Pharmacology PrepU Chapter 16: Anit-Inflammatory & Anti-Arthritis Agents
A patient with arthritis is on NSAID therapy. What should be evaluated by the nurse to determine the effectiveness of NSAID therapy? A. Body temperature B. Better mobility C. Respiratory Rate D. Blood sugar
Better mobility
A 49-year-old woman has been diagnosed with myalgia. The health care provider has recommended aspirin. The client is concerned that the aspirin will upset her stomach. The nurse will encourage the client to take this medication by: A. crushing the tablet before swallowing. B. avoiding drinking milk for 3 hours after swallowing the tablet. C. swallowing the tablet whole. D. swallowing the tablet with milk or food.
swallowing the tablet with milk or food.
A client with acute joint inflammation tells the nurse , "I've been taking acetaminophen as it's ordered on the bottle, but my swelling and inflammation doesn't seem to be getting better." What should the nurse teach the client? A. "Acetaminophen has no effect on inflammation." B. "It takes some people a few weeks to feel a difference." C. "Keep taking it as ordered, and watch for any signs of bleeding." D. "Acetaminophen's only clinical use is for pain treatment."
"Acetaminophen has no effect on inflammation."
A female client reports a mild headache and is prescribed acetaminophen 325 mg, two tablets by mouth every 4 to 6 hours. The client states that she usually takes ibuprofen for her headaches and asks why the health care provider ordered acetaminophen. Which explanation would the nurse give? A. "Acetaminophen is often the initial drug of choice for relieving mild to moderate pain." B. "Acetaminophen is less expensive and more efficient for pain relief." C. "Acetaminophen is more effective than ibuprofen for headaches." D. "Acetaminophen will reduce the inflammation causing your headache."
"Acetaminophen is often the initial drug of choice for relieving mild to moderate pain."
Which instruction would be most important to include when teaching parents about OTC anti-inflammatory agents? A. "Make sure to give the drug on an empty stomach or before meals." B. "Aspirin is best for treating your child's flulike symptoms." C. "Refrain from using acetaminophen for the child's symptoms." D. "Be sure to read the label for the ingredients and dosage."
"Be sure to read the label for the ingredients and dosage."
The client has had an open reduction internal fixation ORIF of the right hip. Which statement by the client identifies that the use of celecoxib is effective? A. "I do not have a fever any longer." B. "My hip aches all of the time." C. "My hip pain has decreased." D. "My stomach doesn't burn today."
"My hip pain has decreased."
After teaching a local community group about the use of OTC anti-inflammatory agents, the nurse determines that the group needs additional teaching when they state: A. "We can easily overdose on them if we don't follow the directions." B. "These drugs are relatively safe since they don't have adverse effects." C. "Other signs and symptoms of an illness might not appear with these drugs." D. "The drugs might interact with other drugs and cause problems."
"These drugs are relatively safe since they don't have adverse effects."
What effects are exerted by aspirin? (Select all that apply.) A. Anti-infective B. Anti-inflammatory C. Antiviral D. Antipyretic E. Analgesic
-Analgesic -Antipyretic -Anti-inflammatory
What should a nurse recognize as a property of ibuprofen/Motrin? (Select all that apply.) A. Analgesic B. Anti-inflammatory C. Antipruritic D. Antibacterial E. Antipyretic
-Anti-inflammatory -Analgesic -Antipyretic
Nurses need to understand the basic mechanism of how a drug exerts its effects. Which are mechanisms by which NSAIDs elicit their effects? (Select all that apply.) A. Inhibition of platelet aggregation B. Inhibition of prostaglandins C. Inhibition of cyclooxygenase-1 D. Synthesis of cyclooxygenase-3 E. Synthesis of cyclooxygenase-2
-Inhibition of prostaglandins -Inhibition of cyclooxygenase-1
What conditions are salicylates are effective in managing? (Select all that apply.) A. Fever B. Infection C. Inflammation D. Pain E. GI upset
-Pain -Fever -Inflammation
The nurse instructs the client that with the use of NSAIDs some adverse reactions can occur. Which are they? Select all that apply. A. Dysmenorrhea B. Somnolence C. Hematuria D. Purpura E. Ecchymosis
-Somnolence -Hematuria -Purpura -Ecchymosis
A client was given 400 mg ibuprofen PO at approximately 000 hours for the treatment of back pain. The client would most likely feel peak effects of the drug at which time? A. 1230 B. 1030 C. 1130 D. 1330
1130
A nursing student correctly identifies a normal dose of aspirin for the adult client as which? A. 325 to 650 mg orally q 4 hours B. 1000 mg orally every morning C. 650 to 1000 mg orally q 4 hours D. 81 mg orally q 4 hours
325 to 650 mg orally q 4 hours
A 7-year-old child with juvenile arthritis has been prescribed auranofin 0.125 mg/kg/day PO. The client weighs 88 lbs. How many mg of auranofin should the nurse administer each day?
