ATI: Pain and Inflammation (Pharmacology Made Easy 4.0)

A provider prescribes prednisone for a client who has T1DM. Recognizing the risk for an adverse drug reaction to the prednisone, which of the following precautions should the primary care provider take for this client? a. Reduce the insulin dose b. Increase carbohydrate intake c. Reduce the prednisone dose d. Increase serum glucose monitoring

d. Increase serum glucose monitoring

A nurse is planning care for a client who has started taking prednisone. Which of the following interventions should the nurse include? a. Monitor the client's blood glucose b. Administer an antacid 30 min prior c. Administer aspirin rather than NSAIDS if client has pain d. Monitor for hyperkalemia

a. Monitor the client's blood glucose -Prednisone can cause hyperglycemia. The nurse should monitor the client's blood glucose regularly.

A nurse is caring for a client who takes low-dose aspirin to prevent CV events. The client asks the nurse about taking ibuprofen to treat rheumatoid arthritis. Which of the following responses should the nurse make? a. Ibuprofen will increase your risk for developing salicylism b. Ibuprofen will reduce the cardioprotective effects of low-dose aspirin c. Low dose aspirin will reduce the anti-inflammatory effects of ibuprofen d. Low dose aspirin will reduce the analgesic effects of ibuprofen

b. Ibuprofen will reduce the cardioprotective effects of low-dose aspirin -Ibuprofen, an NSAID, reduces the cardioprotective effects of low-dose aspirin. Clients taking low-dose aspirin for its ability to decrease platelet aggregation should not take ibuprofen.

A nurse is caring for a client who currently takes furosemide and has a new prescription for prednisone. The nurse should monitor the client for which of the following manifestations during concurrent use of the 2 drugs? a. Hypercalcemia b. Hypoglycemia c. Hypothermia d. Hypokalemia

d. Hypokalemia -Prednisone, a glucocorticoid, can cause hypokalemia. The risk for this electrolyte imbalance increases when the client is taking potassium-depleting diuretics, such as furosemide. The nurse should clarify the prescription with the provider and monitor the client's potassium levels.

A nurse is caring for a client who has a new prescription for celecoxib. The nurse should tell the client to report which of the following adverse drug reactions? a. Tinnitus b. Chest pain c. Constipation d. Diaphoresis

b. Chest pain -Celecoxib, a COX-2 inhibitor, can cause cardiovascular or cerebrovascular events. Clients should report chest pain, shortness of breath, headache, numbness, weakness, or confusion. Providers should prescribe the lowest effective dosage of the drug for the shortest time period possible.

A nurse is reviewing the medical record of a client who reports taking acetaminophen at home. The nurse should identify that which of the following client conditions is a contraindication for acetaminophen? a. Asthma b. Diabetes mellitus d. Heart failure d. Alcohol use disorder

d. Alcohol use disorder -Acetaminophen can cause liver toxicity. Clients who have a history of alcohol use disorder should not take acetaminophen.

Classes of drugs: Ibuprofen = Prednisone = Naloxone = Morphine =

Ibuprofen = NSAID Prednisone = Glucocorticoid Naloxone = Opioid antagonist Morphine = Opioid analgesic

A nurse is teaching a client who has a new prescription for allopurinol. Which of the following instructions should the nurse include? a. Avoid driving or activities that require mental alertness. b. Avoid crushing tablets. c. Limit fluid intake during therapy. d. Limit K while taking allopurinol.

a. Avoid driving or activities that require mental alertness. -Allopurinol can cause drowsiness. The nurse should instruct the client to avoid driving or activities that require mental alertness until they know the effect the drug will have on them.

Therapeutic Use: Butorphanol - Acetaminophen - Prednisone - Morphine -

Butorphanol - Anesthesia adjunct Acetaminophen - Fever reduction Prednisone - Prevention of organ rejection Morphine - Sedation

A client is about to start taking tramadol to treat moderate pain. Which of the following instructions should you include when talking with the client about taking this drug? a. Allow 1 hr for it to take effect b. Take it on an empty stomach c. Chew the ER tablets d. Do not take it with grapefruit juice

a. Allow 1 hr for it to take effect

A client is about to begin celecoxib therapy for osteoarthritis. You should instruct the client to watch for and report which of the following possible indications of a serious reaction to this drug? a. Black, tarry stools b. Polyuria c. Bone pain d. Dry mouth

a. Black, tarry stools

A nurse is caring for a client who is taking acetaminophen at regular intervals for mild discomfort. The nurse should tell the client to report which of the following early indications of acetaminophen toxicity? (SATA). a. Diaphoresis b. Palpations c. SOB d. Nausea e. Diarrhea

a. Diaphoresis d. Nausea e. Diarrhea

As the health care provider prepares to give the client morphine IV for pain, she makes sure she has which of the following drugs available? a. Naloxone b. Protamine sulfate c. Flumazenil d. Physostigmine

a. Naloxone

A client is about to start taking oral morphine to treat acute pain from an injury. Which of the following instructions should you include when talking with the client about taking morphine? (SATA) a. Take it with food b. Rise slowly from sitting/reclining c. Take it on a fixed schedule d. Increase fluid/fiber intake e. Do not take before driving.

a. Take it with food b. Rise slowly from sitting/reclining d. Increase fluid/fiber intake e. Do not take before driving.

