fingers
4. Wrists
5. Forearms

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Page Number: 609

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 36-4 Explain drug treatments for weak and fragile bones such as osteoporosis and Paget disease.

Question 12

Type: MCMA

A client has been prescribed raloxifene (Evista). What information about side effects should the nurse include in the client teaching about the medication? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Hot flashes
2. Breast pain
3. Sinus headache
4. Vaginal bleeding
5. Hyperlipidemia

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 611

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 36-4 Explain drug treatments for weak and fragile bones such as osteoporosis and Paget disease.

Question 13

Type: MCSA

A client has been prescribed alendronate (Fosamax). Which condition would this medication not be used to treat?

1. Symptomatic Paget disease in both women and men
2. Prevention of osteoporosis in postmenopausal women
3. Glucocorticoid-induced osteoporosis in both women and men
4. Fractures as a result of osteoporosis

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 612

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 36-4 Explain drug treatments for weak and fragile bones such as osteoporosis and Paget disease.

Question 14

Type: MCMA

A client diagnosed with osteoarthritis asks the nurse what different types of treatment are available. Which treatments will the nurse include in the response? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Immunosuppressants
2. Intra-articular glucocorticoids
3. Topical medications
4. NSAIDs
5. Hypoglycemic agents

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Numbers: 614–615

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 36-5 Explain drug treatments directly related to weak bones and joints such as osteoarthritis, rheumatoid arthritis, and gout.

Question 15

Type: MCSA

A client has been diagnosed with rheumatoid arthritis. Which medication would be appropriate to treat this client?

1. Hydroxychloroquine (Plaquenil)
2. Probenecid (Benemid)
3. Allopurinol (Lopurin)
4. Sulfinpyrazone (Anturane)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 616

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 36-5 Explain drug treatments directly related to weak bones and joints such as osteoarthritis, rheumatoid arthritis, and gout.

Question 16

Type: MCMA

A client asks the nurse how to prevent gout attacks. Which responses are appropriate by the nurse? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Treatment with antigout medications
2. Dietary management
3. Decrease stressors
4. Decreased fluid intake
5. Using hypoglycemia medications

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 617

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 36-5 Explain drug treatments directly related to weak bones and joints such as osteoarthritis, rheumatoid arthritis, and gout.

Question 17

Type: MCSA

What will the nurse teach a client who is taking antigout medication?

1. Decrease fluid intake
2. Increase intake of high-purine foods
3. Drink plenty of fluids
4. Restrict activities

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 619

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 36-5 Explain drug treatments directly related to weak bones and joints such as osteoarthritis, rheumatoid arthritis, and gout.

Question 18

Type: MCMA

Which medications are used to treat rheumatoid arthritis? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Rituximab (Rituxan)
2. Leflunomide (Arava)
3. Sulfasalazine (Azulfidine)
4. Tizanidine (Zanaflex)
5. Ibuprofen (Advil)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 616

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 36-5 Explain drug treatments directly related to weak bones and joints such as osteoarthritis, rheumatoid arthritis, and gout.

Question 19

Type: MCSA

What is the drug of choice for the pharmacotherapy of Paget disease?

1. Bisphosphonates
2. Selective estrogen-receptor modulators (SERMs)
3. Hormone replacement therapy (HRT)
4. NSAIDs

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 614

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 36-5 Explain drug treatments for weak and fragile bones such as osteoporosis and Paget disease.

Question 20

Type: MCSA

The nurse is educating a client about the importance of calcium and vitamin D. Why are these items important for bone health?

1. They allow for normal blood coagulation.
2. They allow for neurotransmitter release.
3. They provide stability to the skeletal system.
4. They are important for seizure prevention.

Cognitive Level: Remembering

Client Need: Physiological Integrity

Page Number: 606

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 36-1 Describe the roles of calcium, vitamin D, parathyroid, and calcitonin in maintaining bone health.

Question 21

Type: MCMA

The nurse is educating a client about the importance of calcium and vitamin D. The client asks how they can increase their vitamin D. Which are ways a client can increase the exposure to vitamin D? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Increase exposure to sunlight or ultraviolet light

2. Drink milk

3. Eat foods rich in vitamin D

4. Increase food consumption by 300 calories a day

5. Decrease exercise

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 605

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 36-1 Describe the roles of calcium, vitamin D, parathyroid, and calcitonin in maintaining bone health.