Ch 24 Drugs Treating Mild To Moderate Pain, Fever, INFLammation, And Migrane

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  • 1/35 Questions

    Patient teaching for acetaminophen therapy should include

    • Take only the recommended dose
    • Read the labels of all OTC meds to avoid overdose
    • Seek medical care immediately in case of overdose
    • All of the above
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Pain Management Quizzes & Trivia
About This Quiz

Quiz for Pharmacology, Fall 2009Ch 24 Drugs treating Mild to Moderate Pain, Fever, Inflammation, and Migraine Headache

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  • 2. 

    Your 55 year old patient has bipolar disorder and takes lithium. The patient also has arthritis and the provider has prescribed ibuprofen. The patient states, "I am not sure I should be taking other drugs with my lithium". Which is the most appropriate statement?

    • "Taking these drugs together is not a problem"

    • "We will monitor your lithium level closely and make any adjustments necessary"

    • "Call us if you have any adverse reactions. You should be OK"

    • "I'm not sure why your provider prescribed this. It's pretty dangerous"

    Correct Answer
    A. "We will monitor your lithium level closely and make any adjustments necessary"
    Explanation
    The most appropriate statement is "We will monitor your lithium level closely and make any adjustments necessary." This response acknowledges the patient's concern about taking other drugs with lithium and reassures them that their lithium levels will be closely monitored. It also suggests that any necessary adjustments to the medication regimen will be made based on these monitoring results. This response demonstrates a proactive approach to the patient's care and addresses their concerns effectively.

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  • 3. 

    Your patient has arthritis. This patient smokes one pack of cigarettes a day and drinks at least six beers each evening. Which of the following statements would be most appropriate during teaching for this patient?

    • "Take the aspirin at least 4 times a day. If there is no relief, take another dose"

    • "Because of your age, you should limit your aspirin intake to only 6 per day"

    • "You have three predisposing factors for an increased risk to develop an ulcer with aspirin therapy. Let's start with trying to quit smoking"

    • "You just can't take these pills because of your lifestyle. Get used to the discomfort"

    Correct Answer
    A. "You have three predisposing factors for an increased risk to develop an ulcer with aspirin therapy. Let's start with trying to quit smoking"
    Explanation
    The correct answer is "You have three predisposing factors for an increased risk to develop an ulcer with aspirin therapy. Let's start with trying to quit smoking." This statement acknowledges the patient's risk factors (arthritis, smoking, and alcohol consumption) and addresses the most important factor, which is smoking. Quitting smoking can significantly reduce the risk of developing an ulcer with aspirin therapy. It shows a proactive approach to addressing the patient's lifestyle choices and promoting their overall health.

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  • 4. 

    In which of the following patients would aspirin be contradicted?

    • Mary with hypertensions

    • Judy with migraine headaches

    • Constance with peptic ulcer disease

    • Clair with chronic constipation

    Correct Answer
    A. Constance with peptic ulcer disease
    Explanation
    Aspirin is contraindicated in patients with peptic ulcer disease. This is because aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that can irritate the lining of the stomach and increase the risk of developing ulcers or worsening existing ulcers. Therefore, Constance, who has peptic ulcer disease, should avoid taking aspirin to prevent further damage to her stomach lining.

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  • 5. 

    The most common adverse effects to most NSAIDs are _________ in nature

    • CNS

    • Respiratory

    • GI

    • Cardiovascular

    Correct Answer
    A. GI
    Explanation
    The most common adverse effects to most NSAIDs are gastrointestinal (GI) in nature. NSAIDs can irritate the lining of the stomach and intestines, leading to symptoms such as stomach pain, indigestion, nausea, vomiting, and even ulcers or bleeding in severe cases. These GI side effects occur because NSAIDs inhibit the production of certain chemicals in the body that help protect the stomach lining. It is important to take NSAIDs with food or use stomach-protective medications to minimize these GI effects.

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  • 6. 

    Which of the following adverse effects is associated with acetaminophen therapy?

