chapter 24 antiinflammatories Flashcards


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1

Which NSAID may cause Rye syndrome in children with viral illnesses or fever?

A. Aspirin

B. meloxicam

C. piroxicam

D. Nabumetone

A. Aspirin

2

Which response would the nurse give to a client who asks, "what is causing my Gout?

A. eating too many organ meats causes gout

B. an autoimmune disorder is causing your gout

C. Gout is a metabolic disorder caused by uric acid and purine

D. Gout is an infection caused by a Gram positive Bacillus

C. Gout is a metabolic disorder caused by uric acid and purine

3

Antiinflammatories inhibit which substance?

A. prolactin

B. serotonin

C. Prostiglandins

D. Gama-imunobutyric acid

C. Prostiglandins

4

Which drug is considered a cox 2 inhibitor?

A entodolac

B. Naproxen

C. Celocoxib

D. Meloxicam

C. Celocoxib

5

Which nonsteroidal anti-inflammatory drug can be administered Intravenously?

A. Mefenamic acid

B. flurbiprofen sodium

C. Diclofenac Sodium

D. Ketorolac Tromethamine

D. Ketorolac is IV and PO. Sort term pain 5 days or less. All others are by mouth only.

p 280

6

Which class of drugs are second-generation non steroidal anti-inflammatory drugs?

A. Phenylacetic acids

B. Propionic acids

C. Para-chlorobenzoic acid derivatives

D. Selective cyclooxyrgenase - 2. COX 2 inhibitors

D. Selective cyclooxyrgenase - 2. COX 2 inhibitors

all other are first gen.

283

7

Which are sign or symptom is associated with gout?

A. Cough

B. Constipation

C. Nausea and vomiting

D. Tophi in the great toe

E. pain in the back that travels down both legs.

D. Tophi in the great toe

Gout- Tophi in the great toe, elbows, and hands.

8

Which phrase describes the function of prostaglandins? select all that apply

A. Promote vasodilation

B Stimulate smooth muscles

C. decrease platelet aggregation

D. Increase capillary permeability

E. Promote the release of cyclooxyrgenase

A. Promote vasodilation

D. Increase capillary permeability

Prostaglandins promote vasodilation and increase capillary permeability. Prostaglandins are involved in relaxation of smooth muscle. They increase platelet aggregation, which results in inflammation. Cyclooxygenases are the enzyme responsible for the production of prostaglandins.

P. 278

9

The nurse is caring for a patient who states, "I probably shouldn't take aspirin." Which response will the nurse make?

A. You should take ibuprofen instead

B. You can try enteric-coated aspirin

C. I'll get you a prescription pain reliever

D. Try taking aspirin with milk

B. You can try enteric-coated aspirin would be the first intervention. Milk may not relieve gastric distress. Pg. 281

10

Which phrase describes the mechanism of action of allopurinol?

A. Reduces uric acid synthesis

B. inhibits prostaglandin synthesis

C. Reduces infiltration of inflammatory cells

D. Inhibits hypothalamic heat - regulator center

A. Reduces uric acid synthesis

pg. 289

11

Which symptom is an adverse effect of celecoxib? Select all that apply

A. Sinusitis

B. Dizziness

C. Headache

D. Constipation

E. Hypotension

A. Sinusitis

B. Dizziness

C. Headache

Celecoxib is a COX2 inhibitor

12

which action of colchicine would the nurse include when teaching a patient newly diagnosed with gout?

A. Inhibits uric acid synthesis

B. Promotes uric acid excretion

C. Promotes purine metabolism

D. Inhibits the migration of leukocytes to the inflamed site

D. Inhibits the migration of leukocytes to the inflamed site

13

Which property of aspirin differentiates it from other NSAID's?

A Analgesic

B. Antipyretic

C. Antiplatelet

D. Antiinflammatory

C. Antiplatelet

All NSAID's have antipyretic, antiinflammatory, and analgesic properties.

278

14

Which information regarding the use of methotrexate is accurate?

A. Inhibits the migration of leukocytes to the inflamed site

B. Used in combination with NSAID's to suppress inflammation

C. Delays the inflammatory process y attaching to tumor necrosis factor receptors on synovial cell surfaces

D. May be used to suppress the inflammatory process of rheumatoid arthritis when other treatment fail

D. May be used to suppress the inflammatory process of rheumatoid arthritis when other treatment fail

Pg. 286

15

Which assessment finding indicates that the NSAID's drug has been effective?

