Ch 12-Anti-inflamatory agents

Question 1

The nurse knows to monitor a client on long-term, high-dose aspirin use for:

Answer 1

tinnitus and gastrointestinal bleeding.

Question 2

The nurse understands that currently the most common indication for aspirin therapy is:

Answer 2

prevention of heart attacks.

Question 3

Clients who are allergic to aspirin can usually tolerate:

Answer 3

acetaminophen.

Question 4

The nurse explains to the client that the morning stiffness of arthritis may be decreased by:

Answer 4

taking the largest dose of aspirin at bedtime.

Question 5

The nurse understands that a nonsteroidal anti-inflammatory drug considered to be more ulcerogenic than aspirin is:

Answer 5

indomethacin.

Question 6

A client receiving which of the following nonsteroidal anti-inflammatory agents would need to be monitored for CNS adverse effects?

Answer 6

indomethacin-Indomethacin (Indocin) is associated with a wide range of adverse effects, including central nervous system effects.

Question 7

Clients with prolonged use of which of the following anti-inflammatory drugs should be monitored for development of adverse hematological effects?

Answer 7

phenylbutazone

Question 8

The health care provider is starting a client with rheumatoid arthritis (RA) on chrysotherapy. The nurse will need to provide teaching concerning:

Answer 8

administration of gold salts.

Question 9

Which of the following routes of administration for corticosteroids is designed to limit systemic absorption and increase local effectiveness?

Answer 9

intra-articular

Question 10

The nurse collaborates with the health care provider to decrease the negative effects of corticosteroids on growth and development in children by:

Answer 10

use of alternate-day therapy.

Question 11

Which of the following would be appropriate to teach a client using long-term corticosteroid therapy?

Answer 11

Do not stop taking the medication abruptly.

Question 12

Weight gain, edema, hypertension, weakness, and alkalosis resulting from corticosteroid use are mainly due to:

Answer 12

mineralocorticoid effects.

Question 13

For clients to prevent or alleviate the metabolic effects of long-term steroid therapy, the nurse should instruct them to increase their intakes of:

Answer 13

protein, vitamins C and D, and calcium

Question 14

When explaining to a client why corticosteroids can cause peptic ulceration, the nurse would explain that this occurs because:

Answer 14

“The medications increase the production of hydrochloric acid in the stomach.”

Question 15

Most nonsteroidal anti-inflammatory drugs (NSAIDs) are believed to work by inhibiting the synthesis of:

Answer 15

prostaglandins.

Question 16

The nurse should instruct clients using hydroxychloroquine sulfate (Plaquenil Sulfate) for the treatment of rheumatoid arthritis to:

Answer 16

have periodic ophthalmological exams.

Question 17

The nurse understands that for clients receiving infliximab, monitoring is needed for:

Answer 17

complete blood count and liver function

Question 18

A client is beginning therapy with auranofin (Ridaura), so the nurse realizes the client will need instruction concerning:

Answer 18

an oral gold product.

Question 19

The client is receiving intra-articular injections of a corticosteroid. The client tells the nurse she feels so much better that she is now able to resume usual gardening activities. The best response by the nurse is:

Answer 19

“Corticosteroid injections reduce inflammation but are not a cure; therefore, you must be careful not to put too much stress on the joints and cause further damage.”

Question 20

Clients receiving long-term corticosteroid therapy may require dietary modifications. All of the following statements are true about special diets for long-term corticosteroid therapy EXCEPT:

Answer 20

A potassium-restricted diet may be needed due to potassium retention.

Question 21

Client teaching regarding the use of biologic response modifiers (DMARDs) should include:

Answer 21

increased risk of infection.

Question 22

An 80-year-old client receiving corticosteroids for rheumatoid arthritis is admitted to the hospital for weakness and lethargy. The nurse should monitor the client’s:

Answer 22

potassium level

Question 23

A client on corticosteroid therapy is returning from surgery after a hip replacement. In the past 2 hours his blood pressure has decreased from 126/76 to 104/60; he is restless and complains of a headache. The nurse should:

Answer 23

notify the health care provider immediately.

Question 24

Which of the following statements from a 60-year-old woman on corticosteroid therapy indicates she understands her medications?

Answer 24

“I should take a calcium supplement while I’m on prednisone.”

Question 25

A client on long-term corticosteroid therapy asks the nurse, “What is a buffalo hump?” The nurse’s best reply is:

Answer 25

“It is increased fat deposited in the upper back of some people on long-term corticosteroid therapy.”

Question 26

When caring for postoperative clients receiving corticosteroid therapy, the nurse should monitor for:

Answer 26

delayed wound healing

Question 27

A client receiving corticosteroid therapy should be instructed to avoid crowds and people with infectious diseases because:

Answer 27

corticosteroids suppress the immune system of the client

Question 28

When orienting new nurse recruits to aspirin therapy, which of the following statements would NOT be providing correct information?

Answer 28

Aspirin and acetaminophen are equally effective as anti-inflammatory agents.

Question 29

The client is to receive Simponi. The nurse would:

Answer 29

prepare to administer the agent SC.

Question 30

Which of the following is true for clients who receive DMARD therapy? Select all that apply.

Answer 30

The client should be monitored for stomatitis if receiving gold therapy. The client should report fever or respiratory symptoms. The client should be monitored for lymphoma.

Question 31

The client has an order for abatacept IV. Which of the following statements by the nurse would exhibit an understanding of this agent?

Answer 31

“I must protect the vial from light.” “My client will need to be monitored for infection.” “My client will be monitored for TB.” “It is not indicated as first-line treatment for RA.”

Question 32

Your client is to receive Decadron Phosphate IV. You would monitor your client for which of the following adverse effects?

Answer 32

a. infection b. glycosuria c. headache d. hemorrhage e. electrolyte imbalances, especially sodium and potassium f. hypersensitivity reactions

Question 33

Which of the following statements by the nurse recruit would be correct information concerning the nonsalicylate, nonselective NSAID patch Flector? Select all that apply.

Answer 33

a. “There is an increased risk of gastric ulcers and bleeding in older adults.” b. “The patch must not be applied to broken or damaged skin.” c. “The protective liner must be removed prior to applying the patch.” d. “The client should be instructed not to wear the patch while taking a bath, while showering, or when swimming.”