Chapter 16: Anti-inflammatory, Anti-arthritis, and Related Agents
A child w/ juvenile arthritis has been prescribed auranofin 0.125 mg/kg/day PO. The pt weights 88 lb. How many milligrams of auranofin should the nurse administer each day?
5 mg; lb-->kg then kg X 0.125 mg
A pt has been given acetaminophen to reduce a fever. How will this be achieved? A) Acting directly on thermoregulatory cells in the hypothalamus B) Reducing inflammation by inhibiting prostaglandins C) Increasing fluid reabsorption in the kidney to reduce fever D) Causing vasodilation, allowing heat to be expelled from the body
A
A pt has developed a fever. What aspect of the pts health history would contraindicate the safe and effective use of acetaminophen? A) The pt has hepatitis C and abuses alcohol B) The pt was prescribed diclofenac for back pain and did not experience pain relief C) The pt had an allergic rxn to penicillin during a previous admission D) The pts most recent hospital admission was because of seizures, which were treated with benzodiazepines
A
A pt w/ chronic pain has been prescribed a salicylate. The nurse should expect what med on their pts medication administration record? A) Diflunisal B) Indomethacin C) Piroxicam D) Celecoxib
A
A pt w/ rheumatoid arthritis is relieved to have less pain and inflammation since a change in medications. The nurse is aware that the new med inhibits phagocytosis and prevents the release of lysosomal enzymes. What med classification is this pt receiving? A) Gold salts B) DMARDs C) Salicylates D) NSAIDs
A
Pts taking NSAIDs should be taught to avoid the use of OTC meds without checking w/ their prescriber because: A) Many of the OTC preparations contain NSAIDs, and inadvertent toxicity could occur B) No one should take more than one type of pain reliever at a time C) Increased GI upset could occur D) There is a risk of Reye syndrome
A
SATA. A pt is being treated for severe rheumatoid arthritis. The nurse could anticipate treatment with which of the following? A) Etanercept-TNF blocker B) Gold therapy C) Hylan G-F 20---hylans with elastic properties D) Ketoprofen E) Interferon beta-2a F) Methotrexate
A B C F
A pt who is taking salicylate present to the ED for eval. What assessment findings should lead the nurse to suspect acute salicylate toxicity? Select all that apply A) Respiratory rate of 38 B) Muscle spasms C) Tinnitus D) Agitaiton E) Diarrhea
A, B & D
A pt experiences intense knee pain due to arthritis and the use of a hyaluronidase derivative is being considered. What assessment finding must be considered? A) Allergies to shellfish or diagnostic contrast solution B) Whether the pt is comfortable having an injection into the knee joint C) The pt's expectation for future mobility D) The pt's adherence to previous medication regimens
B
A pt is receiving auranofin as treatment for rheumatoid arthritis. The nurse should expect this drug to be given by which route? A) Subcutaneous B) PO C) IM D) IV
B
A pt is to receive Etanercept. What characteristic of the pt may contraindicate the use of this medication? A) Employment involving heavy machinery B) Fear of injections C) Occasional dysphagia D) Lack of social support
B
A pt w/ acute joint inflammation tells the nurse, "I've been taking acetaminophen as it's ordered on the bottle, but my swelling and inflammation don't seem to be getting better." What should the nurse teach the pt? A) "It takes some people a few weeks to feel a difference." B) "Acetaminophen has no effect no inflammation." C) "Acetaminophen's only clinical use is for pain treatment." D) "Keep taking it as ordered, and watch for any signs of bleeding."
B
A pt w/ intractable rheumatoid arthritis has been prescribed a gold salt. What med should the nurse look for on the pts medication administration record? A) Anakinra B) Auranofin C) Mesalamine D) Celecoxib
B
A pts history reveals an allergy to sulfonamides. The nurse understands that which drug would be contraindicated? A) Diclofenac B) Celecoxib C) Naproxen D) Ibuprofen
B
The nonsteroidal NSAIDs affect the COX-1 and COX-2 enzymes. By blocking COX-2 enzymes the NSAIDs block inflammation and the signs and symptoms of inflammation at the site of injury or trauma. By blocking COX-1 enzymes these drugs block: A) Fever regulation B) Prostaglandins that protect the stomach lining C) Swelling in the periphery D) Liver function
B
The nurse would question the physician who prescribed NSAIDs for which pt? A) The pt diagnosed w/ diabetes B) The pt diagnosed w/ peptic ulcers C) The pt. diagnosed w/ psoriasis D) The postpartum pt who had a vaginal birth
B
What salicylate would be appropriate for treating inflammation in a client w/ ulcerative colitis? Select all that apply A) Salsalate B) Balsalazide C) Mesalamine D) Aspirin E) Olsalazine
B, C, & E
A pt w/ dysmenorrhea has been prescribed naproxen 1,250 mg PO b.i.d. What is the nurse's best action? A) Assess the pts baseline renal and hepatic status B) Question the prescriber about the dose C) Question the prescribe about the route D) Question the prescriber about the frequency
B; usually 250-500 mg PO b.i.d
A parent has sought care from the nurse practitioner to treat a child's fever. The nurse practitioner is most likely to recommend what drug? A) Indomethacin B) Naproxen C) Acetaminophen D) Ibuprofen
C
A pt w/ a history of chronic pain is scheduled to undergo a colonoscopy. What health education should the nurse provide the pt? A) "Some pts have some discomfort during a colonoscopy, but the provider will likely give you an anti-inflammatory before it." B) "It's very important that you write down every drug that your'e allergic to and bring it to your appt." C) "Confirm w/ your provider, but you'll likely have to stop taking aspirin 1 week before the procedure." D) "Make sure not to take any Tylenol for at least 3 days before the day of the procedure."
