Deck 44: Pharmacotherapy of Inflammation and Fever

Question 1

Which of the following best describes the "aspirin triad"?
1)Aspirin should not be used for clients with chronic rhinitis, acute bronchospasm, or congestive heart failure.
2)Clients with a hypersensitivity to any salicylate should not be administered aspirin.The "aspirin triad" includes clients who have ibuprofen allergy, nasal congestion, and asthma.
3)Clients with a hypersensitivity to any salicylate should not be administered aspirin.The "aspirin triad" includes clients who have aspirin allergy, nasal polyps, and asthma.
4)Clients with a hypersensitivity to any salicylate should not be administered aspirin.The "aspirin triad" includes clients who have head trauma, congestive heart failure, and asthma.

Answer 1

3

Question 2

Salicylism is:
1)A serum salicylate level below 100 mcg/ml.
2)A serum salicylate level above 100 mcg/ml.
3)A serum salicylate level above 400 mcg/ml.
4)A serum salicylate level above 200 mcg/ml.

Answer 2

4

Question 3

Salicylates primarily inhibit the synthesis of:
1)Prostaglandin.
2)Pyrogens.
3)Thromboxane A₂.
4)Histamines.

Answer 3

1

Question 4

The client is experiencing breakthrough pain.What type of nursing interventions may be applied to alleviate and prevent further breakthrough pain?
1)Reposition the client frequently.
2)Time the repeated doses in relation to client need.
3)Medicate the client on an as-needed basis.
4)Suggest to the client that his pain is not real, since appropriate medications have been administered.

Question 5

A 3-year-old is admitted to the pediatric unit with a traumatic injury to his right forearm.His mother had been giving him aspirin at home to control his pain and fever.Approximately three weeks prior to his admission, the 3-year-old developed an upper respiratory infection.The mother asked the nurse why the doctor changed her son's medication from aspirin to acetaminophen.The nurse's best response is:
1)"Acetaminophen is given to children for inflammation and fever when there has been a recent or current history of a viral infection due to the possibility of the development of Reye's syndrome."
2)"It would have been important for the doctor to allow you to continue to medicate your son, since there is a strong level of trust that develops with mother and child."
3)"Typically, aspirin is the only salicylate recommended for children of any age, regardless of prior or current infections."
4)"I really do not know; however, I do not think you should ask the physician about treatment of this child."

Question 6

The first treatment of choice for salicylism includes:
1)Emesis, gastric lavage, and alkalinization of urine.
2)Hemodialysis.
3)Gastric gavage and acidation of urine.
4)Retroperitoneal dialysis.

Question 7

Clients who are taking NSAIDs should not take OTC medications without checking with their primary care provider because:
1)There is an increased risk for Reye's syndrome.
2)Cough medications and other OTC drugs could contain NSAIDs; inadvertent toxicity can occur.
3)No one should be taking more than one medication for pain
4)There could be an increased risk for bleeding in the stomach and within other organs of the body.

Question 8

Inflammation that has a slow onset and that lacks the inflammatory response of distinct stages is:
1)Autoimmune process.
2)Acute inflammation.
3)Chronic inflammation.
4)Histocompatibility.

Question 9

The inflammatory response produces which of the following signs and symptoms associated with disease?
1)Pain, irritability, and change in level of consciousness
2)Fever, change in level of consciousness, and tremors
3)Pain, fever, and tremors
4)Fever, aches and pains, and lethargy

Question 10

When instructing a group of seniors on the actions and adverse effects of aspirin compared to ibuprofen-like drugs, the nurse is asked why the doctor prescribed a low dose of aspirin daily to prevent heart problems.The nurse's best response would be:
1)"Either medication is helpful for the prevention of heart attacks."
2)"Ibuprofen is better for you, even though you might be a candidate for heart attacks."
3)"Ibuprofen and ibuprofen-like medications are not indicated to treat or prevent cardiovascular problems."
4)"Talk to your doctor, because both medications can cause heart disease."

Question 11

Non-aspirin NSAIDs are not used for the prophylaxis of adverse cardiac events because:
1)They have no effect on blood coagulation.
2)They cause a significantly increased risk of stroke.
3)They have less effect on coagulation.
4)They are not safely used with anticoagulant therapy.

