Chapter 29-musculosketal health

Question 1

A client is admitted to the hospital with acute severe burns to his upper torso from an explosion. He is prescribed a neuromuscular blocking agent for which of the following reasons?

Answer 1

to prevent muscle spasm of the larynx in clients who require endotracheal intubation
Acute severe upper torso burns from a explosion will result in the need for endotracheal intubation and mechanical ventilation.

Question 2

When preparing a client for the administration of atracurium, the nurse should:

Answer 2

prepare emergency equipment to support the client’s respiratory system
.Because of the risk of respiratory muscle blockade, the nurse needs to be sure this equipment is available.

Question 3

The nurse should monitor clients receiving dantrolene for hepatic adverse effects:

Answer 3

3 to 12 months after initiating therapy.

Question 4

The nurse understands that the most common use of neuromuscular blockade is to:

Answer 4

facilitate intubation and mechanical ventilation.

This is one of four uses for neuromuscular blockade.

Question 5

Nursing care of the client receiving a neuromuscular blocking agent while on a mechanical ventilator includes to:

Answer 5

communicate to the client what the nurse is going to do before touching the client.
The client is unable to speak and can be easily startled and frightened.

Question 6

The nurse questions the use of which of the following agents in a client who has recently received a neuromuscular blocking agent?

Answer 6

gentamicin-can intensify the action of the neuromuscular blocking agent.

Question 7

A client with cerebral palsy is prescribed diazepam for involuntary muscle movement because of its action as a(n):

Answer 7

centrally acting skeletal muscle relaxant.

Question 8

The nurse understands that methocarbamol is contraindicated:

Answer 8

for use in clients under 16 years of age.

Question 9

For the client prescribed baclofen, the nurse should:

Answer 9

instruct the client that this drug causes drowsiness.

As a centrally acting skeletal muscle relaxant, baclofen causes drowsiness.

Question 10

Dantrolene is prescribed intravenously for a client to:

Answer 10

prevent development of malignant hyperthermia.

Question 11

The nurse knows that when caring for clients being treated with neuromuscular blocking agents, what drug should be available?

Answer 11

pyridostigmine-This is one of the antidotal agents to reverse the effects of neuromuscular blocking agents. Edrophonium is the other antidotal agent.

Question 12

When instructing a client about dantrolene, the nurse should:

Answer 12

inform client to avoid direct sunlight.-can cause photosensitivity.

Question 13

A 40-year-old woman receiving estrogen therapy has a new prescription for dantrolene. The nurse should monitor the client for:

Answer 13

hepatotoxicity. Women clients over 35 years of age and receiving estrogen therapy are at risk for hepatotoxicity when using dantrolene.

Question 14

A client with myasthenia gravis is prescribed pyridostigmine bromide (Mestinon) to:

Answer 14

increase concentration of acetylcholine.

Mestinon inhibits cholinesterase to increase concentration of acetylcholine.

Question 15

A client is scheduled for a diagnostic test to see if the client has myasthenia gravis (MG). The nurse prepares what medication for this test?

Answer 15

edrophonium - Edrophonium is a skeletal muscle stimulant used to diagnose MG.

Question 16

When caring for a client receiving pyridostigmine bromide (Mestinon), the nurse should:

Answer 16

monitor for cholinergic crisis.

Question 17

A client receiving pyridostigmine bromide (Mestinon) develops muscle weakness, difficulty breathing, and difficulty swallowing. The nurse should:

Answer 17

prepare to administer atropine sulfate.
These are manifestations of cholinergic crisis, a critical adverse effect of pyridostigmine treatment, and atropine sulfate is an anticholinergic treatment for this.

Question 18

When instructing a client receiving pyridostigmine about self-administration at home, which client comment indicates that the client understands the teaching?

Answer 18

“I must take my medication exactly on time.”

Question 19

A client is diagnosed with restless legs syndrome (RLS). The nurse anticipates which of the following agents specifically approved for the treatment of RLS to be prescribed for this client?

Answer 19

ropinirole

Question 20

When obtaining the history from a client with primary RLS, the nurse expects complaints that symptoms are:

Answer 20

worse in the evening and at bedtime.

Question 21

A client from the nursing unit in radiology for a chest radiograph is scheduled to receive pyridostigmine bromide at 1700. At 1645, the client has not returned to the nursing unit from x-ray. The nurse should:

Answer 21

take the medication to the client in radiology, so it can be administered at 1700.

Question 22

A client is prescribed atropine sulfate 2 mg IV stat. The pharmacy supplies atropine sulfate 0.8 mg/mL. The nurse should administer:

Answer 22

2.5 mL.-2 mg divided by 0.8 mg = 2.5; multiplied by 1 mL = 2.5 mL.

Question 23

A client is prescribed ropinirole HCl 2.25 mg by mouth in three divided doses daily. The pharmacy supplies ropinirole 0.5 mg tablets. The nurse should administer how many tablets per dose?

Answer 23

1 1/2 tablets

2.25 divided by 0.5 = 4.5 tablets; divided by 3 doses = 1 1/2 tablets per dose.

Question 24

The nurse recruit is preparing to administer the medication doxacurium chloride. As she explains this medication to her instructor, which of the following statements would be incorrect?

Answer 24

“I will discard any unused portion of diluted drug after 24 hours.”

Any unused portion of diluted drug should be discarded after 8 hours, not 24 hours.

Question 25

Which of the following statements made by the nurse recruit indicates an understanding of the drug Norflex?

Answer 25

“It is a diphenhydramine derivative with anticholinergic effects.”

Question 26

The client is receiving treatment for osteoporosis, and the prescription is for human monoclonal antibody. The nurse would prepare to administer the medication:

Answer 26

SC-Human monoclonal antibody is administered SC.

Question 27

A nurse assessing a client with myasthenia gravis (MG) should include what information in the assessment of this client? Select all that apply.

Answer 27

a. forced vital capacity
b. presence of ptosis
c. negative inspiratory force
d. muscle strength
e. vital signs

Question 28

The nurse recruit has a new client who is receiving tizanidine HCl. Which of the following statements indicates an understanding of this medication and its effects? Select all that apply.

Answer 28

b. “I can open the capsule and sprinkle the contents on applesauce if the client will be consuming the food immediately.”
c. “I will need to monitor the BP.”
d. “To discontinue therapy, the drug must be tapered over a 1- to 2-week period.”
e. “Alcohol causes additive CNS depression.

Question 29

Which of the following statements are true of RLS? Select all that apply.

Answer 29

a. Symptoms are relieved temporarily by movement.
b. It is triggered by inactivity.
c. It may interfere with ADL.
d. Caffeine may be a trigger.
e. It follows a circadian pattern.

Question 30

Clients who receive oral Boniva should be monitored for which of the following? Select all that apply.

Answer 30

a. dyspepsia
b. back pain
c. headache
d. skin rash
e. diarrhea
f. abdominal pain