Deck 6: Anti-Inflammatory Drugs

Question 1

Which side effect of corticosteroid therapy is permanent even after the drug is stopped?

A) Difficulty sleeping
B) Stretch marks
C) Weight gain
D) Moon face

Answer 1

Stretch marks

Question 2

A nursing home resident has been prescribed to take 20 mg of prednisolone immediately.The facility does not have prednisolone,only prednisone.What is your best action?

A) Substitute prednisone for prednisolone because they are both corticosteroids.
B) Hold the dose until the pharmacy opens the next day.
C) Notify the prescriber immediately of this situation.
D) Administer the parenteral form of the drug.

Answer 2

Notify the prescriber immediately of this situation.

Question 3

A patient is prescribed topical hydrocortisone 0.1% for skin inflammation.What action is most important to teach the patient for applying this drug?

A) "Use a thick layer of drug just to the area that needs treatment."
B) "Apply a thin layer to the affected area and to the skin near the area."
C) "Apply a thick layer over and 1 inch around the affected area."
D) "Use as thin a layer as possible just to the area that needs treatment."

Answer 3

"Use as thin a layer as possible just to the area that needs treatment."

Question 4

Why is inflammation considered a nonspecific body response?

A) Inflammation is the basis for almost every type of chronic disease.
B) Infection by bacteria or viruses is always a part of inflammation.
C) The same tissue responses occur regardless of the type of triggering event.
D) The discomfort associated with inflammation can be reduced by over-the-counter drugs.

Question 5

Which problem is a common side effect of long-term corticosteroid use?

A) Acne
B) Weight loss
C) Redness and pain
D) Low blood pressure

Question 6

A patient who has been prescribed long-term low-dose prednisone to control inflammation reports concern about the changes in her appearance caused by the drug.What is your best response?

A) "This often happens when an individual takes this drug.You now have Cushing's disease."
B) "When you stop taking this drug,the changes will disappear,but it may take a while."
C) "You can make use of different styles of clothes to minimize changes in appearance."
D) "Changes in your diet and an exercise program will eliminate these changes while you are on this drug."

Question 7

Which assessment is most important to perform when providing care to an older adult patient who has been prescribed a topical corticosteroid?

A) Skin assessment
B) Intake and output
C) Cognition or mental status
D) Urinary tract infection

Question 8

A patient who has been taking 30 mg of prednisone daily for the last 10 days reports crying more often and then suddenly getting angry at small issues.What is your best action?

A) Document the patient's response as the only action.
B) Hold the next dose and notify the prescriber immediately.
C) Reassure the patient that this is an expected drug response.
D) Suggest that the patient see a counselor or attend an anger management class.

Question 9

Why are corticosteroid drugs usually prescribed for a short period of time?

A) The inflammatory process cannot be controlled with less powerful drugs.
B) Inhalation of corticosteroid drugs causes irreversible damage to the lungs.
C) These drugs work less effectively when given over an extended period.
D) Corticosteroids have many adverse effects and side effects.

Question 10

Which drug is a leukotriene inhibitor?

A) Piroxicam (Feldene)
B) Loratadine (Claritin)
C) Montelukast (Singulair)
D) Diphenhydramine (Benadryl)

Question 11

Which anti-inflammatory drug is classified as a "COX-1" inhibitor?

A) Hydrocortisone (Lanacort)
B) Celecoxib (Celebrex)
C) Zyleuton (Zyflo)
D) Naproxen (Aleve)

Question 12

Which drug should NOT be given to children?

A) Prednisone
B) Ibuprofen (Motrin)
C) Aspirin (Bufferin)
D) Acetaminophen (Tylenol)

Question 13

What is the most common side effect of antihistamines?

A) Drowsiness
B) Weight gain
C) Difficulty breathing
D) Excessive urination

Question 14

Which stage of the inflammatory response involves capillary leak syndrome?

A) Stage I
B) Stage II
C) Stage III
D) Stage IV

Question 15

When is an inflammatory response a health problem rather than a helpful protection?

A) When a patient's immune system is suppressed
B) When infection accompanies inflammation
C) When inflammation is prolonged
D) When pain is experienced

Question 16

Which NSAID is a COX-2 inhibitor?

