1.
1. Prostaglandins (chemical mediators) are secreted during the inflammatory process. The effects of prostaglandins include:
Correct Answer
B. Vasodilation and pain
Explanation
Prostaglandins are chemical mediators that are secreted during the inflammatory process. One of their effects is vasodilation, which means they cause the blood vessels to widen. This leads to increased blood flow to the affected area, which can result in redness and warmth. Another effect of prostaglandins is pain. They can sensitize the nerve endings in the area, causing pain to be felt more intensely. Therefore, the correct answer is vasodilation and pain.
2.
2. A client is ordered to receive an NSAID for a disorder. The client states that he is aware that NSAIDs are frequently taken to decrease inflammation. The nurse clarifies that these agents may also be taken to:
Correct Answer
B. Reduce body temperature
Explanation
NSAIDs, or nonsteroidal anti-inflammatory drugs, are commonly used to decrease inflammation. However, they can also be used to reduce body temperature. This is because NSAIDs have antipyretic properties, meaning they can help lower fever by reducing inflammation in the body. Therefore, it is important for the nurse to clarify that NSAIDs can be taken not only to decrease inflammation but also to reduce body temperature.
3.
3. A nurse is teaching a client who has been prescribed NSAIDs for osteoarthritis. The nurse instructs the client that a common side effect of NSAIDs is:
Correct Answer
B. Gastrointestinal upset or distress
Explanation
NSAIDs (Nonsteroidal anti-inflammatory drugs) are commonly prescribed for osteoarthritis. One of the most common side effects of NSAIDs is gastrointestinal upset or distress. This can include symptoms such as stomach pain, nausea, vomiting, and diarrhea. NSAIDs can irritate the lining of the stomach and intestines, leading to these symptoms. It is important for the nurse to educate the client about this side effect so that they are aware and can take appropriate measures to manage it, such as taking the medication with food or using a stomach protectant medication if necessary.
4.
4. A nurse is working on a pediatric unit. One of the client’s parents asks the nurse why aspirin is not used with children. The nurse’s response is based on the fact that aspirin is contraindicated if a child has:
Correct Answer
B. Virus or flu
Explanation
Aspirin is contraindicated in children with virus or flu because it can increase the risk of developing Reye's syndrome. Reye's syndrome is a rare but serious condition that causes swelling in the liver and brain. It primarily affects children and teenagers recovering from a viral infection, such as the flu or chickenpox. The use of aspirin during a viral illness can trigger this syndrome, leading to potentially life-threatening complications. Therefore, it is important to avoid giving aspirin to children with virus or flu symptoms.
5.
5. A client is ordered to receive aspirin after an acute heart attack. The nurse is evaluating use of this medication with other medications. The nurse is aware that aspirin can cause which of the following drug interactions?
Correct Answer
A. Increased risk of bleeding with anticoagulants
Explanation
Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that works by inhibiting platelet aggregation. This means that it can increase the risk of bleeding when taken with anticoagulant medications, which also have a blood-thinning effect. Anticoagulants, such as warfarin or heparin, are prescribed to prevent blood clots. When aspirin is taken concurrently with anticoagulants, it can further enhance the anticoagulant effect, leading to an increased risk of bleeding. Therefore, the correct answer is "increased risk of bleeding with anticoagulants."
6.
6. A group of clients cared for by the nurse is ordered to take NSAIDs. All of the following instructions are possible. Which of the following client instructions would the nurse question?
Correct Answer
C. Instruct women to take NSAIDs during heavy menstrual flow for pain.
Explanation
The nurse would question instructing women to take NSAIDs during heavy menstrual flow for pain because NSAIDs are not typically recommended for use during heavy menstrual flow.
7.
7. The population of clients most often responsive to the NSAID groups of medications is those with:
Correct Answer
A. Rheumatoid arthritis and osteoarthritis
Explanation
The population of clients most often responsive to the NSAID groups of medications is those with rheumatoid arthritis and osteoarthritis. NSAIDs, or nonsteroidal anti-inflammatory drugs, are commonly used to reduce pain and inflammation in these conditions. Rheumatoid arthritis is an autoimmune disease that causes chronic joint inflammation, while osteoarthritis is a degenerative joint disease. Both conditions involve inflammation of the joints, making NSAIDs an effective treatment option. NSAIDs work by inhibiting the production of certain chemicals in the body that cause pain and inflammation. Therefore, individuals with rheumatoid arthritis and osteoarthritis are more likely to benefit from NSAID medications.
8.
8. The nurse is caring for a client with rheumatoid arthritis. The nurse is aware that disease-modifying antirheumatic drugs (DMARDs) may be prescribed when NSAIDs do not control immune-mediated arthritic disease sufficiently. Which of the following is a DMARD?