Butorphanol is an unsafe analgesic choice for clients who: a. take glucocorticoids for rheumatoid arthritis b. use a fentanyl patch for chronic pain c. have T1DM and use an insulin pump d. take warfarin for thrombophlebitis

b. use a fentanyl patch for chronic pain

A nurse is reviewing the medical record of a client who has a new prescription for celecoxib. The nurse should identify that which of the following conditions is a contraindication to celecoxib? a. Rheumatoid arthritis b. Ankylosing spondylitis c. Sulfonamide allergy d. Adrenocortical insufficiency

c. Sulfonamide allergy -Clients who are allergic to sulfonamides can have severe allergic reactions to celecoxib, a COX-2 inhibitor. Clients who are allergic to salicylates can also react adversely to celecoxib.

A nurse is caring for a client who has a prescription for aspirin to treat an ankle sprain. The nurse should instruct the client to report which of the following adverse drug reactions? a. Polyuria b. Bone pain c. Weight gain d. Infection

c. Weight gain -Aspirin use can cause renal impairment, which can result in the retention of salt and water. Clients should report reduced urine output, weight gain, edema, or bloating. The nurse should monitor BUN and creatinine levels and stop aspirin therapy for clients who develop signs of renal dysfunction.

A nurse is reviewing the drug list for a client who has a new prescription for allopurinol. The nurse should identify that which of the following drugs interacts with allopurinol? a. Warfarin b. Ibuprofen c. Insulin d. Furosemide

a. Warfarin -Allopurinol can increase the effectiveness of warfarin. A lower dosage of warfarin might be required.

A nurse is teaching a client who is taking allopurinol about minimizing adverse effects. Which of the following instructions should the nurse include? a. Eat a small meal before taking the drug. b. Suck on hard candy or chew gum. c. Take a stool softener daily d. Avoid the use of NSAIDS

a. Eat a small meal before taking the drug. -Taking allopurinol after eating a meal or drinking a glass of milk can prevent stomach upset.

A nurse is caring for a client who is about to report which of the following manifestations of Salicylism? (SATA) a. Fever b. Tinnitus c. Diaphoresis d. Thrombophlebitis e. Dizziness

a. Fever b. Tinnitus c. Diaphoresis e. Dizziness

A nurse is caring for a client who is taking naloxone to treat acute morphine toxicity. The nurse should monitor the client for which of the following adverse drug reactions? (SATA) a. Increase RR b. Increased pain c. Thrombophlebitis d. Ventricular arrythmias e. Hypertension

a. Increase RR b. Increased pain d. Ventricular arrythmias e. Hypertension

A nurse is teaching a client who has a new prescription for tramadol. Which of the following instructions should the nurse include? (SATA). a. Increase fiber/fluid intake b. Take drug with food c. Avoid driving after taking the drug d. Change positions gradually e. Reduce exercise level temporarily

a. Increase fiber/fluid intake b. Take drug with food c. Avoid driving after taking the drug d. Change positions gradually

A nurse is caring for a client who asks about taking acetaminophen. The nurse should identify acetaminophen is indicated for which of the following conditions? (SATA) a. reduce fever b. decrease inflammation c. relieve mild pain d. promote sedation e. alleviate anxiety

a. reduce fever c. relieve mild pain

A nurse is teaching a client who has a new prescription for prednisone. Which of the following instructions should the nurse include? (SATA). a. Reduce the dose during periods of stress b. Discontinue the drug gradually c. Report illness or infection d. Increase intake of calcium and vitamin D e. Monitor for signs of gastric bleeding

b. Discontinue the drug gradually c. Report illness or infection d. Increase intake of calcium and vitamin D e. Monitor for signs of gastric bleeding

A client who is receiving chemotherapy take allopurinol prior to the chemotherapy to reduce the risk for which condition? a. Agranulocytosis b. Hyperuricemia c. Aplastic anemia d. Thrombocytopenia

b. Hyperuricemia

A nurse is reviewing the medical record of a client who has a new prescription for tramadol. The nurse should identify that which of the following conditions is a contraindication for tramadol? a. Hyperthyroidism b. Seizure disorder c. Rheumatoid arthritis d. Urinary incontinence

b. Seizure disorder -Tramadol, a nonopioid analgesic, can cause seizure activity. Clients who have seizure disorders, head injuries, or increased intracranial pressure should not take tramadol.