A. Pain has decreased for a 6 to a 1 on a scale of 10

B. patient's bleeding time is prolonged

C. patient has increased circulation to his legs

D. PTT is 100 seconds

A. Pain has decreased for a 6 to a 1 on a scale of 10

16

A patient at risk for a stroke tells the nurse that the doctor told me to take aspirin every day. The patient states that he is on nabumetone daily, so he does not need to take the aspirin also. What is the nurse's best response to the patient?

A. You are correct

B. Ask your doctor to increase your dose of Relafen.

C. You should take Tylenol every day instead

D. Take your aspirin every day even though you are on nabumetone

D. Take your aspirin every day even though you are on nabumetone

17

A patient has been taking aspirin for chronic pain. The patient states the pain is not relieved with 650 mg of aspirin every 4 hours. What is the best instruction for the nurse to give the patient?

A. Increase your dose to 1000 mg every 4 hours

B. Alternate aspirin and a narcotic analgesic every 4 hours

C. Take aspirin and a cox 1 inhibitor at the same time

D. Notify your HCP that the medication is not effective.

D. Notify your HCP that the medication is not effective.

18

Which assessment finding in a patient taking NSAID's requires immediate intervention?

A. Black tarry stools

B. headache

C. Nonproductive cough

D. Palpitation

A. Black tarry stools

19

A patient has been prescribed celecoxib to treat arthritis. The nurse will contact the HCP if the patient shows symptoms of which condition?

A. Anemia

B. Cataracts

C. Glaucoma

D. Hyperthyroidism

A. Anemia

20

What is the most important information for the nurse to include in a teaching plan for the patient receiving allopurinol?

A. do not take this medication during an acute attack of gout

B. include salmon and organ meats in your diet weekly

C. take the medication with an antacid

D. This medication may cause your urine to turn orange.

A. do not take this medication during an acute attack of gout

21

Which intervention is most appropriate for a patient who needs treatment for acute postoperative pain?

A. Administer allopurinol PO every 4 hours

B. Administer celecoxib PO every 6 hours

C. administer indomethacin PO every 4 hours

D. Administer ketorolac IV every 4 hours

D. Administer ketorolac IV every 4 hours

Acute postoperative pain can not be managed with PO meds.

22

Which statement best describes the mechanism of action of uricosuric agents AKA probenecid?

A. Reduces the synthesis of uric acid

B. Increases the renal excretion of uric acid

C. Decreases inflammation associated with gout

D. increases purine metabolism

B. Increases the renal excretion of uric acid

23

The nurse providing patient education to the patient starting probenecid for treatment of gout should include which fact in the teaching plan?

A. Increase intake of calcium

B. Avoid taking aspirin concurrently

C. Take pulse daily

D. Watch for tarry stools

B. Avoid taking aspirin concurrently

Aspirin causes uric acid retention.

24

A 35 year old woman diagnosed with rheumatoid arthritis has been prescribed infliximab. The nurse identifies infliximab as which type of medication?

A. immunosuppressive

B. immunomodulator

C. antimalarial

D. Steroid

B Immunomodulator

25

The nurse identifies Infliximab as useful in the treatment of rheumatoid arthritis as well as

A. Crohn disease

B. Asthma

C. Peptic ulcer disease

D. Multiple sclerosis

A. Crohn disease

26

The nurse is asked how the infliximab will be administered. The nurse should respond that this medication is administered

A. Orally

B. Sucutaneously

C. intramuscularly

D. Intravenously

D. Intravenously

27

A patient has been advised to take ibuprofen. When teaching the patient about ibuprofen, which instruction should the nurse include? Select all that apply

A. Avoid taking aspirin with ibuprofen

B. Take with food to reduce GI upset

C. Monitor for bleeding gums, nosebleeds, black tarry stools

D. Take Herbs, ginkgo and garlic with Ibuprofen

E. Take NSAID's 2 days before menstruation to decrease discomfort

A. Avoid taking aspirin with ibuprofen

B. Take with food to reduce GI upset

C. Monitor for bleeding gums, nosebleeds, black tarry stools

28

An older patient takes tolmetin for arthritis pain. Which statement made by the patient is of most concern to the nurse?

A. I feel like I am coming down with a cold

B. My stomach aches and burns

C. I have a bad headache

D. I feel dizzy when I get up fast

B. My stomach aches and burns

29

A 65 year old has been diagnosed with chronic gout. The nurse anticipates that the patient will be treated with

A. Allopurinol

B. Colchicine

C. Abalibumab

D. Infliximab

A. Allopurinol

30

A patient is taking ibuprofen. The nurse understands that COX 1 and COX 2 inhibitors are different in that ibuprofen is more likely than celecoxib to cause which adverse effect?