    • Pulmonary edema

    • Urinary retention

    • Hepatoxicity

    • Ototoxicity

    Correct Answer
    A. Hepatoxicity
    Explanation
    Hepatoxicity is a well-known adverse effect associated with acetaminophen therapy. Acetaminophen is primarily metabolized in the liver, and excessive or prolonged use can lead to liver damage or toxicity. This can occur due to the formation of a toxic metabolite called N-acetyl-p-benzoquinone imine (NAPQI), which depletes glutathione and causes oxidative stress in the liver. Hepatoxicity can manifest as elevated liver enzymes, jaundice, liver failure, or even death in severe cases. It is important to use acetaminophen within the recommended dose range and avoid concomitant use with alcohol to minimize the risk of hepatoxicity.

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  • 7. 

    Your patient was prescribed ibuprofen for burstis 1 week ago. The patient calls the clinic and states "I just don't feel any better". Which of the following statements is most appropriate?

    • "It may take up to 2 weeks to feel the benefit of this medication"

    • "I guess you should make an appt and get something else"

    • "Your burstis is obviously resistant to NSAIDs"

    • "It might work better if you double the dose for a few days"

    Correct Answer
    A. "It may take up to 2 weeks to feel the benefit of this medication"
    Explanation
    The correct answer is "It may take up to 2 weeks to feel the benefit of this medication." This response acknowledges the patient's concern and provides an explanation for why they may not be feeling better yet. It is important to educate the patient about the expected timeline for improvement with ibuprofen and reassure them that it may take some time for the medication to take effect. This response also indicates that the current treatment plan should be continued for now.

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  • 8. 

    Sumatriptan should not be given to patients with pre-existing __________ disorders

    • Hematologic

    • Intergumentary

    • Cardiovascular

    • Respiratory

    Correct Answer
    A. Cardiovascular
    Explanation
    Sumatriptan should not be given to patients with pre-existing cardiovascular disorders because it can cause vasoconstriction, which may lead to an increase in blood pressure and potentially worsen the condition. It is important to consider the patient's medical history and assess the risks and benefits before prescribing any medication, especially for patients with underlying cardiovascular issues.

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  • 9. 

    A 67 year old patient with a history of a gastric ulcer is to begin a regimen of celeoxib, a COX-2 inhibitor, for osteoarthritis. She asks you, "Why do I have to have a prescription? Can't I take something over the counter like aspirin or ibuprofen?" Your best reply is

    • Either aspirin or ibuprofen can be substituted if the patient prefers

    • Aspirin and ibuprofen don't relieve arthritis pain

    • Celeoxib does not cause GI upset as frequently as aspirin or ibuprofen

    • Celeoxib is prescription strength aspirin

    Correct Answer
    A. Celeoxib does not cause GI upset as frequently as aspirin or ibuprofen
    Explanation
    Celecoxib is a prescription medication because it is a COX-2 inhibitor that is specifically designed to target inflammation and pain associated with osteoarthritis. Unlike aspirin and ibuprofen, which are available over the counter, celecoxib has a lower risk of causing gastrointestinal (GI) upset. This is particularly important for the patient with a history of a gastric ulcer, as COX-2 inhibitors are known to have a reduced risk of causing GI complications compared to non-selective NSAIDs like aspirin and ibuprofen. Therefore, prescribing celecoxib ensures better pain relief with a lower risk of GI side effects for the patient.

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  • 10. 

    The most frequently occurring adverse effects to sumatriptan most commonly affect the _______ system

    • Cardiovascular

    • Integumentary

    • Respiratory

    • Immune

    Correct Answer
    A. Cardiovascular
    Explanation
    The most frequently occurring adverse effects of sumatriptan commonly affect the cardiovascular system. This means that the drug is more likely to cause negative effects on the heart and blood vessels. It is important to monitor patients taking sumatriptan for any cardiovascular symptoms or complications.

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  • 11. 

    Which of the following is not an action of aspirin?

    • Analgestic

    • Anti-inflammatory

    • Antipyretic

    • Antihistamine

    Correct Answer
    A. Antihistamine
    Explanation
    Aspirin is known for its analgesic (pain-relieving), anti-inflammatory, and antipyretic (fever-reducing) properties. However, aspirin is not an antihistamine. Antihistamines are medications commonly used to treat allergies and allergic reactions by blocking the effects of histamine, a chemical released by the immune system during an allergic response. Aspirin does not have this specific action and is not typically used for allergy relief.

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  • 12. 

    Which of the following effects occur with acetaminophen therapy?