5 mg -2.2 lbs= 1 kg 88/2.2=40 40 x 0.125=5
A client began taking acetylsalicylic acid several years ago to prevent platelet aggregation following a myocardial infarction. Which dose of aspirin is the client most likely taking daily? A. 650 mg B. 325 mg C. 81 mg D. 180 mg
81 mg
A home care nurse is seeing a 66-year-old female who has just been released from the hospital after being treated for pneumonia. The nurse knows that it is important to assess the client's knowledge of which area? A. Nutrition and health B. Adverse effects of nonsteroidal anti-inflammatory drugs C. Exercise routine D. Medication regimen for herbal supplements
Adverse effects of nonsteroidal anti-inflammatory drugs
A parent has sought care from the nurse practitioner to treat a child's fever. The nurse practitioner is most likely to recommend what nonsalicylate drug? A. Ibuprofen B. Indomethacin C. Naproxen D. Acetaminophen
Acetaminophen
A child has symptoms of influenza, including a fever. Which medication should not be administered to the child because of the risk of Reye's syndrome? A. ascorbic acid B. ibuprofen C. acetaminophen D. acetylsalicylic acid
Acetylsalicylic acid
A client is taking Indocin for arthritis. The nurse knows that as a COX-1 inhibitor, this drug inhibits prostaglandins associated with which functions? A. All tissues and cell types, especially platelets, endothelial cells, the GI tract, and the kidneys B. Kidneys and female reproductive system C. Liver, kidneys, and GI tract D. Heart, brain, and kidneys
All tissues and cell types, especially platelets, endothelial cells, the GI tract, and the kidneys
A nurse is assigned to care for a patient with arthritis in a health care facility. The patient has been prescribed celecoxib. Celecoxib is contraindicated in clients with: A. cataract. B. diabetic retinopathy. C. acute gout. D. allergy to sulfonamides.
Allergy to sulfonamides
A nurse is aware that a client prescribed meloxicam is most likely being treated for what health problem? A. fever B. a chronic wound C. migraine D. arthritis
Arthritis
How should a nurse best explain the presence of the inflammation process? A. as a normal response to infection or trauma, which results in necrotic tissue formation B. as a typical response to bacterial infection C. as the initial stage of infection, requiring antibiotic medication for resolution D. as an attempt by the body to remove the damaging agent and repair the damaged tissue
As an attempt by the body to remove the damaging agent and repair the damaged tissue
A male 16 years of age presents to the health care provider's office with nausea, vomiting, and pain in the right upper quadrant. He states he has had flu-like symptoms for four to five days. What is the most appropriate action of the nurse? A. Ask if he has been exposed to anyone with a fungal infection. B. Ask if he has been around anyone with hepatitis. C. Ask how much alcohol he drinks. D. Ask for a medication history.
Ask for a medication history.
A nurse is reviewing the medical record of a client who is prescribed NSAID therapy. The nurse determines that the drug would be contraindicated for the client if a hypersensitivity to which drug was found? A. acetaminophen B. hydrochlorothiazide C. lisinopril D. aspirin
Aspirin
The client reports to the nurse that the client is having ringing in the ears. The nurse questions the client on use of what medication? A. Steroids B. Aspirin C. Acetaminophen D. Antibiotics
Aspirin
A client is receiving anakinra as treatment for arthritis. The nurse understands that this drug acts in which manner? A. Interferes with free-floating tumor necrosis factor B. Lowers immunoglobulin M factor levels C. Inhibits the DHODH enzyme D. Blocks interleukin-1
Blocks interleukin-1
A student nurse asks the nurse why acetaminophen and NSAIDs help to reduce cancer pain. What is the nurse's best explanation? A. Cancer rarely produces severe pain from tumor invasion of tissues or complications of treatment. These drugs prevent sensitization of peripheral pain receptors by inhibiting prostaglandin formation. B. Cancer often produces chronic pain from tumor invasion of tissues or complications of treatment. These drugs potentiate sensitization of peripheral pain receptors by increasing prostaglandin formation. C. Cancer often produces chronic pain from tumor invasion of tissues or complications of treatment. These drugs prevent sensitization of peripheral pain receptors by inhibiting prostaglandin formation. D. Cancer rarely produces chronic pain from tumor invasion of tissues or complications of treatment. These drugs eliminate sensitization of peripheral pain receptors by inhibiting prostaglandin formation.