A. Fever

B. Constipation

C. Peptic ulcer disease

D. Metallic taste when eating

C. Peptic ulcer disease

31

When teaching a patient about allopurinol, what should the nurse encourage the patient to do?

A. eat more meat

B. Increase vitamin C intake

C. Have an annual eye examination

D. Take medication 2 hours before meals

C. Have an annual eye examination

32

A patient is admitted to the hospital with an acute gout attack. The nurse expect that which medication will be ordered to treat acute gout?

A. Colchicine

B. Allopurinol

C. Probenecid

D. Sulfinpyrazone

A. Colchicine

33

The patient taking aspirin for arthritis. Which adverse reaction should the nurse teach the patient to report to the HCP?

A. Tinnitus

B. Seizures

C. Sinusitis

D. Palpitations

A. Tinnitis

34

The HCP has prescribed cyclobenzaprine to the patient with muscle spasms. Which condition, if found in the patient's medical history, prompts the nurse to contact the HCP for an alternative prescription? Select all

A. Asthma

B. peptic Ulcers

C. hyperthyroidism

D. Hepatic impairment

E. Narrow angle Glaucoma

C. Hyperthyroidism

E. Narrow angle glaucoma

Cyclobenzaprine may cause hypertension and tachycardia in a patient who has hyperthyroidism and this med increases IOP.

Pyridostigmine may not be administered in patient who have asthma, peptic ulcers, and hepatic impairment

pg 248

35

Which assessment finding in a patient taking NSAIDs requires immediate intervention?

Black, tarry stools
Headache
Nonproductive cough
Palpitations

Black, tarry stools

36

A patient at risk for stroke tells the nurse that the doctor "told me to take aspirin every day." The patient states that he is on nabumetone daily, so he does not need to take the aspirin also. What is the nurse's best response to the patient?

"You are correct."
"You should take Tylenol every day instead."
"Ask your doctor to increase your dose of Relafen."
"Take an aspirin every day even though you are on nabumetone."

"Take an aspirin every day even though you are on nabumetone"

37

What is the most important information for the nurse to include in a teaching plan for the patient receiving allopurinol?

"Do not take this medication during an acute attack of gout."
"Include salmon and organ meats in your diet weekly."
"Take the medication with an antacid to minimize gastrointestinal distress."
"This medication may cause your urine to turn orange."

"Do not take this medication during an acute attack of gout"

38

The nurse is caring for a patient who states, "I can't take aspirin. It makes my stomach hurt." What is the nurse's best response to the patient?

"You should take ibuprofen instead."
"You can try enteric-coated aspirin."
"I will see if you can get a prescription for another pain reliever."
"Try taking the aspirin with milk."

"You can try enteric-coated aspirin"

39

Which intervention is most appropriate for a patient who needs treatment for acute postoperative pain?

Administer allopurinol PO every 4 hours.
Administer celecoxib PO every 6 hours.
Administer indomethacin PO every 4 hours.
Administer ketorolac IV every 4 hours PRN.

Administer ketorolac IV every 4 hours PRN

40

Which assessment finding indicates that the nonsteroidal anti-inflammatory drug has been effective?

Pain has decreased from "a 6 to a 1" on a scale of 10.
Patient's bleeding time is prolonged.
Patient has increased circulation to his legs.
PTT is 100 seconds.

Pain has decreased from "a 6 to a 1" on a scale of 10

41

A patient has been taking aspirin for chronic pain. The patient states that the pain is not relieved with 650 mg of aspirin every 4 hours. What is the best instruction for the nurse to give the patient?

Increase your dose to 1000 mg every 4 hours.
Alternate aspirin and a narcotic analgesic every 4 hours.
Take aspirin and a COX-1 inhibitor at the same time.
Notify your health care provider that the medication is not effective.

Notify your health care provider that the medication is not effective

42

A patient has been prescribed celecoxib to treat arthritis. The nurse will contact the health care provider if the patient shows symptoms of which condition?

Anemia
Cataracts
Glaucoma
Hyperthyroidism

Anemia

43

A patient is prescribed ketorolac 40 mg and antibiotics after orthopedic surgery. Which nursing action does the nurse expect to perform while caring for the patient?

A. Stop administering ketorolac after 5 days

B. Administer ketorolac 40 mg and aspirin

C. Adminitser 80 mg of ketorolac if the patient has severe pain

D . Avoid administering antibiotics while administering ketorolac

A. Stop administering ketorolac after 5 days

44

A female patient who is at risk for stroke is on aspirin therapy. The nurse provides instruction regarding the correct use of aspirin to ensure an effective outcome of the treatment. Which statement made by the patient indicates effective understanding?

