Deck 41: Pharmacotherapy of Inflammation and Fever Hyperactivity Disorder

Question 1

In the 1950s,researchers began searching for safer medications to treat rheumatoid arthritis (RA).Prior to this time,RA was treated with aspirin and corticosteroids.Which drug was identified by the researchers to be safer in the treatment of inflammation and pain for RA clients?

A)Gold compounds
B)Acetaminophen (Tylenol)
C)Celecoxib (Celebrex)
D)Ibuprofen (Motrin,Advil,others)

Answer 1

Ibuprofen (Motrin,Advil,others)

Question 2

Which type of inflammation has a slow onset and lacks distinct stages?

A)Autoimmune
B)Chronic
C)Acute
D)Histocompatibility

Answer 2

Chronic

Question 3

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.What is the most important assessment for this client?

A)Respiratory auscultation to rule out congestion
B)Reviewing renal laboratory studies
C)A complete blood count (CBC)with differential to monitor for infection
D)An electrocardiogram for possible cardiomyopathy

Answer 3

Reviewing renal laboratory studies

Question 4

The nurse has administered an antipyretic agent to a client.What is the intended effect of this drug?

A)To stop inflammation
B)To reduce fever
C)To stop swelling
D)To block pain transmission

Question 5

A client has just been admitted after taking an overdose of aspirin.The nurse prepares to assist with which initial treatment?

A)Gastric lavage
B)Administration of medication to acidify the urine
C)Retroperitoneal dialysis
D)Hemodialysis

Question 6

When instructing a group of senior citizens 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 daily aspirin rather than ibuprofen to prevent heart problems.What is the nurse's best response?

A)Talk to your doctor,because both medications can cause heart disease."
B)Ibuprofen and ibuprofen-like medications are not indicated to treat or prevent cardiovascular problems."
C)Either medication is helpful for the prevention of heart attacks."
D)Ibuprofen is better for you,even though you might be a candidate for heart attacks."

Question 7

A client has been prescribed acetaminophen and has been instructed by the nurse not to take any over-the-counter (OTC)cough or cold medications without first checking with the health care provider or pharmacist.What is the rationale for this instruction?

A)There could be an increased risk for bleeding in the stomach and within other organs of the body.
B)Cough medications and other OTC drugs could contain acetaminophen,so inadvertent overdose could occur.
C)There is an increased risk for Reye's syndrome.
D)No one should be taking more than one medication for pain.

Question 8

Both aspirin and ibuprofen products inhibit which process in the body?

A)Histamine production
B)Platelet production
C)Cytokine IL-1 synthesis
D)Cyclooxygenase (COX)synthesis

Question 9

A client has been started on a first-generation nonsteroidal anti-inflammatory medication for arthritis pain.The client says,I remember something about one of these drugs causing heart attacks and strokes.Which drug was that?" The nurse responds that the drug was celecoxib (Celebrex)but that:

A)Celebrex causes no problems at lower dosages.
B)the client has been prescribed a different medication.
C)the drug has been taken off the market.
D)newer research has proven that the concerns were unfounded.

Question 10

A client presents to the emergency department with influenza-like symptoms.The nurse assesses the client's medication history and finds that the client has been taking ibuprofen for arthritic pain.Warfarin (Coumadin)was recently prescribed due to a diagnosis of atrial fibrillation.What is the nurse's rationale for immediately discussing this finding with the health care provider?

A)If taken with NSAID medications,warfarin can cause a change in the client's oral mucosa and white patchy lesions.
B)Oral anticoagulants taken with ibuprofen can increase the risk of bleeding.
C)Taking ibuprofen and warfarin at the same time decreases the client's immune response.
D)Ibuprofen is contraindicated for patients who have influenza-like symptoms.

Question 11

Salicylates primarily inhibit the synthesis of which substance?

A)Pyrogens
B)Superoxide radicals
C)Histamines
D)Prostaglandins

Question 12

A client has been admitted with possible aspirin overdose.Which finding should the nurse be alert for in this client?

A)Metabolic alkalosis
B)Respiratory acidosis
C)Hypoventilation
D)Tinnitus

Question 13

A 3-year-old is admitted to the pediatric unit with a traumatic injury to the right forearm.The mother had been giving the child aspirin at home to control pain and fever.Approximately 3 weeks prior to admission,the child had an upper respiratory infection.The mother asks the nurse why the doctor changed the child's medication from aspirin to acetaminophen.What is the nurse's best response?