Correct Answer
C. Antimalarials
Explanation
DMARDs, or disease-modifying antirheumatic drugs, are medications that are used to treat immune-mediated arthritic diseases such as rheumatoid arthritis. These drugs work by suppressing the immune system and reducing inflammation in the joints. Antimalarials, such as hydroxychloroquine, are a type of DMARD that can be prescribed when NSAIDs (nonsteroidal anti-inflammatory drugs) are not effective enough in controlling the symptoms of rheumatoid arthritis. Antibiotics and corticosteroids are not classified as DMARDs.
9.
9. A client is ordered to receive gold therapy. The client asks how long it will take for him to feel the effects of this medication. The nurse responds that gold medications generally:
Correct Answer
B. Achieve the desired effect in 3 to 6 months
Explanation
Gold therapy is a treatment used for certain autoimmune diseases, such as rheumatoid arthritis. It works by reducing inflammation and slowing down the progression of the disease. However, the effects of gold therapy are not immediate, and it takes time for the medication to build up in the body and produce noticeable results. Therefore, it is generally expected that it will take 3 to 6 months for the client to feel the desired effects of gold therapy.
10.
10. A client is ordered to receive auranofin (Ridaura) for her advanced arthritic condition. The nurse instructs the client that this medication is administered:
Correct Answer
A. Orally
Explanation
Auranofin (Ridaura) is administered orally. This means that the client will take the medication by mouth, usually in the form of a pill or capsule. This route of administration is commonly used for medications that can be absorbed through the gastrointestinal tract and distributed throughout the body via the bloodstream. By taking the medication orally, the client can conveniently self-administer the medication at home without the need for injections or visits to a healthcare facility.
11.
11. A client is receiving auranofin (Ridaura). Which of the following instructions takes priority?
Correct Answer
D. “Frequent blood tests must be done.”
Explanation
The priority instruction in this case is "Frequent blood tests must be done." Auranofin is a medication used to treat rheumatoid arthritis, and it can have potential side effects on the blood, such as bone marrow suppression and liver toxicity. Regular blood tests are necessary to monitor the client's blood cell counts and liver function. This instruction takes priority because it ensures the client's safety and allows for early detection of any adverse effects. The other instructions about hair loss, skin irritation, and taking the medicine with food are important, but they are not as critical as the need for frequent blood tests.
12.
12. A client is ordered to receive colchicine (Novocolchine) for an acute gout episode. Colchicine, an antigout drug, acts by inhibiting:
Correct Answer
B. Migration of leukocytes to the inflamed site
Explanation
Colchicine acts by inhibiting the migration of leukocytes to the inflamed site. This means that it prevents white blood cells from moving to the site of inflammation, reducing the inflammatory response. This can help alleviate the symptoms of an acute gout episode, which is characterized by inflammation and pain in the joints. By inhibiting leukocyte migration, colchicine helps to reduce the inflammation and relieve the symptoms of gout.
13.
13. A client with gout is ordered to receive a medication that acts by increasing uric acid excretion. This drug is:
Correct Answer
D. Probenecid (Benemid)
Explanation
Probenecid (Benemid) is the correct answer because it is a medication that increases uric acid excretion. It works by blocking the reabsorption of uric acid in the kidneys, allowing more of it to be excreted in the urine. This helps to lower the levels of uric acid in the body and prevent gout attacks. Allopurinol (Zyloprim) is used to lower uric acid levels by inhibiting the production of uric acid, while colchicine is used to reduce inflammation and pain during acute gout attacks. Aurothioglucose (Solganal) is a gold compound used in the treatment of rheumatoid arthritis and is not indicated for gout.
14.
14. Client teaching related to colchicine (Novocolchine) includes which of the following?
Correct Answer
B. Instruct the client to increase fluid intake.
Explanation
Colchicine is a medication used to treat gout, a type of arthritis caused by the buildup of uric acid crystals in the joints. One of the side effects of colchicine is dehydration, which can lead to kidney damage. Therefore, it is important for the client to increase fluid intake to prevent dehydration and promote kidney function. The other options are not directly related to colchicine and gout treatment.
15.
15. A client with rheumatoid arthritis is ordered to receive tumor necrosis factor as treatment for symptoms. The manifestations of most concern to the nurse include:
Correct Answer
A. Elevated temperature and a sore throat
Explanation
The correct answer is elevated temperature and a sore throat. Tumor necrosis factor (TNF) inhibitors, such as etanercept and infliximab, are commonly used to treat rheumatoid arthritis. However, these medications can suppress the immune system, making the client more susceptible to infections. Elevated temperature and a sore throat are indications of an infection, which can be a serious concern for clients on TNF inhibitors. It is important for the nurse to monitor for these manifestations and promptly report them to the healthcare provider for further evaluation and management.
16.
16. Indomethacin (Indocin) is highly protein-bound and is ordered as a new medication for the client. The client is taking another medication that is moderately protein-bound. Upon administration of both medications, the nurse is most concerned with:
Correct Answer
D. Toxic levels of the first drug
Explanation
The correct answer is "toxic levels of the first drug". Indomethacin is highly protein-bound, meaning it binds strongly to proteins in the blood. When administered with another moderately protein-bound medication, there is a risk that the two drugs may compete for binding sites on the proteins, leading to increased levels of the first drug in the blood. This can result in toxic levels of the first drug, increasing the risk of adverse effects. Therefore, the nurse should be most concerned about toxic levels of the first drug when administering both medications together.