A. I should take aspirin at mealtime

B. I should take aspirin with warfarin

C. I should discontinue aspirin for the first 2 days of my menstrual cycle

D. I should avoid large doses of Vitamin C during aspirin therapy

A. I should take aspirin at meal time.

Aspirin should be discontinued 2 days prior to menstrual period and 2 days after start.

45

A patient with arthritis is on Ibuprofen therapy. Which action performed by the patient could cause complications?

A. Eating more ginger and garlic

B. Increasing Vitamin C in diet

C. Avoiding aspirin 2 days before menstruation

D. Taking acetaminophen in place of aspirin during menstrual period

A. Eating more ginger and garlic

pg 285

46

Which drug is most appropriate for a patient with back pain caused by inflammation?

A. Aspirin

B. Ketorolac

C. Ibuprofen

D. Diclofenac sodium

C. Ibuprofen

47

A nurse is teaching a patient with gout about dietary management during the administration of allopurinol. Which instruction given by the nurse ensures effective treatment?

A. Eat more organ meat

B. Eat more oranges

C. Take the medication with lots of fluids

D. Take the medication with coffee

C. Take the medication with lots of fluids

to avoid development of kidney stones. meat should be avoided, oranges with Vitamin C can lead to kidney stones while on allopurinol. Caffeine increases uric acid levels.

pg. 289

48

A patient with rheumatoid arthritis is on infliximab therapy. The nurse teaches the patient to report which side effect to the primary health care provider immediately? Select all that apply

A. Dyspnea

B. Sinusitis

C. Seizures

D. Depression

E. Metallic tast

A. Dyspnea, C. Seizures, D . Depression

49

Which is an indication for a disease modifying antirheumatic drugs? select all that apply

A.. Rosacia

B. psoriasis

C. Osteoarthritis

D. Chrohn disease

E. Rheumatoid arthritis

B. Psoriasis, D. Chrohn disease, E. Rheumatoid arthritis

50

A family visits a patient in a long term care facility, and they notice several large bruises on the patient and become alarmed. The patient is on a moderate dose of aspirin daily. Which response would the nurse make?

A. We have already called 911

B. There is nothing to worry about

C. This is common with people taking aspirin

D. The patient is very Clumsy and always getting hurt

C. This is common with people taking aspirin

pg. 283

51

The nurse is assessing a 3 year old child who has a fever. After checking the laboratory reports, the nurse finds that the child has influenza B. Which medication does the nurse expect to find included in the care plan?

A. Aspirin

B. Acetaminophen

C. Aspirin combination drug

D. Aspirin and ibuprofen

B. Acetaminophen

Aspirin should not be given to children. Reye syndrome, Encephalopathy and damage to the child's liver

52

The parent's of a 5 year old child informs the nurse that they frequently give aspirin to the child. The nurse understands that this child is at risk for developing which condition?

A. Asthma

B. Diarrhea

C. Stomach Cramps

D. Reye Syndrome

D. Reye syndrome

pg 281

53

The nurse assessing a patient with pain in multiple joints who has been prescribed indomethacin. When reviewing the laboratory results the patient has hyperuricemia and deposition of sodium rate crystals in the synovial fluid. Which drug does the nurse expect to be added to the patient's regimen?

A. Tolmetin

B. Celecoxib

C. Nabumetone

D. Allopurinol

D. Allopuriol

Pain in multiple joints, hyperuricemia, and deposition of sodium rate crystals indicates that the patient has gouty arthritis.

p. 289

54

A patient with osteoarthritis is on drug therapy. During a follow up visit, the patient reports severe pain in the upper abdomen and is diagnosed with a gastrointestinal ulcer. The nurse advocates to switch the patient to switch the patient to which medication for treatment of osteoarthritis?

A. Meloxicam

B. Celecoxib

C. Nabumetone

D. Indomethacin

C. Nabumetone

It does not cause GI upset, and it is approved to treat osteoarthritis.

p. 279

55

Prostaglandin inhibitors are primarily used as which type of agent?

A. Analgesic

B. Antipyretic

C. Anticoagulant

D. Antiinflammatory

D. Antiinflammatory

pg. 278

56

Which medication is effective for the treatment of ulcerative colitis?