Cancer often produces chronic pain from tumor invasion of tissues or complications of treatment. These drugs prevent sensation of peripheral pain receptors by inhibiting prostaglandin formation
A client has a sulfonamide allergy. Which drug would the nurse identify as being contraindicated? A. ibuprofen B. meloxicam C. celecoxib D. ketorolac
Celecoxib
A nurse is reviewing a journal article about an NSAID that is associated with an increased risk of cardiovascular thrombosis, myocardial infarction, and stroke. The nurse is most likely reading about which drug? A. sulindac B. celecoxib C. oxaprozin D. ketorolac
Celecoxib
The 56-year-old client is diagnosed with osteoarthritis and reports joint pain and stiffness. Which medication would be identified as appropriate for the client to take? A. Celecoxib B. Ergotamine C. Eletriptan D. Sumatriptan
Celecoxib
The nurse knows that acetaminophen should not be used in older adults with which condition? A. cirrhosis. B. diabetes. C. myocardial infarction (MI). D. chronic obstructive pulmonary disease (COPD).
Cirrhosis
True or False: Gold compounds are commonly used as first-line therapy for the treatment of rheumatoid arthritis.
False -Gold compounds are used for a client with rheumatoid arthritis who does not respond to the usual anti-inflammatory agents and in whom the conditions worsen despite weeks or months of standard pharmacologic treatment
The nurse is administering chrysotherapy to a patient with rheumatoid arthritis. What drug will the nurse be administering? A. Azothiaprine B. Humira C. Gold salts D. Hydroxychloroquine
Gold Salts
A patient is admitted to the emergency department with a suspected overdose of acetaminophen (Tylenol). What adverse effect is most common in acute or chronic overdose of acetaminophen (Tylenol)? A. Nephrotoxicity B. Pancreatitis C. Pulmonary insufficiency D. Hepatotoxicity
Hepatotoxicity
A neonate is diagnosed with patent ductus arteriosus. What nonsteroidal anti-inflammatory agent is administered intravenously for treatment of this congenital heart defect? A. Nabumetone (Relafen) B. Etodolac C. Indomethacin (Indocin) D. Sulindac (Clinoril)
Indomethacin (Indocin)
What best describes the action of NSAIDs? A. Inhibit phagocytosis B. Act directly on thermoregulatory cells C. Blocks hypothalamus activity D. Inhibit prostaglandin synthesis
Inhibit prostaglandin synthesis
The nurse is aware that aspirin not only lowers the client's fever but can also reduce the pain the client is experiencing by: A. promoting the production of prostaglandins. B. prolonging the bleeding time. C. inhibiting the aggregation of platelets. D. inhibiting the production of prostaglandins.
Inhibiting the production of prostaglandins
When NSAIDs are combined with lithium, there is a potential for: A. lithium toxicity. B. increased diuretic effect. C. anaphylactoid reactions. D. decreased antihypertensive effect.
Lithium toxicity
An 8-year-old child is experiencing pain following tonsillectomy. Which drug would be an appropriate pain reliever for this client? A. Nonsalicylates B. Salicylates C. Barbiturates D. Morphine
Nonsalicylates
A black client is receiving a high dose of NSAID for pain relief. Which would be most important for the nurse to include in the teaching plan? A. Signs and symptoms of gastrointestinal bleeding B. Importance of adequate hydration C. The need to combine the drug with an OTC salicylate D. Avoidance of warm soaks for additional pain relief
Signs and symptoms of gastrointestinal bleeding
A client is receiving auranofin as treatment for rheumatoid arthritis. The nurse should expect this drug to be given by which route? A. Intravenous B. Subcutaneous C. Intramuscular D. Oral
Oral
When acetylsalicylic acid is administered in low doses, it blocks the synthesis of thromboxane A2. What physiologic effect results from this action? A. Core body temperature is reduced. B. Inflammation is relieved. C. Pain is relieved. D. Platelet aggregation is inhibited.
Platelet aggregation is inhibited.
A client with dysmenorrhea has been prescribed naproxen 1250 mg PO b.i.d. What is the nurse's best action? A. Question the prescriber about the route B. Question the prescriber about the dose C. Assess the client's baseline renal and hepatic status D. Question the prescriber about the frequency
Question the prescriber about the dose
An 11-year-old client is having a cavity filled in the left mandibular first molar. The health care provider has prescribed aspirin for pain relief after the procedure. The nurse discovers upon assessment that the child is suffering from a flulike illness. The nurse contacts the health care provider about the prescribed medication for pain. What is the risk if aspirin is administered to this client? A. Salicylate poisoning B. Asthma C. Reye syndrome D. Excess antiplatelet action
Reye Syndrome
A 15-year-old client is brought to the emergency department by his friends. He reports visual changes, drowsiness, and tinnitus. He is confused and hyperventilating. These symptoms may be attributable to which condition? A. Acute acetaminophen poisoning B. Salicylate intoxication C. Caffeine abuse D. Ibuprofen overdose
Salicylate intoxication
A 15-year-old client is brought to the emergency department by his friends. He reports visual changes, drowsiness, and tinnitus. He is confused and hyperventilating. These symptoms may be attributable to which condition? A. Salicylate intoxication B. Caffeine abuse C. Acute acetaminophen poisoning D. Ibuprofen overdose
Salicylate intoxication
Which of the following agents would be least appropriate to use as treatment for ulcerative colitis? A. Salsalate B. Olsalazine C. Balsalazide D. Mesalamine
Salsalate
A client diagnosed with osteoarthritis has been prescribed meloxicam. Which instruction should the client be given to assure the medication's safe administration? A. Crush enteric-coated tablets to aid swallowing. B. Take the medication with food. C. Take the medication with orange juice. D. Take the medication at bedtime.
