1. A nurse is preparing to administer diclofenac to a client
who has chronic bursitis. Which of the following actions
should the nurse take?
a. administer the medication at bedtime
b. avoid administering the medication with antacids
c. administer the medication with food
d. crush the medication prior to administration ANS Administer
the medication with food
Diclofenac is an NSAID and can cause gastric irritation. Clients should
take NSAIDs with food or milk to minimize gastric irritation.he nurse
should not admin- ister the medication at bedtime because the client
should remain upright for 15 to 30 min after administration to prevent
esophageal irritation. Diclofenac is available as an enteric-coated
tablet for delayed release. Clients should not crush or chew sustained-
release medications because doing so will increase gastrointestinal
adverse effects and decrease the effectiveness of the medication.
,2. A nurse is planning care for a client who has asthma and a
prescription for methylprednisolone. Which of the following
laboratory values should the nurse monitor while the client is
receiving this medication?
a. Aspartate aminotransferase (AST)
b. Fibrin split products
c. BUN
d. Glucose ANS Glucose
Methylprednisolone therapy increases the synthesis of glucose and
decreases the uptake of glucose by the muscles and adipose tissues,
resulting in increased circulating glucose. Therefore, it is important for
the nurse to monitor blood glucose levels regularly while clients are
receiving corticosteroid therapy.
Aspartate aminotransferase is an enzyme that is present in the heart,
liver, skeletal muscles, and other highly metabolic tissues. AST levels
are increased in conditions that cause cellular injury, such as liver
disease; however, methylprednisolone therapy does not affect AST
levels. Fibrin split products are present in the serum when thromboses
are present. Increased levels of fibrin split products can increase
disseminated intravascular coagulation (DIC); however,
methylprednisolone thera- py does not affect blood clotting. BUN levels
,reflect kidney function and glomerular filtration. Hydration status and
nephrotoxic medications can alter BUN levels; however,
methylprednisolone therapy does not affect renal function.
, 3. A nurse is caring for a client who is postmenopausal and
has a prescrip- tion for raloxifene. The nurse should instruct
the client that raloxifene is prescribed for which of the
following reasons?
a. To treat irritable bowel syndrome
b. To reduce the risk for breast cancer
c. To reduce the occurrence of hot flashes
d.To lower the risk of pulmonary embolism ANS To reduce the risk
for breast cancer
Raloxifene can lower the risk for breast cancer in postmenopausal
clients who have a high risk for developing estrogen-receptive types of
breast cancer. The medication also reduces the risk for and can treat
postmenopausal osteoporo- sis.Raloxifene is a selective estrogen
receptor modulator. In clients who are post- menopausal, it can reduce
the risk for and treat osteoporosis and protect against breast cancer.
Hot flashes are an adverse effect of raloxifene. Raloxifene reduces the
occurrence of fractures related to osteoporosis and reduces the
cholesterol level in clients who are postmenopausal.Raloxifene can
cause several significant cardiovascular and respiratory adverse
effects, such as thromboembolism, stroke, peripheral edema,
pneumonia, and the development of pulmonary emboli. Clients should
not take this medication prior to periods of prolonged immobilization,
such as surgery. A history of thromboembolic events is a
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