A)Typically,aspirin is a safe salicylate for children of any age."
B)Acetaminophen is given to children for inflammation and fever when there is a recent or current history of a viral infection,due to the risk of Reye's syndrome."
C)I really do not know,but I am certain the health care provider has a good reason."
D)It would be important for the doctor to allow you to continue to medicate your child,since there is a strong level of trust between mother and child."

Question 14

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:

A)chemotaxis.
B)activation of Hageman factor.
C)phagocytosis.
D)anaphylaxis.

Question 15

Which assessment findings would the nurse evaluate as possibly indicating an inflammatory response?

A)Pain,fever,and tremors
B)Fever,change in level of consciousness,and tremors
C)Pain,irritability,and change in level of consciousness
D)Fever,aches and pains,and lethargy

Question 16

A client has been advised to take a low-dose aspirin daily.Which significant adverse effect of aspirin should the nurse teach this client about?

A)Significant stomach irritation,heartburn,nausea/vomiting,diarrhea,and stomach pain
B)Significant tremors and change in level of consciousness
C)An increase in the amount of platelets in the body,causing blood clots to occur
D)Direct effect on the central nervous system,causing irritability and decreased level of consciousness

Question 17

A client has been admitted for treatment of salicylism.The nurse would expect laboratory results to include a serum salicylate level:

A)below 100 mcg/mL.
B)above 200 mcg/mL.
C)above 400 mcg/mL.
D)of 100 mcg/mL.

Question 18

The nurse supervisor has directed all nurses giving medications to be alert for the aspirin triad." What will the nurses be alert for in their clients?

A)Chronic rhinitis,acute bronchospasm,and congestive heart failure
B)Ibuprofen allergy,nasal congestion,and asthma
C)History of head trauma,congestive heart failure,and asthma
D)Aspirin allergy,nasal polyps,and asthma

Question 19

Once the inflammation process is initiated,which process causes edema of the surrounding tissues?

A)Typically,swelling and edema do not occur during the inflammatory process.
B)Increased permeability of the blood vessels causes edema.
C)Nearby blood vessels become permeable,allowing T-suppressor cells to reach and neutralize the antigen.
D)Tissue damage from the antibodies causes swelling of the surrounding tissues.

Question 20

The nurse supervisor notices that the nurse administering medications in a long-term care facility routinely crushes enteric-coated medications so that they can be administered through feeding tubes.How should the nurse supervisor respond to this situation?

A)Tell the nurse that it is okay to crush these medications as long as they can be easily dissolved in water prior to administration.
B)Tell the nurse that enteric-coated or sustained-release medications should never be crushed or altered in any manner.
C)Tell the nurse to continue crushing enteric-coated medications so they can be administered via feeding tube.
D)Tell the nurse that there is no real reason for the enteric coating to be on many medications.

Question 21

A client's home medication list includes sulfasalazine (Azulfidine).Which questions would be appropriate for the admitting nurse to ask the client?
Select all that apply.

A)Do you currently see any blood in your stool?"
B)Are your toes painful now?"
C)Are you taking this drug because you have an aspirin allergy?"
D)Do you have inflammatory bowel disease?"
E)Do you have gouty arthritis?"

Question 22

The nurse is instructing the parents of a young child on appropriate dosing of acetaminophen.Which instruction should the nurse include?
Select all that apply.

A)Use the dosage cup that comes with the acetaminophen to measure the dosage."
B)If you use an eyedropper to draw up the dose out of the bottle,it is not so sticky and messy."
C)If you already have acetaminophen pills at home,you can crush one up and put it in juice."
D)If you lose this medication cup,use a cereal spoonful to measure the dose."
E)Your pharmacist may be able to supply a calibrated dosing spoon you can use for this medication."

Question 23

A client has been advised to take a low-dose aspirin daily for prophylaxis of adverse cardiac events.The client states,I can't take aspirin because it upsets my stomach.Can I take ibuprofen instead?" How should the nurse respond?

A)Ibuprofen works differently than aspirin."
B)Ibuprofen is not safe when used with your anticoagulant therapy."
C)Ibuprofen has no effect on blood coagulation."
D)Taking ibuprofen will significantly increase your risk of respiratory failure."

Question 24

A person being seen at a health fair says,I hurt my foot running last week and have been taking aspirin for the pain.Is that okay?" Which questions should the nurse ask before answering this question?
Select all that apply.