    • Analgestic and anti-inflammatory

    • Antipyretic and antiplatelet

    • Antiplatelet and anti-inflammatory

    • Analgestic and antipyretic

    Correct Answer
    A. Analgestic and antipyretic
    Explanation
    Acetaminophen is a medication commonly used for pain relief and reducing fever. It has analgesic properties, meaning it can relieve pain, and antipyretic properties, meaning it can reduce fever. Therefore, the correct answer is "analgesic and antipyretic."

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  • 13. 

    Salicyclism is a form of mild aspirin toxicity with symptoms such as 

    • Headache, tinnitus, and GI distress

    • Resp stimulation, constipation, GI distress

    • GI distress, diarrhea, and resp depression

    • Headache, hypervigilance, and confusion

    Correct Answer
    A. Headache, tinnitus, and GI distress
    Explanation
    Salicyclism is a condition that occurs due to mild aspirin toxicity. The symptoms of salicyclism include headache, tinnitus (ringing in the ears), and gastrointestinal (GI) distress. Headache is a common symptom experienced by individuals with salicyclism. Tinnitus is another symptom characterized by a ringing or buzzing sound in the ears. GI distress refers to discomfort or pain in the gastrointestinal system, which can include symptoms such as nausea, vomiting, and stomach pain. Therefore, the answer choice "headache, tinnitus, and GI distress" accurately describes the symptoms associated with salicyclism.

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  • 14. 

    Your patient with migraines states, "I'm taking that sumatriptan, but my headaches just don't go away for a long time." Which of the following questions would be appropriate in response to this statement?

    • "Have you tried doubling the dose?"

    • "Are you taking the drug at the first sign of the headache?"

    • "Are you still smoking?"

    • "Do you take it with a glass of water?"

    Correct Answer
    A. "Are you taking the drug at the first sign of the headache?"
    Explanation
    The question "Are you taking the drug at the first sign of the headache?" would be appropriate in response to the patient's statement because it addresses the timing of when the patient takes the medication. Sumatriptan is most effective when taken at the earliest sign of a migraine attack, so if the patient is not taking it at the first sign, it may explain why their headaches are not going away for a long time. This question helps to assess if the patient is using the medication correctly and may provide insight into potential reasons for the lack of response to the medication.

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  • 15. 

    Sumatriptan works by

    • Inhibiting prostaglandin synthesis

    • Vasoconstriction and inhibiting the release of proinflammatory neuropeptides

    • Enhancing the release of proinflammatory neuropeptides

    • Stimulating prostaglandin synthesis

    Correct Answer
    A. Vasoconstriction and inhibiting the release of proinflammatory neuropeptides
    Explanation
    Sumatriptan works by vasoconstriction and inhibiting the release of proinflammatory neuropeptides. Vasoconstriction refers to the narrowing of blood vessels, which helps to reduce the blood flow and pressure in the affected area, relieving pain. Inhibiting the release of proinflammatory neuropeptides helps to reduce inflammation and pain. This dual mechanism of action makes sumatriptan effective in treating migraines and cluster headaches.

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  • 16. 

    Your patient takes aspirin for chronic arthritis pain. The patient is currently hospitalized for treatment of a deep vein thrombosis and is prescribes warfarin. Which of the following interventions should be done with this patient?

    • Daily PT/INR

    • Urine output

    • Resp rate

    • CBC every other day

    Correct Answer
    A. Daily PT/INR
    Explanation
    The correct answer is daily PT/INR. PT/INR stands for prothrombin time/international normalized ratio, which measures the clotting ability of the blood. Warfarin is an anticoagulant medication that works by thinning the blood, so monitoring the PT/INR levels is crucial to ensure that the patient is receiving the appropriate dosage of warfarin. Daily monitoring is necessary because the patient is at an increased risk of bleeding due to the combination of aspirin and warfarin. Monitoring urine output, respiratory rate, and CBC every other day are not directly related to the patient's anticoagulation therapy.

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  • 17. 

    A patient is brought to the ER after having attempted to commit suicide by swallowing half a bottle of acetaminophen. The nurse should expect to 

    • Draw blood for a platelet count

    • Administer acetylcysteine

    • Administer acetylsalicylic acid

    • Send the patient for an abdominal CT scan

    Correct Answer
    A. Administer acetylcysteine
    Explanation
    Acetaminophen overdose can cause liver damage, and acetylcysteine is the antidote for acetaminophen toxicity. It helps to prevent or reduce liver damage by replenishing glutathione, a substance that helps the liver process toxins. Therefore, the nurse should expect to administer acetylcysteine to the patient who attempted suicide by swallowing acetaminophen.

