Chapter 33

The client experienced a sports-related injury to his leg. During the morning assessment, what signs of inflammation will the nurse most likely assess? Standard Text: Select all that apply. 1. Swelling 2. Pain 3. Warmth 4. Pallor 5. Pitting edema

1,2,3

Which client statement would the nurse evaluate as indicating the goal of treatment with an anti-inflammatory drug has been met? Standard Text: Select all that apply. 1. "My fever went away yesterday." 2. "I've not been coughing up so much phlegm." 3. "The skin over my knee is red and hot to the touch." 4. "The pain in my shoulder is much relieved." 5. "My rash is spreading."

1,4

A client has just been prescribed ibuprofen for a mild ankle sprain. Which health history information should alert the nurse to question this prescription? Standard Text: Select all that apply. 1. The client has asthma. 2. The client had a similar ankle strain a year ago. 3. The client reports getting a rash when eating strawberries. 4. The client is allergic to aspirin. 5. The client reports having a peptic ulcer 6 months ago.

1,4,5

The client receives a nonsteroidal anti-inflammatory drug (NSAID) for treatment of arthritis. What is a priority for the nurse to include when doing medication education? 1. "Constipation is common; include roughage in your diet." 2. "Drink at least eight glasses of water a day." 3. "Take your medication with food." 4. "Take your medication on an empty stomach."

2

The nurse conducts group education for clients with seasonal allergies and teaches about the role of histamine. The nurse evaluates that the education has been effective when the clients make which statement? 1. "Histamine is inhibited by nonsteroidal anti-inflammatory drugs (NSAIDs). 2. "Histamine dilates the vessels in the nose, so it is congested and stuffy." 3. "Histamine constricts vessels, causing capillaries to become more permeable." 4. "Histamine is primarily stored in phagocyte cells in the skin."

2

A client presents with a rash and is prescribed an over-the-counter ointment for treatment. The client says, "I thought I would need a shot or an expensive prescription." How should the nurse respond? Standard Text: Select all that apply. 1. "Medications that go on your skin don't usually have as many side effects." 2. "Mild rashes often respond well to topical ointments." 3. "Many of the products used on the skin are available over-the-counter." 4. "You should try to discover what caused your rash." 5. "Prescription ointments are usually better at healing."

1,2,3,4

The nurse is explaining inflammation to a patient who has Crohn's disease. Which information should the nurse provide? Standard Text: Select all that apply. 1. When cells are damaged nearby vessels get bigger. 2. The vessels in the area allow fluids to escape. 3. Inflammation produces pus. 4. Inflammation causes bleeding and inability to clot. 5. Inflammation causes pain.

1,2,3,5

A patient has been prescribed a short course of high dose aspirin. The nurse would educate the patient to monitor for which findings associated with salicylism? Select all that apply apply. 1. Tinnitus 2. Excessive sweating 3. Cold chills 4. Headache 5. Bloating

1,2,4

The client receives prednisone as treatment for his inflammatory disease. He has experienced great relief and asks the nurse if he can just keep taking this medication. What is the best response by the nurse? 1. "No, because this medication has serious adverse effects." 2. "No, your doctor said the best treatment for your illness is to alternate medications." 3. "No, your body would get used to it and it would lose its effectiveness." 4. "No, because your illness is in remission and you don't need medication now."

1

The nurse teaches clients with rheumatoid arthritis about the side effects of nonsteroidal anti-inflammatory drugs (NSAIDs). The nurse evaluates that education has been effective when the clients make which statement? 1. "Blood tests may be necessary to monitor for side effects of this drug." 2. "We must be careful about falling with this medication because it can cause drowsiness." 3. "We must take the medicine just as the doctor said to take it." 4. "We must be sure and keep all scheduled doctors' appointments."

1

Which finding is a sign or symptom of inflammation? 1. Redness 2. Cyanosis 3. Dizziness 4. Cold skin

1

A patient presents with an intermittent fever of unknown origin. The nurse reviews the patient's medication history and identifies which medications that may be implicated in fever? Standard Text: Select all that apply. 1. Paroxetine (Paxil) 2. Chlorpromazine (Thorazine) 3. Vitamin E 4. Metformin (Glucophage) 5. Furosemide (Lasix)

1,2

A patient reports that he has been taking aspirin to treat the muscle pain that results from his new walking routine. The nurse would be concerned about this treatment plan if the patient has which history? Standard Text: Select all that apply. 1. Myocardial infarction at age 61 2. Helicobacter pylori infection treatment last month 3. No influenza vaccine in last 2 years 4. Mild hypertension 5. History of migraine headaches

1,2

A client is taking aspirin (ASA) for arthritis. The nurse will advise the client to take the medication 1. with a glass of milk. 2. with other medications. 3. with orange juice at bedtime. 4. on an empty stomach in the morning.

1

Acetaminophen reduces fever by 1. directly acting on the hypothalamus. 2. inhibiting prostaglandins. 3. blocking impulses to the brain. 4. affecting nerve fibers.