A)How old are you?"
B)Do you smoke?"
C)Do you take vitamin C?"
D)Have you ever been told you have a gastric ulcer?"
E)Are you of Hispanic heritage?"

Question 25

A client reports taking the herb goldenseal for a sore throat.How should the nurse respond to this information?

A)Goldenseal is not indicated for sore throat."
B)That herb is dangerous and you should not take it."
C)Not many scientific studies have been done on goldenseal."
D)Goldenseal is not recognized as a drug in the United States."

Question 26

Last week,a client was advised to drink fluids,rest,and take aspirin to minimize symptoms of a head cold.Today the client calls the clinic and reports dizziness,nausea,and a strange buzzing sound in my head." How should the nurse respond?
Select all that apply.

A)Are you having difficulty hearing?"
B)You should increase your fluid intake."
C)Come to the clinic today."
D)Take an additional aspirin with each dose."
E)Are you allergic to aspirin?"

Question 27

The client has been treated with a corticosteroid for the last 3 weeks for a severe inflammatory response.The condition has improved but is not resolved.The nurse plans care for this client based on what prediction?

A)The dose of the corticosteroid will be increased.
B)The corticosteroid therapy will be discontinued and a nonsteroidal anti-inflammatory drug will be started.
C)The client will be changed to a different corticosteroid.
D)Treatment for the inflammatory response will be discontinued.

Question 28

The nurse suspects that a client has an infection.Which assessment findings support that suspicion?

A)Heart rate of 110 and rapid,shallow respirations
B)Temperature of 37°C and increased heart rate
C)Respirations of 12/minute and increased heart rate
D)Respirations of 10/minute and decreased heart rate

Question 29

A client whose knee is inflamed after running a marathon is prescribed a regimen of rest,ice,and elevation.The client says,I don't have time for all of that.Why doesn't the doctor just give me some medication?" How should the nurse respond?
Select all that apply.

A)I am not sure; you should ask when the doctor comes back in the room."
B)You have overused your knee,so rest is a good treatment."
C)Inflammation is a natural process.We would like to give your body a chance to heal itself first."
D)The medications for this condition are very expensive and have major adverse effects."
E)You need to slow down and take care of your body."

Question 30

A client is brought to the emergency department (ED)after overdosing on acetaminophen last night.The client is conscious and tearful.The nurse prepares to administer the antidote to acetaminophen:
Select all that apply.

A)in three stages by intravenous administration.
B)rectally by suppository.
C)orally.
D)intramuscularly.
E)subcutaneously.

Question 31

A nurse's friend says,I may have to have some dental work done and I am concerned because I take aspirin every day." How should the nurse respond to this information?
Select all that apply.

A)When you go to the dentist,be sure to report your aspirin use."
B)Since you take such a small dose of aspirin,there is no problem."
C)The usual recommendation is to stop taking aspirin a week before any dental or surgical procedure."
D)Aspirin therapy is not associated with bleeding from dental procedures."
E)Any bleeding from your procedure can be reversed by taking vitamin E."

Question 32

Salicylates are very popular anti-inflammatory drugs because they:

A)are given primarily by the IM or IV route.
B)have no adverse effect on blood clotting.
C)have minimal-to-no side effects.
D)reduce pain.

Question 33

The nurse is administering an analgesic medication to a client who has an infected surgical incision.Which response at the infection site would the nurse expect?

A)Reduction in swelling
B)Less surrounding redness
C)Reduction in skin temperature
D)Less pain

Question 34

Which instructions should be included as part of medication teaching for a client who has been started on a nonsteroidal anti-inflammatory drug (NSAID)?
Select all that apply.

A)Take this medication at least 2 hours after eating."
B)Be watchful for a yellow,grainy material if you vomit."
C)If you start experiencing light-headedness,call the office for instructions."
D)You should avoid alcohol while taking this medication."
E)You will know that you are taking enough of the drug when your stools take on a dark color."

Question 35

A woman in her third trimester of pregnancy has a history of back pain.The client says,I do best on Doan's pills (magnesium salicylate),so I will just start taking them again." How should the nurse respond?
Select all that apply.

A)If they helped you before,I would recommend you take them now."
B)The magnesium salicylate in Doan's pills is not related to the salicylate in aspirin."
C)I believe we should talk with the doctor to find a different medication for your discomfort."
D)You should take aspirin instead."
E)Have you tried any nonpharmaceutical pain relief measures?"