Question 12

Once the inflammation process is initiated, which of the following processes causes the edema of the surrounding tissues?
1)Nearby blood vessels become permeable, allowing T-suppressor cells to reach and neutralize the antigen.
2)Increased permeability of the blood vessels causes edema.
3)Tissue damage from the antibodies causes swelling of the surrounding tissues.
4)Typically, swelling and edema will not occur during the inflammatory process.

Question 13

Occasionally, acute inflammation is initiated by a rapid, massive release of inflammatory chemical mediators, which becomes a life-threatening allergic reaction that can cause cardiovascular shock and death.This condition is known as:
1)Phagocytosis.
2)Chemotaxis.
3)Anaphylaxis.
4)Activation of Hageman factor.

Question 14

An antipyretic agent is a drug that will:
1)Block inflammation.
2)Stop swelling.
3)Stop fever.
4)Block pain.

Question 15

Salicylates are very popular anti-inflammatory drugs.This is because they have which of the following properties?
1)They have minimal-to-no side effects.
2)They have no adverse effect on blood clotting.
3)They have the ability to reduce pain.
4)They are primarily given by the IM or IV route.

Question 16

Signs of acute aspirin toxicity or salicylism include which of the following?
1)Tinnitus, metabolic acidosis, hyperventilation, respiratory alkalosis (secondary to stimulation of the respiratory center), dehydration, agitation, CNS depression, nausea, and vomiting
2)Metabolic alkalosis, hypoventilation, respiratory alkalosis, dehydration, CNS depression, nausea, and vomiting
3)Respiratory acidosis, metabolic acidosis, hyperventilation, dehydration, CNS depression, nausea, and vomiting
4)Respiratory acidosis, metabolic alkalosis, hyperventilation, dehydration, CNS depression, nausea, and vomiting,

Question 17

A client is admitted through the Emergency Department with severe gastrointestinal bleeding.The nurse assesses the client's medication history and finds that the client has been taking ibuprofen for arthritic pain.Warfarin (Coumadin)has been recently prescribed due to a diagnosis of atrial fibrillation.The nurse immediately reports her findings and concerns to the physician because:
1)Oral anticoagulants taken with ibuprofen can increase the risk of bleeding.
2)If taken with other NSAID medications, ibuprofen can cause a change in the client's oral mucosa and can cause white patchy lesions.
3)There has been little-to-no research performed that would indicate that the combination of oral coagulants with ibuprofen has caused any increased risk of bleeding.
4)The only real concern for gastrointestinal bleeding with ibuprofen is when it is combined with alcohol.

Question 18

Which of the following drugs was introduced in the 1990s and was found to be effective in the management of mild-to-moderate pain, but has limited use due to increased risk of MI and stroke?
1)Aspirin
2)Acetaminophen (Tylenol)
3)Etanercept (Embrel)
4)Celecoxib (Celebrex)

Question 19

An analgesic is a medication that:
1)Reduces inflammation.
2)Reduces fever.
3)Reduces redness.
4)Reduces pain.

Question 20

A client has been admitted to the medical-surgical unit for pain evaluation.The client has arthritis, and has been taking ibuprofen for many years to help alleviate the pain.Which of the following assessment should be performed on this client?
1)Renal studies; monitor BUN and serum creatinine for renal toxicity.
2)An electrocardiogram for possible congestive heart failure
3)A CBC with differential to monitor for infection.
4)Respiratory auscultation to rule out congestion

Question 21

Through appropriate nursing assessment, the physiological manifestations of pain are:
1)Rapid heart rate and rapid, shallow respirations.
2)Slow respirations with a decreased heart rate.
3)Decreased blood pressure with increased heart rate.
4)Increased blood pressure with decreased heart rate.

Question 22

There are many misconceptions regarding pain control.Which of the following statements is most correct when assessing pain?
1)Incorrect diagnosis frequently occurs as a result of pain.
2)All clients lie about their pain.
3)Pain is a cause, not a result.
4)Narcotic pain medications are too risky in the treatment of chronic pain because there is a high risk of addiction.