17.
17. A client is ordered to receive acetaminophen (Tylenol) for mild pain. The client asks how this medication works. The nurse instructs him that Tylenol:
Correct Answer
B. Inhibits prostaglandin synthesis
Explanation
Tylenol inhibits prostaglandin synthesis. Prostaglandins are chemicals in the body that contribute to pain and inflammation. By inhibiting their synthesis, Tylenol helps to reduce pain and inflammation.
18.
18. A child is diagnosed with a viral syndrome. The parent contacts the nurse practitioner for a recommendation for over-the-counter medication. Which medication is contraindicated?
Correct Answer
C. ASA (aspirin)
Explanation
ASA (aspirin) is contraindicated in children with viral syndrome due to the risk of developing Reye's syndrome, a rare but serious condition that can cause liver and brain damage. Therefore, it is not recommended to give aspirin to a child with a viral syndrome.
19.
19. A client asks the nurse questions about NSAIDs. The nurse instructs the client that NSAIDs are frequently taken to decrease inflammation; however, these agents may also be taken to:
Correct Answer
C. Reduce body temperature
Explanation
NSAIDs are commonly used to decrease inflammation, but they can also be taken to reduce body temperature. This is because NSAIDs have antipyretic properties, meaning they can help lower fever by reducing the production of prostaglandins, which are responsible for regulating body temperature. By inhibiting the production of prostaglandins, NSAIDs can help bring down an elevated body temperature.
20.
20. In teaching a client about NSAIDs, the nurse is careful to teach about how to monitor for side effects. The following side effect is of special concern to older adults:
Correct Answer
D. Gastrointestinal upset or distress
Explanation
Older adults are more susceptible to gastrointestinal upset or distress as a side effect of NSAIDs. This is because NSAIDs can irritate the lining of the stomach and intestines, leading to symptoms such as stomach pain, heartburn, nausea, and even ulcers or bleeding. Older adults may already have a higher risk of developing these gastrointestinal issues due to factors such as decreased stomach acid production and weakened mucosal lining. Therefore, it is important for the nurse to educate the client about monitoring for and reporting any signs of gastrointestinal upset or distress while taking NSAIDs.
21.
21. A client enters the emergency clinic with the following symptoms: difficulty walking, pain in his toes, and aches in his feet. The nurse would anticipate giving which of the following medications to treat his acute gout episode?
Correct Answer
D. Colchicine (Novocolchine)
Explanation
Colchicine is the correct medication to treat an acute gout episode. Gout is a type of arthritis that occurs when there is a buildup of uric acid crystals in the joints, causing inflammation and pain. Colchicine works by reducing the inflammation and relieving the symptoms of gout. Allopurinol is used to prevent gout attacks, not treat acute episodes. Gold (auranofin) is not commonly used for gout treatment. Ibuprofen can help with pain relief, but it does not specifically target the underlying cause of gout.
22.
22. A client is ordered to receive celecoxib (Celebrex) for chronic pain caused by osteoarthritis. The nurse should assess the patient with the knowledge that the following pathophysiologic change is associated with the COX-2 inhibitors:
Correct Answer
D. Decrease in inflammation
Explanation
COX-2 inhibitors like celecoxib (Celebrex) work by specifically targeting the enzyme COX-2, which is responsible for producing inflammatory substances in the body. By inhibiting COX-2, these medications help decrease inflammation, which is the body's response to injury or irritation. Therefore, the correct answer is "decrease in inflammation."
23.
23. A client is ordered to receive a medication to relieve inflammation. The nurse evaluates that the medication is needed quickly. Which drug form is most rapidly absorbed from the gastrointestinal (GI) tract?
Correct Answer
D. Liquid suspension
Explanation
A liquid suspension is the drug form that is most rapidly absorbed from the gastrointestinal (GI) tract. This is because the medication is already in a liquid form, which allows for quicker and easier absorption into the bloodstream compared to solid forms such as tablets, enteric-coated pills, or capsules. The liquid suspension can be quickly broken down and absorbed by the body, providing faster relief from inflammation.
24.
24. A client is ordered to receive an NSAID for osteoarthritis. The most common side effect may be treated with which of the following nursing interventions?
Correct Answer
A. Taking the medication with meals
Explanation
Taking the medication with meals is the correct answer because NSAIDs (Nonsteroidal anti-inflammatory drugs) can irritate the stomach lining and cause gastrointestinal side effects such as stomach pain, heartburn, and ulcers. Taking the medication with meals helps to reduce the irritation and minimize these side effects. By doing so, the food acts as a buffer and helps protect the stomach lining from the medication's potential harmful effects.