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  • 18. 

    A 70 year old patient is prescribed aspirin for the treatment of arthritis. Patient teaching should include

    • Take aspirin on an empty stomach

    • Store aspirin in a bathroom medicine chest

    • Return for lab tests every 6 mo

    • Crush the ER tablets for easier swallowing

    Correct Answer
    A. Return for lab tests every 6 mo
    Explanation
    It is important for a 70-year-old patient prescribed with aspirin for arthritis treatment to return for lab tests every 6 months because aspirin can potentially affect kidney and liver function. Regular lab tests can help monitor any changes in these organs and ensure the safety and effectiveness of the medication.

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  • 19. 

    Your patient has received a diagnosis of migraine headaches and is to be sent home with a prescription of sumatriptan. Your patient teaching should include all of the following EXCEPT

    • Take the med at the first sign of a migraine headache

    • Take the med with a full glass of water

    • The med can be crushed if the patient has difficulty swallowing

    • The med may cause dizziness, weakness, or light headedness

    Correct Answer
    A. The med can be crushed if the patient has difficulty swallowing
    Explanation
    It is important to explain to the patient that the medication should not be crushed if they have difficulty swallowing. Crushing the medication may alter its absorption and effectiveness.

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  • 20. 

    Your patient takes acetaminophen daily for chronic headaches. The patient should have which of the following lab tests done periodically?

    • CBC

    • Liver function tests

    • Kidney function tests

    • All of the above

    Correct Answer
    A. All of the above
    Explanation
    The patient should have all of the above lab tests done periodically because acetaminophen can have potential side effects on the liver and kidneys. CBC (complete blood count) can help monitor any changes in blood cell counts, liver function tests can assess the liver's health and detect any potential liver damage, and kidney function tests can evaluate the kidney's ability to filter waste products from the blood. Regular monitoring of these lab tests can ensure the patient's safety and detect any adverse effects of long-term acetaminophen use.

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  • 21. 

    Which of the following NSAIDs has a decreased incidence of GI adverse effects?

    • Naproxen

    • Diclofenac sodium

    • Celecoxib

    • Mefenamic acid

    Correct Answer
    A. Celecoxib
    Explanation
    Celecoxib is the correct answer because it is a selective COX-2 inhibitor, which means it specifically targets the enzyme responsible for inflammation without affecting the COX-1 enzyme that protects the stomach lining. This selective action reduces the incidence of gastrointestinal adverse effects compared to other non-selective NSAIDs like naproxen, diclofenac sodium, and mefenamic acid.

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  • 22. 

    Which of the following should be included in patient teaching for the patient receiving sumatriptan?

    • "Be sure to increase the intake of your fluids"

    • "Do not take sumatriptan for ordinary headaches"

    • "You can take as many as 3 tablets in an hour for a really bad headache"

    • "Drink a caffeine product if your headache is not relieved in an hour"

    Correct Answer
    A. "Do not take sumatriptan for ordinary headaches"
    Explanation
    Patients receiving sumatriptan should be taught not to take the medication for ordinary headaches because sumatriptan is specifically indicated for the treatment of migraines. Taking sumatriptan for ordinary headaches may lead to unnecessary medication use and potential side effects. It is important for patients to understand the appropriate use of sumatriptan and to consult their healthcare provider for guidance on managing different types of headaches.

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  • 23. 

    Your patient has nasal polyps and asthma. Because of this health status history, the patient has an increased risk for aspirin-induced _________ with aspirin therapy

    • Ototoxicity

    • CHF

    • GI bleeding

    • Bronchospasm

    Correct Answer
    A. Bronchospasm
    Explanation
    Patients with nasal polyps and asthma are at an increased risk for aspirin-induced bronchospasm when undergoing aspirin therapy. Aspirin can trigger an exaggerated response in the airways, leading to narrowing and constriction of the bronchial tubes, resulting in bronchospasm. This can cause difficulty in breathing, wheezing, and coughing. It is important for healthcare providers to be aware of this potential risk and take necessary precautions when prescribing aspirin to patients with nasal polyps and asthma.