1

The client has been taking hydrocortisone (Cortef) for a month and abruptly stops it. What will the best assessment by the nurse include? 1. Fatigue and anorexia 2. Hyperglycemia and depression 3. Dilated pupils and auditory hallucinations 4. Tachycardia and weight gain

1

A patient has been prescribed a second 10-day course of a corticosteroid. The nurse should provide which medication education? Standard Text: Select all that apply. 1. "Make certain you do weight-bearing exercises at least three times each week." 2. "Weigh yourself every day." 3. "Let us know if you development a fever." 4. "Monitor the color of your urine." 5. "If you feel jittery or anxious, discontinue the medication."

1,2,3

The nurse plans to teach a class on acetaminophen (Tylenol) to mothers with young children. What will the best plan by the nurse include? 1. "It is best to give your child acetaminophen (Tylenol) with a high-carbohydrate meal." 2. "Read the labels of all over-the-counter (OTC) medications for the amount of acetaminophen (Tylenol) in them." 3. "Acetaminophen (Tylenol) will only need to be given once a day because it is long-lasting." 4. "It is okay to substitute a baby aspirin for acetaminophen (Tylenol) if you run out of acetaminophen (Tylenol)."

2

The physician orders acetaminophen (Tylenol) four time a day for a client with arthritis. The nurse would plan to validate which other order with the physician? 1. Heparin 5000 units subcutaneously every 8 hours 2. Warfarin (Coumadin) 2 mg orally every day 3. Penicillin G benzathine (Bicillin LA) 2.4 million units IM one time 4. Paroxetine (Paxil) 37.5 mg orally every day

2

A client presents with severe inflammation of the knee. The physician prescribes a corticosteroid and asks the client to return to the office in 10 days for follow-up. How does the nurse explain these instructions? Standard Text: Select all that apply. 1. "We need to check to see if this is the correct treatment." 2. "We need to re-examine the knee after a few days of treatment." 3. "Corticosteroids should only be taken for 1 to 3 weeks." 4. "You may be able to change to an NSAID at that visit." 5. "You may need a 3-month prescription for a stronger corticosteroid at that time."

2,3,4

The nurse is managing care for clients who will receive ibuprofen (Advil) for long-term therapy. What are the primary laboratory tests the nurse will assess prior to initiation of therapy? Standard Text: Select all that apply. 1. Electrolytes 2. Hemoglobin and hematocrit 3. Bleeding times 4. Liver function tests 5. Serum amylase

2,3,4

A client is placed on aspirin. A toxic reaction to this medication that the nurse will teach the client to report is 1. blurred vision. 2. muscle cramps. 3. tinnitus. 4. joint pain.

3

After the client begins taking glucocorticoid medications, the nurse would observe for adverse effects of 1. hypoglycemia. 2. hypotension. 3. bruising. 4. weight loss.

3

The client has experienced a sports-related injury. He asks the nurse how long it will take for him to respond to treatment. What is the best response by the nurse? 1. "With proper care, it will take about a month for symptoms to resolve." 2. "It will depend on your response to the medications." 3. "It will take about a week and a half for symptoms to resolve." 4. "The inflammatory process is too complex to predict a time frame for healing."

3

The nurse in the emergency department frequently sees clients who have overdosed on acetaminophen (Tylenol). Which client is at highest risk for developing hemolysis? 1. A Native American client 2. A Jewish client 3. An African American client 4. A Caucasian client

3

The nurse plans care for an older adult receiving nonsteroidal anti-inflammatory drug (NSAID) therapy. What is the best outcome for this client as it relates to side effects of nonsteroidal anti-inflammatory drugs (NSAIDs)? 1. The client will refrain from taking other medications with the nonsteroidal anti-inflammatory drug (NSAID). 2. The client will avoid the use of caffeine while taking the nonsteroidal anti-inflammatory drug (NSAID). 3. The client will report any bleeding or bruising while taking the nonsteroidal anti-inflammatory drug (NSAID). 4. The client will report any mood changes while taking the nonsteroidal anti-inflammatory drug (NSAID).

3

The nurse teaches a group of clients with arthritis about the use of ibuprofen (Motrin), emphasizing the maximum daily amount. The nurse evaluates that education has been most effective when the clients make which statement? 1. "We cannot take over 4000 mg/day." 2. "We cannot take over 3600 mg/day." 3. "We cannot take over 3200 mg/day." 4. "We cannot take over 3000 mg/day."

3

Which finding is a common adverse effect of anti-inflammatory drugs, such as ibuprofen? 1. Diarrhea 2. Palpitations 3. Heartburn 4. Hypotension

3

A mother calls the clinic and tells the nurse that her 4-month-old baby has a fever. The mother asks if she can use the liquid acetaminophen (Tylenol) that is used for her 10-year-old child. What is the best response by the nurse? 1. "Infants should not have acetaminophen (Tylenol) because it damages the liver." 2. "It is best if the pediatrician is called; he can be asked this question." 3. "It is fine to use the same medicine for both children." 4. "Infant drops should be used for the baby; they are different from liquid medicine."

4

Histamine release produces which response? 1. Bronchodilation 2. Vasoconstriction 3. Diarrhea 4. Vasodilation

4