A nurse is teaching a client who has a new prescription for allopurinol. The nurse should instruct the client to report which of the following adverse drug reactions? (SATA). a. Palpations b. Sore throat c. Vertigo d. Bruising e. Vision changes

b. Sore throat c. Vertigo d. Bruising e. Vision changes

Which of the following instructions should the health care provider give the client regarding the use of aspirin prior to the surgery? a. Continue to take it once a day b. Stop taking it 1 week before surgery c. Increase the dose to twice a day d. Reduce the dose to every other day

b. Stop taking it 1 week before surgery

A nurse is caring for a client who is receiving morphine to relieve severe pain. The nurse should monitor the client for which of the following adverse drug reactions? (SATA) a. Diarrhea b. Urinary retention c. Respiratory depression d. Sedation e. Orthostatic hypotension

b. Urinary retention c. Respiratory depression d. Sedation e. Orthostatic hypotension

A nurse is caring for a client who is opioid dependent and has a new prescription for butorphanol. The nurse should monitor the client for which of the following manifestations of abstinence syndrome? (SATA) a. Bronchospasm b. Vomiting c. Peripheral edema d. Abdominal cramps e. Hypertension

b. Vomiting d. Abdominal cramps e. Hypertension

Because the client is taking celecoxib (Celebrex) for osteoarthritis, he knows to watch for an report which of the following possible indications of an adverse reaction to celecoxib? a. Tinnitus b. Weight gain c. Anxiety d. Tremors

b. Weight gain

A client arrives to the ER immediately following an acetaminophen overdose. Which drug should you prepare to administer? a. Atropine b. Naloxone c. Acetylcysteine d. Flumazenil

c. Acetylcysteine (a mucolytic)

A nurse is caring for a client who has a new prescription for prednisone for long-term tx of rheumatoid arthritis. The nurse should monitor the client for which of the following adverse drug reactions? a. Pulmonary embolism b. Hepatitis c. Bone loss d. Breast cancer

c. Bone loss -Prednisone, a glucocorticoid, can cause osteoporosis, especially with long-term use. Clients who are taking the drug should increase weight-bearing activity and report back pain. The nurse should monitor the client's bone density.

In addition to celecoxib, the client takes low-dose aspirin daily for which of the following purposes? a. Decreases the risk for anaphylaxis b. Potentiates the therapeutic effects of celecoxib c. Reduces the risk of a cardiovascular event d. Increases renal perfusion

c. Reduces the risk of a cardiovascular event

A nurse is caring for a group of postop clients. The nurse should identify that morphine is contraindicated for which of the following clients? a. A client who had a mastectomy. b. A client who had a knee arthroplasty. c. A client who had a colectomy. d. A client who had a cholecystectomy.

d. A client who had a cholecystectomy. -Morphine can cause biliary colic. It should not be administered to a client who has just had biliary tract surgery, such as a cholecystectomy.

A client is about to start taking aspirin to prevent cardiovascular events. You should instruct the client to watch for and report which adverse drug reaction of aspirin? a. Dyspnea b. Constipation c. Calf pain d. Petechiae

d. Petechiae

The health care provider prepares to give the client morphine IV for pain. Knowing the adverse drug reactions of morphine, she should monitor the client for which of the following? a. Jaundice b. Fever c. Hypertension d. Respiratory depression

d. Respiratory depression

A nurse is caring for a client who is taking allopurinol to treat gout. The nurse should monitor the client for which of the following manifestations of hypersensitivity syndrome? a. Muscle pain b. Fever c. Anxiety d. Tremors

b. Fever -Allopurinol, an antigout drug, can cause hypersensitivity syndrome. The nurse should monitor the client for rash, itching, or fever, as manifestations of hypersensitivity syndrome, which can lead to renal or liver dysfunction. Clients who develop this type of reaction should stop taking the drug.

A nurse is caring for a client who has a new prescription for butorphanol. The nurse should monitor the client for which of the following adverse drug reactions? (SATA). a. Infection b. Nausea c. Tachycardia d. Dizziness e. Headache

b. Nausea d. Dizziness e. Headache

A nurse is caring for a child who has a viral infection. The nurse should identify that which of the following drugs can increase the risk of Reye syndrome in children who have viral infections? a. Butorphanol b. Acetaminophen c. Tramadol d. Aspirin

d. Aspirin -Aspirin can increase the risk for Reye syndrome in children who have a viral infection, particularly chickenpox or influenza. Manifestations of Reye syndrome include lethargy and persistent vomiting.