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  • 24. 

    Patients receiving ibuprofen on a regular basis should be told to contact the physician or nurse practitioner immediately if they note

    • Unusual brusing

    • Slow heartbeat

    • Upset stomach

    • Slight dizziness

    Correct Answer
    A. Unusual brusing
    Explanation
    Patients receiving ibuprofen on a regular basis should be told to contact the physician or nurse practitioner immediately if they note unusual bruising. This is because ibuprofen can affect blood clotting and increase the risk of bleeding. Unusual bruising may indicate a problem with blood clotting or a potential bleeding disorder, and it is important for the patient to seek medical attention promptly to prevent any further complications.

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  • 25. 

    Analgestic effects of ibuprofen occur within 

    • 30 min

    • 24 h

    • 2 to 4 h

    • 12 h

    Correct Answer
    A. 2 to 4 h
    Explanation
    The analgesic effects of ibuprofen typically start to occur within 2 to 4 hours after administration. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that works by reducing inflammation and pain. It inhibits the production of prostaglandins, which are responsible for causing pain and inflammation in the body. While ibuprofen may start to provide some relief within 30 minutes, it usually takes a few hours for the full analgesic effects to be felt. The duration of these effects can vary from person to person, but they generally last for around 4 to 6 hours.

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  • 26. 

    What is the usual dosage of aspirin?

    • 325 mg q 8 h

    • 650 mg q 4 to 6 h

    • 325 mg q 4 h

    • 650 mg q 12 h

    Correct Answer
    A. 650 mg q 4 to 6 h
    Explanation
    The usual dosage of aspirin is 650 mg every 4 to 6 hours. This means that a person should take 650 mg of aspirin every 4 to 6 hours as directed.

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  • 27. 

    Which of the following NSAIDs has both oral and IM administration?

    • Ketoprofen

    • Mefenamic acid

    • Naproxen

    • Ketorolac

    Correct Answer
    A. Ketorolac
    Explanation
    Ketorolac is the NSAID that can be administered both orally and intramuscularly (IM). This means that it can be taken by mouth as well as injected into the muscle. Ketoprofen, mefenamic acid, and naproxen, on the other hand, are typically only available in oral formulations and cannot be administered intramuscularly. Therefore, ketorolac is the correct answer as it offers both oral and IM administration options.

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  • 28. 

    Which of the following statements concerning celecoxib is correct?

    • It does not have antiplatelet activity

    • It has increased antiplatelet activity

    • It has an increased risk for CNS depression

    • It has a decreased risk of CNS depression

    Correct Answer
    A. It does not have antiplatelet activity
    Explanation
    Celecoxib is a nonsteroidal anti-inflammatory drug (NSAID) that selectively inhibits the enzyme cyclooxygenase-2 (COX-2). Unlike other NSAIDs, celecoxib does not have antiplatelet activity, meaning it does not interfere with the normal clotting function of platelets. This is an important distinction as many other NSAIDs, such as aspirin, do have antiplatelet activity and can increase the risk of bleeding. Therefore, the correct statement is that celecoxib does not have antiplatelet activity.

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  • 29. 

    Which of the following patients should not take acetaminophen?

    • Kelly, age 30, who is pregnant

    • Helen, age 16, who has history of seizure disorder

    • Mark, age 55, with history of hepatitis

    • John, age 40, who is an alcoholic

    Correct Answer
    A. John, age 40, who is an alcoholic
    Explanation
    Acetaminophen should not be taken by individuals who consume alcohol regularly or excessively. This is because both alcohol and acetaminophen can cause liver damage, and when used together, they can increase the risk of liver toxicity. Since John is an alcoholic, it is advisable for him to avoid taking acetaminophen to prevent further harm to his liver.

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  • 30. 

    Salicylate poisoning may occur in adults with a dose of   

    • 5 - 8 g

    • 10 - 30 g

    • 50 - 100 g

    • 40 - 60 g

    Correct Answer
    A. 10 - 30 g
    Explanation
    Salicylate poisoning may occur in adults with a dose of 10 - 30 g. Salicylates are found in aspirin and other medications, and they can be toxic in high doses. Symptoms of salicylate poisoning include nausea, vomiting, tinnitus, rapid breathing, and confusion. In severe cases, it can lead to respiratory distress, seizures, and even death. It is important to seek medical attention if salicylate poisoning is suspected, as treatment may involve gastric decontamination, administration of activated charcoal, and supportive care.

