Chapter 13 Flashcards
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.”
a. “Anti-inflammatory drugs reduce pain and limit blood vessel responses to joint
injury.”
- 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
b. Risk of bleeding
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.”
a. “Notify your healthcare provider and stop taking the aspirin before the dental
procedure.”
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.
d. Take this drug with food to prevent GI upset.
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.
c. Call the healthcare provider, as this is adverse reaction to the drug.
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.”
a. “Aspirin can be dangerous, and should not be given to infants.”
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
c. Gastrointestinal bleeding due to the combination of aspirin and alcohol
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.”
a. “Monitor your blood sugar regularly.”
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
c. Fat redistribution
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.”
b. “Taking corticosteroids for a long time can reduce your immunity.”
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.”
d. “The dose of this drug will need to be tapered down over time to prevent
complications.”
A patient who has been prescribed a topical corticosteroid cream for the treatment of a rash
tells you that he now has a small, reddened, open wound located on the anterior aspect of the
right foot. He asks you if he can apply this same cream to this new wound to reduce the
redness. What is your best response?
a. “You may use the same topical steroid on this wound but apply it with a gloved
hand.”
b. “Dispose of at least inch of the topical steroid before applying it elsewhere.”
c. “Mix the topical steroid with an antibiotic cream for the best effect.”
d. “You should not apply topical steroids to open wounds.”
d. “You should not apply topical steroids to open wounds.”
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.
a. Protect the skin from skin tears.
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.”
c. “These drugs work by inhibiting the inflammatory mediator tumor necrosis factor.”
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.
b. Rotate the injection site of the thighs and abdomen frequently.
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
a. A patient with pre-existing heart failure
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
c. Allopurinol
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
b. Uric acid
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”.
c. “Allopurinol is used only for the prevention of gout attacks.”
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.
b. Avoid foods that are high in purine, such as tuna.