A) Celecoxib (Celebrex)
B) Ketorolac (Toradol)
C) Aspirin (Bufferin)
D) Ibuprofen (Motrin)

Question 17

Which body-produced substance is targeted and inhibited by most disease modifying antirheumatic drugs (DMARDs)?

A) Tumor necrosis factor (TNF)
B) White blood cells (WBCs)
C) Cyclo-oxygenase (COX)
D) Interferon (IFN)

Question 18

Which drug should be avoided during the last 3 months of pregnancy?

A) Prednisone
B) Montelukast
C) Indomethicin
D) Dyphenhydramine

Question 19

A patient is prescribed an oral corticosteroid for a chronic inflammatory health problem.Which precaution is most important to teach?

A) "Never stop taking this drug without consulting your prescriber."
B) "Avoid crowds and people who are ill."
C) "Be sure to take this drug with food."
D) "Reduce your salt intake."

Question 20

Which corticosteroid is applied topically to the skin?

A) Betamethasone (Celestone)
B) Triamcinolone (Kenalog)
C) Dexamethosone (Decadron)
D) Methylprednisolone (Solu-Medrol)

Question 21

A patient who has been taking montelukast (Singulair)for 3 months reports having urine the color of coffee.What is your best response?

A) "You need to increase your intake of water and decrease your intake of coffee."
B) "You need to stop taking this drug and notify your prescriber today."
C) "Don't worry.All patients taking this drug have dark urine."
D) "Do not take this drug any more often than prescribed."

Question 22

Which new symptom in a patient taking celecoxib (Celebrex)requires immediate medical attention?

A) Headache
B) Ankle swelling
C) Chest pain
D) Itchy nose

Question 23

A patient prescribed zileutin (Zyflo)has yellowing of the sclera.Which laboratory test result is most important to check?

A) Kidney function tests
B) Complete blood count
C) Liver function tests
D) Serum electrolytes

Question 24

Which question is most important to ask a patient before giving the first dose of etaneracept (Enbrel)?

A) Do you have diabetes?
B) Are you pregnant or breastfeeding?
C) Do you have psoriasis or another skin disorder?
D) Have you ever had tuberculosis or hepatitis B or C?

Question 25

A patient with an inflammatory response is prescribed ranitidine (Zantac)75 mg once a day.What is your best action?

A) Give the drug as ordered.
B) Hold the drug and notify the prescriber.
C) Teach the patient to take the drug first thing in the morning.
D) Ask the patient if he or she is allergic to any drugs or other substances.

Question 26

An older adult is prescribed naproxen (Naprosyn)250 mg orally twice daily for management of arthritis pain.Which precaution is most important to teach the patient?

A) "Weigh yourself daily every morning,and if you gain more than 3 to 4 lb in a week,report it to your prescriber."
B) "Avoid taking blood pressure medicine at the same time as this drug because Naprosyn inactivates these drugs."
C) "Go to the emergency department for an injection of Naprosyn if you are vomiting and cannot keep the drug down."
D) "Drink a full glass of water every time you take a dose of Naprosyn."

Question 27

Which statement made by the patient newly prescribed to take a nonsteroidal anti-inflammatory drug (NSAID)indicates that more teaching is needed?

A) "I should avoid taking acetaminophen (Tylenol)any time I am also taking an over-the-counter NSAID."
B) "Because aspirin causes me to have asthma,I should never take another NSAID like ibuprofen (Advil)."
C) "I should try to avoid taking any NSAID,even over-the-counter NSAIDs,for more than a few days or a week."
D) "Because Celebrex (celecoxib)has so few side effects,I don't have to worry about how often I take it."

Question 28

For which health problem will you specifically monitor in the older patient prescribed to take a corticosteroid for the next month?

A) Sudden hair loss
B) Weight loss
C) High blood glucose level
D) Change in sleep patterns

Question 29

Why are aspirin and aspirin-containing drugs avoided for use in children?

A) Aspirin is associated with the development of Reye's syndrome.
B) Aspirin would drop a child's body temperature below normal.
C) Children are at higher risk for bleeding with aspirin use.
D) A child's liver is unable to metabolize aspirin.

