Deck 12: Anti-Inflammatory, Antiarthritis, and Antigout Drugs

Question 1

A patient with severe asthma who has been taking systemic corticosteroids for 2 weeks tells you he is feeling better and would like to stop taking this drug today. What is your best response?

A)"Take the last dose today, and then you can stop the drug."
B)"As long as your asthma symptoms have resolved, you can stop the drug."
C)"Skip the drug on the days you feel better and take it only if symptoms reoccur."
D)"The dose of this drug will need to be tapered down over time to prevent complications."

Answer 1

"The dose of this drug will need to be tapered down over time to prevent complications."

Question 2

A patient is beginning a prescribed disease-modifying antirheumatic drug (DMARD) for the treatment of rheumatoid arthritis. The patient asks you how these drugs work to help this condition. What is your best response?

A)"These drugs modify the immune system by decreasing T-cell response."
B)"These drugs act to increase the body's immune response to rheumatoid factor."
C)"These drugs work by inhibiting the inflammatory mediator tumor necrosis factor."
D)"These drugs reduce the amount of an enzyme that controls the production of purines."

Answer 2

"These drugs work by inhibiting the inflammatory mediator tumor necrosis factor."

Question 3

You are teaching a patient with rheumatoid arthritis about giving subcutaneous adalimumab (Humira) at home. What instructions should be included in this patient's teaching plan?

A)Before drawing up drug, shake the vial well to distribute the drug.
B)Rotate the injection site of the thighs and abdomen frequently.
C)Do not discontinue this drug if you have an infection.
D)Rub the injection site well to prevent bleeding.

Answer 3

Rotate the injection site of the thighs and abdomen frequently.

Question 4

A patient with a history of alcoholism is taking aspirin on a regular basis for general aches and pains. The patient reports feeling weak and dizzy, and has developed abdominal pain 7 days ago, which is increasing in severity. What adverse drug effect might this patient be experiencing?

A)Liver damage due to the combination of aspirin and alcohol
B)Reye syndrome due to the combination of aspirin and alcohol
C)Gastrointestinal bleeding due to the combination of aspirin and alcohol
D)Gastroesophageal reflux disease due to the combination of aspirin and alcohol

Question 5

You are preparing a teaching plan for a patient prescribed the nonselective NSAID ibuprofen 800 mg orally daily. Which of the following instructions should be included in this teaching plan?

A)Avoid eating excessive amounts of protein as this can interfere with the drug's action.
B)This drug can increase serum blood sugar levels in patients with diabetes.
C)Taking this drug before bed can cause excessive night-time urination.
D)Take this drug with food to prevent GI upset.

Question 6

A patient with a chronic inflammatory condition has been taking corticosteroids for several months. Which of the following side effects should you monitor this patient for?

A)Weight loss
B)Hypotension
C)Fat redistribution
D)Increased muscle mass

Question 7

A patient with diabetes has been prescribed a course of prednisone to treat an acute exacerbation of asthma. Which of the following instructions should you give to the patient before he is discharged home?

A)"Monitor your blood sugar regularly."
B)"Take this drug on an empty stomach."
C)"You may stop this drug when your symptoms improve."
D)"You may experience a change in the color of your urine."

Question 8

A patient on long-term corticosteroid therapy appears to have frequent colds and upper respiratory infections and is concerned that something may be wrong. What is your best response?

A)"Corticosteroids affect the production of protective mucous."
B)"Taking corticosteroids for a long time can reduce your immunity."
C)"Corticosteroids increase adrenal gland function and result in infections."
D)"There is no relationship between the treatment for your condition and frequent colds."

Question 9

A male patient taking daily aspirin for the prevention of cardiovascular complications informs you that he is planning to have a tooth extraction next week. What correct information should be provided to this patient?

A)"Notify your healthcare provider and stop taking the aspirin before the dental procedure."
B)"You may require aspirin plus additional pain drug after the dental procedure."
C)"Taking enteric-coated aspirin ensures you will not be at risk for any complications."
D)"Aspirin is associated with tooth loss following dental surgery."

Question 10

A patient with acute gout asks you why allopurinol cannot be used at this time. What is your best response?

A)"Allopurinol does not lower uric acid levels."
B)"Allopurinol is useful in rheumatoid arthritis, but not gout."
C)"Allopurinol is used only for the prevention of gout attacks."
D)"Allopurinol can cause swelling of the feet, worsening your gout symptoms".

Question 11

A mother brings her febrile infant to the pediatric clinic for evaluation. The infant has a temperature of 102 degrees. The mother tells you that she wishes she had given the baby a dose of liquid aspirin before leaving the house to bring down the baby's temperature. What is your best response?

A)"Aspirin can be dangerous, and should not be given to infants."
B)"We can give the baby a dose now before you leave the clinic."
C)"Give aspirin alternating with acetaminophen every 4 h for fever."
D)"Aspirin will need to be given with a proton-pump inhibitor to prevent bleeding."

Question 12

A patient with a history of cardiovascular disease has been prescribed aspirin daily. What specific risk should this patient be informed of because of taking aspirin?