C
A pt w/ rheumatoid arthritis who is on a fixed income and who is being treated w/ aspirin should be advised: A) To use only brand name aspirin B) To use only enteric-coated aspirin C) To use generic aspirin D) To switch to one of the NSAIDs
C
A pt was given 400 mg ibuprofen PO at approx. 10:00 hours for the treatment of back pain. The pt would most likely feel peak effects of the drug at which time? A) 12:30 B) 10:30 C) 11:30 D) 13:30
C
A pt with rheumatoid arthritis is prescribed Penicillamine. What should the nurse teach the pt about this medication? A) The pt should avoid Acetaminophen during treatment B) Monthly injections are necessary C) Improvement in symptoms may take 2-3 months D) Weekly injections are necessary
C
A pts care provider has recommended the use of acetaminophen to treat the pts pain. What should the nurse teach the pt about the safe and effective use of acetaminophen? A) "Take the med w/ food to prevent GI upset." B) "Avoid excessive doses because there is no antidote." C) "Avoid taking more than 3,000 mg in any 24 hour period." D) "Avoid drinking grapefruit juice w/ acetaminophen."
C
An antipyretic is a drug that can: A) Block pain B) Block swelling C) Block fever D) Block inflammation
C
Chronic or excessive activity by the inflammatory response can lead to: A) Loss of WBCs B) Coagulation problems C) Release of lysosomal enzymes and tissue destruction D) Adrenal suppression
C
Which conditions would contraindicate the use of gold salts? Select all that apply A) Asthma B) Cardiac arrhythmias C) Uncontrolled diabetes D) Blood dyscrasias E) Hypertension
C, D, E
The nurse notes an order for oxaprozin for the treatment of arthritis. Before administering the drug the nurse would assess the pt for the which problems that could be cautions or contraindications? Select all that apply A) Headaches B) Dysmenorrhea C) Active peptic ulcer disease D) Chronic obstructive pulmonary disease E) Renal impairment F) Bleeding disorders
C, E, F
A drug could be classified as an analgesic if it: A) Reduces fever B) Reduces swelling C) Reduces redness D) Reduces painD
D
A neonate born at 28 weeks gestation has been diagnosed w/ patent ductus arterioles. The nurse should anticipate what action? A) IV administration of naproxen Meloxicam C) Intramuscular injection of ketorolac D) Administration of indomethacin IV
D
A nurse might not see a salicylate used as an anti-inflammatory if a drug was needed for its: A) Antipyretic properties B) Analgesic properties C) OTC availability D) Parenteral availability
D
A pt is alarmed celecoxib is prescribed, stating, "I heard on TV that celecoxib causes heart attacks." How should the nurse best respond? A) "That was a scare that was entirely created by the media." B) "As long as you take your heart meds, you'll be fine." C) "A final decision from the FDA on whether celecoxib is safe will be released in 2018." D) "This drug hasn't been definitively proven to be unsafe, so it's still available."
D
An adult has been admitted to the ED after deliberately OD'ing on approximately 50 g of Tylenol. The nurse should prepare for what intervention? A) Intravenous administration of Lactated Ringer's B) Watchful waiting C) Administration of naloxone as prescribed D) Administration of acetylcysteine as prescribed
D
The nurse has conducted a health education session for new parents. After learning about the safe and effective use of anti-inflammatories, which statement by the parents indicates effective teaching? A) "We should use aspirin if our child develops symptoms of the flu" B) "We need to give the drug on an empty stomach or 2 hours after means." C) "We can temporarily give our child extra doses of acetaminophen if we need to do so." D) "We need to read the labels carefully for the ingredients and dosages."
D
Your pt has been receiving ibuprofen for many years to relieve the pain of osteoarthritis. Assessment of the pt should include: A) An electrocardiogram B) CBC w/ differential C) Respiratory auscultation D) Renal evaluation
D
True or False: African Americans are at lower risk for developing GI adverse effects with NSAIDs.
False
True or False: Gold compounds are commonly used as first-line therapy for the treatment of rheumatoid arthritis.
False
True or False: Blockage of COX-2 receptors results in sodium retention and increased blood pressure.
False; blocking COX-1 does this
True or False: NSAIDs have anti-inflammatory, antipyretic, and analgesic properties.
True
True or False: Rheumatoid factor interacts w/ circulating igG to form immune complexes that deposit in the joints, precipitating an inflammatory rxn.
True
