Nokea
A nurse is reviewing the medical records of several clients. In which of the following clients would the nurse identify that the use of an NSAID would be contraindicated? Select all that apply.
- A. A female client who is lactating
- B. A female client with a hypersensitivity to aspirin
- C. A female client in the first trimester of pregnancy
- D. A female client in the second trimester of pregnancy
- E. A female client in the third trimester of pregnancy
Correct Answer: A,B,E
Rationale: NSAIDs are contraindicated in clients with a hypersensitivity to aspirin. In general, NSAIDs are contraindicated during the third trimester of pregnancy (because they can induce labor) and during lactation.
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A nurse is reviewing the medical record of a client who is diagnosed with migraine headaches. The history also reveals that the client has phenylketonuria. Which of the following would the nurse least expect to be prescribed as treatment for the client's migraine headaches? Select all that apply.
- A. Rizatriptan (Maxalt)
- B. Almotriptan (Axert)
- C. Eletriptan (Relpax)
- D. Sumatriptan (Imitrex)
- E. Zolmitriptan (Zomig)
Correct Answer: A,E
Rationale: Rizatriptan (Maxalt) and zolmitriptan (Zomig) are not used as treatment for migraines in a client with phenylketonuria because both medications contain phenylalanine.
Which of the following would a nurse integrate into the explanation for a client about the mechanism of action for almotriptan? Select all that apply.
- A. Vasoconstriction
- B. Vasodilation
- C. Decreased neurotransmission
- D. Increased neurotransmission
- E. Inhibition of prostaglandin synthesis
Correct Answer: A,C
Rationale: Selective serotonin agonists like almotriptan (Axert) exert their effects by causing vasoconstriction and decreased neurotransmission.
After teaching a group of students about NSAIDs and their uses, the instructor determines that additional teaching is needed when the students identify which of the following as being used to treat osteoarthritis or rheumatoid arthritis? Select all that apply.
- A. Sulindac (Clinoril)
- B. Ketorolac (Toradol)
- C. Piroxicam (Feldene)
- D. Mefenamic (Ponstel)
- E. Oxaprozin (Daypro)
Correct Answer: B,D
Rationale: Ketorolac and mefenamic are NSAIDs that are not used to treat osteoarthritis or rheumatoid arthritis.
A nurse is preparing a presentation for a local community group about over-the-counter analgesics, including NSAIDs. Which of the following would the nurse integrate into the presentation as a serious risk with this class of drugs?
- A. Increased granulocyte count
- B. Cardiovascular thrombosis
- C. Increased WBC count
- D. Sickle cell anemia
Correct Answer: B
Rationale: A serious risk involved with the use of NSAIDs is cardiovascular thrombosis. Increased granulocyte count, increased WBC count, or sickle cell anemia is not caused by NSAIDs. Sickle cell anemia results from an inherited abnormality of hemoglobin. NSAIDs may cause decreased granulocyte count, decreased WBC count, or aplastic anemia.
A nurse is assessing a client's pain. When reporting the assessment findings to the primary health care provider to ensure the proper prescription for analgesic therapy for effective pain management, which of the following would be most important for the nurse to report? Select all that apply.
- A. Duration
- B. Aggravating factors
- C. Location
- D. Remitting factors
- E. Intensity
Correct Answer: C,E
Rationale: Although duration, aggravating and remitting factors, location, and intensity are important to assess, to ensure that the primary health care provider prescribes effective analgesics for pain management, the nurse needs to report two key assessments about pain: location and intensity.