A)Risk of infection
B)Risk of bleeding
C)Risk of liver impairment
D)Risk of cognitive impairment

Question 13

Which laboratory value is most likely to be elevated in a patient presenting with acute gout?

A)Potassium
B)Uric acid
C)Calcium
D)Glucose

Question 14

What would be an appropriate nursing action to prevent complications in an elderly person taking long-term corticosteroid therapy?

A)Protect the skin from skin tears.
B)Bathe the patient twice daily.
C)Check the patient's blood pressure before giving the drug.
D)Ask the patient about the presence of constipation.

Question 15

For which patients may the use of disease-modifying antirheumatic drug (DMARD) be contraindicated?

A)A patient with pre-existing heart failure
B)A patient who has a history of a depressive disorder
C)A patient with diabetes mellitus controlled with insulin
D)A patient who has chronic obstructive pulmonary disease

Question 16

Inflammation is the result of tissue and blood vessel reactions to white blood cells. What are the symptoms associated with inflammation? (Select all that apply.)

A)Pain
B)Warmth
C)Redness
D)Swelling
E)Elevated temperature
F)Bacteria in the bloodstream

Question 17

A patient with joint inflammation is prescribed an anti-inflammatory drug. The patient asks you how this drug works to address this problem. What is your best response?

A)"Anti-inflammatory drugs reduce pain and limit blood vessel responses to joint injury."
B)"Anti-inflammatory drugs contain antibacterial and anti-inflammatory properties."
C)"Anti-inflammatory drugs limit the body's response to cortisol in the body."
D)"Anti-inflammatory drugs increase the release of TNF and other mediators."

Question 18

A patient reports a history of gout in the right big toe. A previous aspiration of the joint revealed uric acid crystals to be present in the joint. Which of the following drugs would be most appropriate to treat this patient?

A)Demerol
B)Colchicine
C)Allopurinol
D)Enteric-coated aspirin

Question 19

A patient reports ringing in her ears while taking aspirin four times a day to relieve arthritis pain. What action should you take?

A)Instruct the patient to reduce the dose of aspirin by half until the ringing stops.
B)No action is needed; this is an expected response to this dose of aspirin.
C)Call the healthcare provider, as this is adverse reaction to the drug.
D)Instruct the patient to take the full dose before bed.

Question 20

A patient with gout requires dietary teaching to help control flare ups of the illness. What should be included in the diet teaching for this patient?

A)Increase your intake of organ meats for protein.
B)Avoid foods that are high in purine, such as tuna.
C)Avoid drinking fruit juices while taking antigout drugs.
D)Increase your intake of vegetables such as cauliflower and asparagus.

Question 21

When caring for a patient who is taking anti-inflammatory drugs, what should be included in the patient's teaching plan? (Select all that apply.)

A)You should take this drug without food.
B)Take this drug with a full glass of water.
C)Only take this drug when you have pain.
D)This drug may interact with anticoagulants.
E)Contact your healthcare provider if you develop dark stools.

Question 22

Corticosteroids are a class of drugs that are used to manage inflammation. What are the properties or actions associated with corticosteroids? (Select all that apply.)

A)Corticosteroids decrease inflammatory mediators.
B)Corticosteroids act only within the cells that are inflamed.
C)Corticosteroids can be used to manage chronic inflammation.
D)Corticosteroids slow the production of WBCs in the bone marrow.
E)Corticosteroids have few adverse effects due to their localized action.
F)Corticosteroids increase arachidonic acid production of inflammatory mediators.

Question 23

Anti-inflammatory analgesics should not be used by patients with which of the following conditions? (Select all that apply.)

A)Stroke
B)Cachexia
C)Liver disease
D)Heart disease
E)Severe migraine
F)Transient ischemic attacks

Question 24

A patient taking anti-inflammatory drugs tells you that some doses of the drug have been missed. What should you teach this patient to do when drug doses are missed? (Select all that apply.)

A)Skip all missed drug dosages.
B)Never take a double dose of this drug.
C)If it is close to the next time the drug is due, skip the missed dose.
D)If possible, take the missed dose within an hour of the scheduled time.
E)Once you have missed a dose, double up on the drug dose at the next time it is due.
F)All missed doses of the drug should be returned to the pharmacy.

Question 25

A patient has been diagnosed with acute adrenal insufficiency. Which of the following symptoms would you expect this patient to present with? (Select all that apply.)

A)Joint pain
B)Increased thirst
C)Peeling of the skin
D)Severe hypertension
E)Lethargy and headache
F)Agitation and sleeplessness

Question 26

You are preparing to teach a patient and family member about long-term corticosteroid therapy. Which instructions should be included in the patient's teaching plan? (Select all that apply.)

A)You may increase the dose of this drug by one-half if your symptoms worsen.
B)Consult your healthcare provider before getting any vaccinations.
C)Stop this drug immediately if you develop nausea or vomiting.
D)Take your dose of this drug early in the morning.
E)Take this drug with food to prevent GI upset.
F)Eat a diet low in potassium-containing foods.