A nursing instructor is preparing a class discussion on the use of NSAIDs and interactions with other drugs. The instructor would emphasize that the effects of which of the following can increase with NSAID therapy? Select all that apply.
- A. Lithium
- B. Cyclosporine
- C. Furosemide
- D. Lisinopril
- E. Phenytoin
Correct Answer: A,B,E
Rationale: The use of NSAIDs can increase the effectiveness of lithium, cyclosporine, and phenytoin, possibly leading to toxicity.
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A nurse informs a client who is prescribed meloxicam that he might experience visual disturbances. The client asks the nurse what types of visual disturbances may occur. Which of the following would the nurse include in the response? Select all that apply.
- A. Double vision
- B. Irreversible loss of color vision
- C. Sensitivity to light
- D. Blurred vision
- E. Halos around objects
Correct Answer: A,C,D
Rationale: The nurse should tell the client that NSAIDs like meloxicam can cause visual disturbances including blurred or diminished vision, double vision, swollen or irritated eyes, photophobia, and reversible loss of color vision.
A nurse caring for a client who is receiving an NSAID for fever reduction documents a decrease in urinary output for the patient. Which of the following would the nurse most likely determine as the reason for the patient's condition?
- A. Prolonged immobility
- B. Reduced intake of fibrous food
- C. Intake of food with antacids
- D. Prolonged temperature elevation
Correct Answer: D
Rationale: If temperature elevation is prolonged while on NSAID therapy, hot, dry, flushed skin and a decrease in urinary output may develop; consequently, dehydration can occur. Prolonged immobility, reduced intake of fibrous food, and intake of food with antacids do not cause a decrease in urinary output.
The nurse would question an order for a selective serotonin agonist as treatment for a migraine headache for a client with which condition? Select all that apply.
- A. Diabetes
- B. Uncontrolled hypertension
- C. Angina
- D. Hyperlipidemia
- E. Transient ischemic attacks
Correct Answer: B,C,E
Rationale: 5-HT agonists should not be used in patients with ischemic heart disease (such as angina or myocardial infarction), transient ischemic attacks (TIA), uncontrolled hypertension, or those patients taking monoamine oxidase inhibitor (MAOI) antidepressants.
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 client who is receiving ibuprofen asks the nurse, 'What should I take the drug with?' Which of the following would the nurse suggest in the response? Select all that apply.
- A. Milk
- B. Orange juice
- C. Food
- D. Clear liquids
- E. Antacids
Correct Answer: A,C,E
Rationale: The nurse should advise the patient to take ibuprofen (Motrin) with food, milk, or antacids.
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