Take the medication with food -decreases the risk of gastric irritation
A 65-year-old man who just had a heart attack is placed on aspirin, 81 mg daily. The nurse is explaining the purpose of this medication to the client and his wife. What would be the nurses best explanation? A. The aspirin is being prescribed to relieve the pain from the heart attack. B. The aspirin is being prescribed because it reduces your risk of a second heart attack. C. The aspirin is being prescribed because it will protect your heart. D. The aspirin is being prescribed because it reduces the prostaglandins in your body.
The aspirin is being prescribed because it reduces your risk of a second heart attack
The nurse would question the health care provider who prescribed NSAIDs for which client? A. The client diagnosed with psoriasis B. The client diagnosed with diabetes C. The postpartum woman who had a vaginal birth D. The client diagnosed with peptic ulcers
The client diagnosed with peptic ulcers
A client is being discharged following an allergic reaction after ingesting aspirin. Included in patient education about the allergy, the nurse would inform the client that: A. the client should not take aspirin or non-aspirin NSAIDs. B. the client should not take regular aspirin, but can take buffered aspirin. C. the client can take NSAIDs, as long as it is with food. D. the client can take medications containing aspirin, as long as it is on a full stomach.
The client should not take aspirin or non-aspirin NSAIDs
An older adult woman has been experiencing significant joint pain and has informed her primary care provider that she has begun taking aspirin two to three times each day. What aspect of this patient's medical history may contraindicate the use of aspirin? A. The patient takes an SSRI for depression. B. The patient has a history of peptic ulcer disease. C. The patient has a diagnosis of type 2 diabetes. D. The patient had a total abdominal hysterectomy 2 years ago.
The patient has a history of peptic ulcer disease -Due to the risk of bleeding, aspirin is contradicted in patients with peptic ulcer disease or bleeding disorders
The client has been prescribed one aspirin a day. The nurse understands that is prescribed for which of the following? A. To decrease pain B. To treat osteoarthritis C. To decrease temperature D. To inhibit platelet aggregation
To inhibit platelet aggregation
The nurse is checking the orders for pain management for a client that had coronary surgery 24 hours ago. The nurse identifies that the client has been receiving Celebrex and a narcotic postoperatively for pain management. What is the most appropriate response of the nurse? A. Administer the Celebrex. B. Withhold the Celebrex and notify the health care provider. C. Discontinue the Celebrex. D. Administer the Celebrex and narcotic because it is his pain management regimen.
Withhold the Celebrex and notify the health care provider.
Which NSAID appears to work by specifically inhibiting cyclooxygenase-2 (COX-2) without inhibiting cyclooxygenase-1 (COX-1)? A. naproxen B. ibuprofen C. celecoxib D. meloxicam
celecoxib
A group of nursing students are reviewing the pain-relieving action of NSAIDs. The students demonstrate understanding of the information when they identify which actions as being blocked to achieve pain relief? A. cyclooxygenase-1 B. cyclooxygenase-2 C. cyclooxygenase-4 D. cyclooxygenase-3
cyclooxygenase-2
A group of nursing students are reviewing the pain-relieving action of NSAIDs. The students demonstrate understanding of the information when they identify which actions as being blocked to achieve pain relief? A. cyclooxygenase-3 B. cyclooxygenase-1 C. cyclooxygenase-4 D. cyclooxygenase-2
cyclooxygenase-2
A nurse is conducting a medication reconciliation for an older adult client who has just relocated to the long-term care facility. The nurse notes that the resident has been taking colchicine on a regular basis. Which medication regimen should signal the nurse to the possibility of what diagnosis? A. gout B. inflammatory bowel disease (IBD) C. osteoarthritis D. bursitis or tendonitis
gout
A client is prescribed acetylsalicylic acid for fever and headache. What is the action of acetylsalicylic acid? A. providing selective action by inhibiting prostaglandin synthesis in the CNS B. suppressing the function of the hypothalamus to decrease inflammation C. inhibiting the release of norepinephrine to increase blood pressure D. inhibiting prostaglandin synthesis in the central and peripheral nervous system
inhibiting prostaglandin synthesis in the central and peripheral nervous system
