Nokea
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.
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A group of nursing students are reviewing NSAIDs. The students demonstrate understanding of this drug class when they identify which of the following as an NSAID? Select all that apply.
- A. Eletriptan (Relpax)
- B. Aspirin (Ecotrin)
- C. Meloxicam (Mobic)
- D. Acetaminophen (Tylenol)
- E. Ibuprofen (Motrin)
Correct Answer: C,E
Rationale: Ibuprofen and meloxicam are both classified as NSAIDs. Aspirin is a salicylate, acetaminophen is a nonsalicylate, and eletriptan is a serotonin receptor agonist.
A nurse is assessing pain in a 3-year-old child. Which of the following would be most appropriate for the nurse to use? Select all that apply.
- A. Number scale
- B. Color scale
- C. Letter scale
- D. Facial expression scale
- E. Shape scale
Correct Answer: B,D
Rationale: Color and facial expression scales are especially helpful with children who have trouble understanding or cannot tell the nurse about their pain using numbers.
After teaching a client receiving NSAID therapy about the drug, the nurse determines that the teaching was successful when the client identifies the need to notify the primary health care provider for which of the following? Select all that apply.
- A. Skin rash
- B. Visual disturbances
- C. Edema
- D. Chest pain
- E. Diarrhea
Correct Answer: A,B,C,D,E
Rationale: The client should notify the primary health care provider if any of the following adverse reactions occur: skin rash, itching, visual disturbances, weight gain, edema, diarrhea, black stools, nausea, vomiting, chest or leg pain, numbness, or persistent headache.
A nurse is performing discharge teaching for a client who is prescribed ibuprofen. After teaching the client about the possible cardiovascular effects of the drug, the nurse determines that additional teaching is needed when the client states which of the following?
- A. My blood pressure may increase.
- B. My blood pressure won't change.
- C. I could develop congestive heart failure.
- D. I could experience a heart attack.
Correct Answer: B
Rationale: The client should be counseled that NSAIDs including ibuprofen may result in the following cardiovascular effects: increased or decreased blood pressure, congestive heart failure, cardiac arrhythmias, and myocardial infarction.
A nurse is providing care to a client with arthritis in several large weight-bearing joints who is receiving NSAID therapy. Which nursing diagnosis would be most likely?
- A. Risk for Unstable Blood Glucose Levels
- B. Impaired Gas Exchange
- C. Risk for Imbalanced Body Temperature
- D. Impaired Physical Mobility
Correct Answer: D
Rationale: The client has arthritis and is receiving NSAID therapy most likely for pain relief and reduction of inflammation. The affected joints would interfere with the client's mobility. Therefore, Impaired Physical Mobility would be most appropriate. There is no indication that the client has diabetes, respiratory problems, or fever. Therefore, the other nursing diagnoses would be inappropriate.