Question 30

A patient who usually takes 40 mg of prednisone daily for a chronic problem has been vomiting for 12 hours.What will you tell the patient about the drug therapy?

A) "Go to the prescriber's office immediately for an injectable dose of the drug."
B) "If you stop vomiting by tomorrow,take two doses of the drug."
C) "Take no drugs until you stop vomiting for at least 24 hours."
D) "Take the drug even though you are vomiting."

Question 31

Which statement about corticosteroid use and pediatric patients is true?

A) Adrenal atrophy does not occur during long-term use because this organ is younger and healthier in children.
B) Because these drugs slow cell division,they can interfere with normal growth and are not used in children.
C) Children are at the same risk for every side effect of long-term corticosteroid use that adults experience.
D) Drug doses are usually higher than for adults because children metabolize corticosteroids faster than adults.

Question 32

A patient is prescribed triamcinolone (Kenalog)ointment for an allergic skin rash.Which precaution is most important to teach this patient?

A) "Always wear gloves when applying this ointment."
B) "Do not use the ointment on an infected skin area."
C) "Keep the drug refrigerated between applications."
D) "Do not wash the ointment off until the area is healed."

Question 33

Which precaution is important to teach a patient who takes antihistamines at home?

A) Avoid drinking coffee and other beverages containing caffeine.
B) Avoid drinking alcohol within 4 hours of taking the drug.
C) Do not stop taking this drug suddenly.
D) Avoid taking aspirin while on this drug.

Question 34

A patient taking a nonsteroidal anti-inflammatory drug (NSAID)tells you that the drug causes an upset stomach.What is your best response?

A) "Always take this drug with food or with milk."
B) "Stop taking the drug and notify your prescriber."
C) "Try chewing the drug instead of swallowing it whole."
D) "Take the drug on an empty stomach to avoid vomiting."

Question 35

For which drug should you ask a patient about an allergy to "sulfa" drugs before administering it?

A) Aspirin (Bufferin)
B) Ketorolac (Toradol)
C) Celecoxib (Celebrex)
D) Oxaprozin (Daypro)

Question 36

A patient is prescribed ibuprofen (Advil)200 mg four times a day as needed for inflammation and pain related to arthritis.The patient is scheduled for oral surgery.What priority teaching is appropriate for this patient?

A) "The Advil will help relieve your pain after surgery."
B) "Report any bruising to your prescriber immediately."
C) "Ask about having the injectable form of this drug after surgery."
D) "Stop taking this drug at least 36 hours before your scheduled surgery."

Question 37

A 78-year-old man has been taking diphenhydramine (Benadryl)for seasonal allergies.Which new symptom should you report to the prescriber?

A) Decreased urination
B) Drowsiness
C) Dry mouth
D) Cough

Question 38

A patient who has been prescribed diphenhydramine (Benadryl)reports a dry mouth and feeling sleepy.What is your best action?

A) Document the finding and notify the prescriber.
B) Remind the patient that naps provide needed rest.
C) Suggest sucking on hard candy to relieve dry mouth.
D) Reassure the patient that these are expected side effects.

Question 39

A patient has all of the following health problems and seasonal allergies.Which should you warn the patient can be made worse by over-the-counter antihistamines?

A) Asthma
B) Breast cancer
C) Rheumatoid arthritis
D) High blood pressure

Question 40

A patient is prescribed 20 mg of ketorolac (Toradol)intramuscularly.How many milliliters should you draw up from a vial of ketorolac containing 30 mg/mL?

A) 0.5
B) 0.7
C) 1
D) 2

Question 41

Which factors determine the size and severity of the inflammatory response? (select all that apply)

A) Intensity of the injury
B) Type of tissue injured
C) Severity of the invasion
D) Gender of the patient
E) Extent of injury
F) Duration of the invasion

Question 42

Which main signs and symptoms should you teach a patient to recognize as inflammation? (select all that apply)

A) Warmth
B) Redness
C) Headache
D) Swelling
E) Pain
F) Bleeding
G) Decreased function

Question 43

Which symptoms of inflammation are caused by leakage of blood plasma into the tissues at the site of injury or invasion? (select all that apply)

A) Increased production and migration of leukocytes
B) Phagocytosis and fever
C) Warmth and redness
D) Swelling and pain