A. Tolmetin

B. Diflunisal

C. Olsalazine Sodium

D. Diclofenac Sodium

c. Olsalazine sodium

Tolmetin treats acute and chronic arthritis, Diflunisal and diclofenac sodium are effective in treatment of osteoarthritis and rheumatoid arthritis.

p 279

57

Cyclooxyrgenase 1 carries out which function? Select all that apply

A. Triggers pain

B. triggers inflammation

C. Regulates blood platelets

D. Protects the stomach lining

E. Inhibits prostaglandin synthesis

C. Regulates blood platelets

D. protects the stomach lining

pg. 278

58

A patient with gouty arthritis is prescribed febuxostat. The nurse reviews the patient's medical history for which condition before administering the medication?

A. infectious diseases

B. Endocrine diseases

C. Chronic mental illness

D. Cardiovascular diseases

D. Cardiovascular diseases

Febuxostat increases blood pressure and heart attacks.

289

59

The nurse is administering ibuprofen to a patient with arthritis. Which nursing intervention does the nurse employ to ensure an effective outcome of the treatment?

Select all that apply

A. Observing the patient for fever, nausea, and vomiting

B. Moitorying peripheral edema, especially in the morning

C. Providing the name and dosage of the medication to the patient

D. Administering a NSAID 30 minutes before meal

E. informing the patient that the desired response of ibuprofen will be experienced very quickly

B. Moitorying peripheral edema, especially in the morning

C. Providing the name and dosage of the medication to the patient

60

A patient is taking infliximab and asks the nurse which side effects / adverse reactions to expect from this drug. The nurse lists which side effects? Select all that apply

A. Fatigue

B. Headache

C. Chest pain

D. Renal damage

E. Severe infection

A fatigue, B. headache, C. Chest pain, E. severe infections

61

The nurse is teaching a patient about taking aspirin. Which are important points to include? Select all that apply

A. Advise the patient to avoid alcohol while taking aspirin

B. Instruct the patient to take aspirin on an empty stomach before meals

C. Instruct the patient to inform dentist of the aspirin dosage before having dental work

D. Instruct the patient to inform surgeon of the aspirin dosage before surgery

E. Suggest that aspirin may be given to children for flu symptoms

A. Advise the patient to avoid alcohol while taking aspirin

C. Instruct the patient to inform dentist of the aspirin dosage before having dental work

D. Instruct the patient to inform surgeon of the aspirin dosage before surgery

62

A nurse is caring for a patient with arthritis who is on aspirin therapy. Which intervention performed by the nurse ensures effective treatment? Select all

A. Performing a TB skin test

B. Monitoring the serum salicylate level

C. Recording the patient's urine output

D. Monitoring peripheral edema in the morning

E. Monitoring dark stools, bleeding gums, and petechiae

B. Monitoring the serum salicylate level

E. Monitoring dark stools, bleeding gums, and petechiae

normal therapeutic range 15-30. over 30 toxic

63

The nurse is educating a patient about antiinflammatory drugs. Which information does the nurse include in the teaching? Select all that apply

A. Cyclooxyrgenase 2 inhibitors may prevent colon cancer

B. Salicylates may reduce the risk for stomach cancer

C. People with diabetes must be careful taking ibuprofen

D. Ketorolac is comparable to opioids for postoperative pain

A. Cyclooxyrgenase 2 inhibitors may prevent colon cancer

C. People with diabetes must be careful taking ibuprofen

D. Ketorolac is comparable to opioids for postoperative pain

64

A patient with rheumatoid arthritis has been taking methotrexate for several months and has developed non-hodgkin lymphoma. Which drug has the ability to treat both disorders?

A. Anakinra

B. Rituximab

C. Golimumab

D. Etanercept

B. Rituximab

65

Which is the drug of choice for chronic joint pain?

A. sulindac

B. Tometin

C. Piroxicam

D. indomethacin

C. Piroxicam

Sulindac, Tolmetin, and indomethacin are all used to treat arthritis, classified as para-chlorobenzoic acids, but they are very irritating to the stomach when compared to piroxicam

66

In which way is tometin similar to aspirin? select all that apply

A. Salicylic acid derivatives

B. Equally effective in treating arthritis

C. Contraindicated during pregnancy

D. Cyclooxyrgenase 1 inhibitors

E. First generation anti-inflammatory agents

C. Contraindicated during pregnancy

D. Cyclooxyrgenase 1 inhibitor

E. First Generation anti-inflammatory agents

67

Which action of adalimumab would the nurse explain to a patient receiving it for treatment of psoriatic arthritis?

A. Decreases inflammation

B. Promotes excretion of uric acid

C. Promotes prostaglandin synthesis

D. Blocks the transmission of pain impulses

A. Decreases inflammation