front 1 Which NSAID may cause Rye syndrome in children with viral illnesses or fever? A. Aspirin B. meloxicam C. piroxicam D. Nabumetone | back 1 A. Aspirin |
front 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 | back 2 C. Gout is a metabolic disorder caused by uric acid and purine |
front 3 Antiinflammatories inhibit which substance? A. prolactin B. serotonin C. Prostiglandins D. Gama-imunobutyric acid | back 3 C. Prostiglandins |
front 4 Which drug is considered a cox 2 inhibitor? A entodolac B. Naproxen C. Celocoxib D. Meloxicam | back 4 C. Celocoxib |
front 5 Which nonsteroidal anti-inflammatory drug can be administered Intravenously? A. Mefenamic acid B. flurbiprofen sodium C. Diclofenac Sodium D. Ketorolac Tromethamine | back 5 D. Ketorolac is IV and PO. Sort term pain 5 days or less. All others are by mouth only. p 280 |
front 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 | back 6 D. Selective cyclooxyrgenase - 2. COX 2 inhibitors all other are first gen. 283 |
front 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. | back 7 D. Tophi in the great toe Gout- Tophi in the great toe, elbows, and hands. |
front 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 | back 8 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 |
front 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 | back 9 B. You can try enteric-coated aspirin would be the first intervention. Milk may not relieve gastric distress. Pg. 281 |
front 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 | back 10 A. Reduces uric acid synthesis pg. 289 |
front 11 Which symptom is an adverse effect of celecoxib? Select all that apply A. Sinusitis B. Dizziness C. Headache D. Constipation E. Hypotension | back 11 A. Sinusitis B. Dizziness C. Headache Celecoxib is a COX2 inhibitor |
front 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 | back 12 D. Inhibits the migration of leukocytes to the inflamed site |
front 13 Which property of aspirin differentiates it from other NSAID's? A Analgesic B. Antipyretic C. Antiplatelet D. Antiinflammatory | back 13 C. Antiplatelet All NSAID's have antipyretic, antiinflammatory, and analgesic properties. 278 |
front 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 | back 14 D. May be used to suppress the inflammatory process of rheumatoid arthritis when other treatment fail Pg. 286 |
front 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 | back 15 A. Pain has decreased for a 6 to a 1 on a scale of 10 |
front 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 | back 16 D. Take your aspirin every day even though you are on nabumetone |
front 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. | back 17 D. Notify your HCP that the medication is not effective. |
front 18 Which assessment finding in a patient taking NSAID's requires immediate intervention? A. Black tarry stools B. headache C. Nonproductive cough D. Palpitation | back 18 A. Black tarry stools |
front 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 | back 19 A. Anemia |
front 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. | back 20 A. do not take this medication during an acute attack of gout |
front 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 | back 21 D. Administer ketorolac IV every 4 hours Acute postoperative pain can not be managed with PO meds. |
front 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 | back 22 B. Increases the renal excretion of uric acid |
front 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 | back 23 B. Avoid taking aspirin concurrently Aspirin causes uric acid retention. |
front 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 | back 24 B Immunomodulator |
front 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 | back 25 A. Crohn disease |
front 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 | back 26 D. Intravenously |
front 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 | back 27 A. Avoid taking aspirin with ibuprofen B. Take with food to reduce GI upset C. Monitor for bleeding gums, nosebleeds, black tarry stools |
front 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 | back 28 B. My stomach aches and burns |
front 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 | back 29 A. Allopurinol |
front 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 | back 30 C. Peptic ulcer disease |
front 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 | back 31 C. Have an annual eye examination |
front 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 | back 32 A. Colchicine |
front 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 | back 33 A. Tinnitis |
front 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 | back 34 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 |
front 35 Which assessment finding in a patient taking NSAIDs requires
immediate intervention? | back 35 Black, tarry stools |
front 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? | back 36 "Take an aspirin every day even though you are on nabumetone" |
front 37 What is the most important information for the nurse to include in a
teaching plan for the patient receiving allopurinol? | back 37 "Do not take this medication during an acute attack of gout" |
front 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? | back 38 "You can try enteric-coated aspirin" |
front 39 Which intervention is most appropriate for a patient who needs
treatment for acute postoperative pain? | back 39 Administer ketorolac IV every 4 hours PRN |
front 40 Which assessment finding indicates that the nonsteroidal
anti-inflammatory drug has been effective? | back 40 Pain has decreased from "a 6 to a 1" on a scale of 10 |
front 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? | back 41 Notify your health care provider that the medication is not effective |
front 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? | back 42 Anemia |
front 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 | back 43 A. Stop administering ketorolac after 5 days |
front 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 | back 44 A. I should take aspirin at meal time. Aspirin should be discontinued 2 days prior to menstrual period and 2 days after start. |
front 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 | back 45 A. Eating more ginger and garlic pg 285 |
front 46 Which drug is most appropriate for a patient with back pain caused by inflammation? A. Aspirin B. Ketorolac C. Ibuprofen D. Diclofenac sodium | back 46 C. Ibuprofen |
front 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 | back 47 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 |
front 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 | back 48 A. Dyspnea, C. Seizures, D . Depression |
front 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 | back 49 B. Psoriasis, D. Chrohn disease, E. Rheumatoid arthritis |
front 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 | back 50 C. This is common with people taking aspirin pg. 283 |
front 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 | back 51 B. Acetaminophen Aspirin should not be given to children. Reye syndrome, Encephalopathy and damage to the child's liver |
front 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 | back 52 D. Reye syndrome pg 281 |
front 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 | back 53 D. Allopuriol Pain in multiple joints, hyperuricemia, and deposition of sodium rate crystals indicates that the patient has gouty arthritis. p. 289 |
front 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 | back 54 C. Nabumetone It does not cause GI upset, and it is approved to treat osteoarthritis. p. 279 |
front 55 Prostaglandin inhibitors are primarily used as which type of agent? A. Analgesic B. Antipyretic C. Anticoagulant D. Antiinflammatory | back 55 D. Antiinflammatory pg. 278 |
front 56 Which medication is effective for the treatment of ulcerative colitis? A. Tolmetin B. Diflunisal C. Olsalazine Sodium D. Diclofenac Sodium | back 56 c. Olsalazine sodium Tolmetin treats acute and chronic arthritis, Diflunisal and diclofenac sodium are effective in treatment of osteoarthritis and rheumatoid arthritis. p 279 |
front 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 | back 57 C. Regulates blood platelets D. protects the stomach lining pg. 278 |
front 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 | back 58 D. Cardiovascular diseases Febuxostat increases blood pressure and heart attacks. 289 |
front 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 | back 59 B. Moitorying peripheral edema, especially in the morning C. Providing the name and dosage of the medication to the patient |
front 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 | back 60 A fatigue, B. headache, C. Chest pain, E. severe infections |
front 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 | back 61 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 |
front 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 | back 62 B. Monitoring the serum salicylate level E. Monitoring dark stools, bleeding gums, and petechiae normal therapeutic range 15-30. over 30 toxic |
front 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 | back 63 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 |
front 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 | back 64 B. Rituximab |
front 65 Which is the drug of choice for chronic joint pain? A. sulindac B. Tometin C. Piroxicam D. indomethacin | back 65 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 |
front 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 | back 66 C. Contraindicated during pregnancy D. Cyclooxyrgenase 1 inhibitor E. First Generation anti-inflammatory agents |
front 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 | back 67 A. Decreases inflammation |