Page 2162 - Saunders Comprehensive Review For NCLEX-RN

Answers

754. Answer: 2

Rationale: Infection and pancytopenia are adverse effects of etanercept.
Laboratory studies are performed prior to and during medication treatment. The
appearance of abnormal white blood cell counts and abnormal platelet counts can
alert the nurse to a potentially life-threatening infection. Injection site itching is a
common occurrence following administration. A metallic taste and loss of appetite
are not common signs of adverse effects of this medication.
Test-Taking Strategy: Note the strategic words, most important. Option 4 can be
eliminated because this is not a common adverse effect. In early treatment, residual
fatigue and joint pain may still be apparent. For the remaining options, the correct
option monitors for a hematological disorder, which could indicate a reason for
discontinuing this medication and should be reported.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Assessment
Content Area: Pharmacology: Musculoskeletal Medications: Antiarthritic
Medications
Health Problem: Adult Health: Musculoskeletal: Rheumatoid arthritis and
osteoarthritis
Priority Concepts: Clinical Judgment; Safety
Reference: Skidmore-Roth (2017), p. 472.

755. Answer: 1

Rationale: Clients taking allopurinol are encouraged to drink 3000 mL of fluid a
day, unless otherwise contraindicated. A full therapeutic effect may take 1 week or
longer. Allopurinol is to be given with, or immediately after, meals or milk. A client
who develops a rash, irritation of the eyes, or swelling of the lips or mouth should
contact the primary health care provider because this may indicate hypersensitivity.
Test-Taking Strategy: Focus on the subject, client instructions for allopurinol.
Option 4 can be eliminated easily because it indicates hypersensitivity, which is not a
normal expected response. From the remaining options, recalling that this
medication is used to treat gout and recalling the pathophysiology of this disorder
will direct you to the correct option.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Teaching and Learning
Content Area: Pharmacology: Musculoskeletal Medications: Antigout
Health Problem: Adult Health: Musculoskeletal: Gout
Priority Concepts: Client Education; Safety
Reference: Ignatavicius, Workman, Rebar (2018), pp. 331-332.

756. Answer: 2

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