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  • 31. 

    Your patient is a steroid-dependent asthmatic. The patient also takes aspirin for burstis. You would anticipate this patient's aspirin dose may

    • Need to be increased

    • Need to be decreased

    • Remain unchanged

    Correct Answer
    A. Need to be increased
    Explanation
    The patient being a steroid-dependent asthmatic suggests that their asthma is severe and requires long-term steroid therapy to control symptoms. Aspirin is known to inhibit the production of substances that cause inflammation in the body, which can be beneficial for asthma. However, in some individuals, aspirin can worsen asthma symptoms. Therefore, to achieve the desired anti-inflammatory effect, the patient may need to increase their aspirin dose.

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  • 32. 

    Which of the following patients with comorbid disorders would have an increased risk for adverse effects when taking sibutramine? The patient with

    • Depression

    • Benign prostatic hypertrophy

    • Diabetes mellitus

    • Hypothyroidism

    Correct Answer
    A. Depression
    Explanation
    Patients with depression would have an increased risk for adverse effects when taking sibutramine. This is because sibutramine is a medication used for weight loss, and depression is a mental health disorder that can be associated with changes in appetite and weight. Therefore, the use of sibutramine in patients with depression may exacerbate their symptoms or have negative effects on their mental health.

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  • 33. 

    Your 54-year old patient takes propranolol for hypertension. The patient has chronic tendonitis from playing tennis. Which of the following interventions should be done for this patient while the patient receives NSAIDs for tendonitis?

    • Monitor renal output

    • Monitor for CHF

    • Monitor for lost of hypertension control

    • Monitor for constipation

    Correct Answer
    A. Monitor for lost of hypertension control
    Explanation
    While the patient receives NSAIDs for tendonitis, it is important to monitor for the loss of hypertension control. Propranolol is a beta-blocker commonly used to treat hypertension, and NSAIDs have the potential to reduce the effectiveness of antihypertensive medications. Therefore, monitoring for the loss of hypertension control is crucial to ensure that the patient's blood pressure remains well-controlled while receiving treatment for tendonitis.

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  • 34. 

    Which of the following statements concerning NSAIDs is accurate?

    • If one medication does not work, none will

    • A benefit of NSAIDs therapy is a longer duration of action than that provided by salicyclates

    • There is a cross-sensitivity among all NSAIDs

    • Unlike salicyclates, NSAIDs do not have antiplatelet actvitiy

    Correct Answer
    A. A benefit of NSAIDs therapy is a longer duration of action than that provided by salicyclates
    Explanation
    NSAIDs (nonsteroidal anti-inflammatory drugs) have a longer duration of action compared to salicylates. This means that the effects of NSAIDs last longer in the body than those of salicylates. This can be beneficial for managing pain and inflammation as it reduces the frequency of medication dosing. It is important to note that this statement does not imply that if one NSAID does not work, none of them will be effective. Each NSAID has its own unique properties and may work differently for different individuals.

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  • 35. 

    Your 60 year old patient has been taking ibuprofen for 6 months. The physician has changed the patient's medication to celecoxib. Because of her age, the patient should be advised to

    • Increase the amt of fluids taken with the celecoxib

    • Take an additional 81 mg of aspirin a day

    • Monitor her BP closely

    • At green leafy vegetables to her diet

    Correct Answer
    A. Take an additional 81 mg of aspirin a day
    Explanation
    Celecoxib is a type of nonsteroidal anti-inflammatory drug (NSAID) just like ibuprofen. However, unlike ibuprofen, celecoxib does not have the same blood-thinning effects. Since the patient is switching from ibuprofen to celecoxib, it is important to add an additional 81 mg of aspirin a day to ensure that the patient continues to receive the blood-thinning benefits. This is especially important for older patients who may be at a higher risk for cardiovascular events. Therefore, the patient should be advised to take an additional 81 mg of aspirin a day.

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  • Current Version
  • Mar 19, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Aug 31, 2009
    Quiz Created by
    Jmtruong1

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