Nokea
A 60-year-old client with rheumatoid arthritis visits the health care facility for a regular checkup. The client informs the nurse that he has been using an over-the-counter NSAID for the last few days. The nurse cautions the client about the use of NSAIDs on a long-term basis because of the increased risk for which of the following?
- A. Ulcer disease
- B. CNS disorders
- C. Hearing impairment
- D. Blindness
Correct Answer: A
Rationale: Age appears to increase the possibility of adverse reactions to NSAIDs. The risk of serious ulcer disease in adults older than 65 years is increased with higher doses of NSAIDs. CNS disorders, hearing impairment, and blindness are not effects associated with using NSAIDs on a long-term basis in older clients.
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A nurse is preparing to administer NSAID therapy to a client. The nurse would be alert to a decrease in the effectiveness of which drug if given together? Select all that apply.
- A. Lithium
- B. Cyclosporine
- C. Furosemide
- D. Lisinopril
- E. Phenytoin
Correct Answer: C,D
Rationale: The use of NSAIDs can decrease the effectiveness of furosemide and lisinopril, possibly leading to increased edema or increased blood pressure.
A client comes to the clinic complaining of muscle aches and asks the nurse about using an over-the-counter NSAID. The client tells the nurse that he takes a medication to control his high blood pressure. The nurse cautions the client against using an NSAID while on antihypertensive drug therapy for which reason?
- A. It increases the metabolism of the antihypertensive drug.
- B. It increases absorption of the antihypertensive drug.
- C. It decreases the effectiveness of the antihypertensive drug.
- D. It decreases the metabolism of NSAIDs.
Correct Answer: C
Rationale: The nurse should inform the patient that taking an NSAID while on antihypertensive drug therapy decreases the effectiveness of antihypertensive drugs. Interactions of NSAIDs and antihypertensive drugs do not include increased metabolism of antihypertensive drugs, increased absorption of antihypertensive drugs, or decreased metabolism of NSAIDs.
Prior to administering an NSAID to a client, the nurse should obtain which of the following? Select all that apply.
- A. History of allergies
- B. Pain assessment
- C. Current medical conditions
- D. Past medical conditions
- E. Vital signs
Correct Answer: A,B,C,D,E
Rationale: Before administering an NSAID, the nurse should obtain a history of allergies and past medical conditions. Other preadministration assessment includes pain, current medical conditions and vital signs.
When discussing effective pain management with a group of nursing students, the instructor would include barriers that need to be overcome. Which of the following would the instructor most likely include? Select all that apply.
- A. Pharmacists do not provide an adequate supply of pain medication.
- B. Primary health care providers prescribe improper pain medicine doses.
- C. Nurses do not administer adequate medication for pain relief.
- D. Clients do not report accurate levels of pain.
- E. Clients have misperceptions about receiving pain medication.
Correct Answer: B,C,D
Rationale: The main barriers a nurse must overcome to obtain effective pain management in a client are primary health care providers who do not prescribe proper pain medicine doses, nurses who do not administer adequate medication for pain relief, and clients who do not report accurate levels of pain.
A nurse is caring for a client who is hospitalized with arthritis. Celecoxib is prescribed. The nurse reviews the client's medical record for which of the following that would contraindicate the use of this drug?
- A. Allergy to sulfonamides
- B. Diabetic retinopathy
- C. Cataract
- D. Acute gout
Correct Answer: A
Rationale: Celecoxib is contraindicated among clients with allergy to sulfonamides. Ethambutol is contraindicated in clients with diabetic retinopathy and clients with cataracts. Pyrazinamide is contraindicated among clients with acute gout.