Nokea
A patient is taking the nonsteroidal anti-inflammatory drug indomethacin (Indocin) as treatment for pericarditis. The nurse will teach the patient to watch for which adverse effect?
- A. Tachycardia
- B. Nervousness
- C. Nausea and vomiting
- D. Dizziness
Correct Answer: C
Rationale: Gastrointestinal effects include dyspepsia, heartburn, epigastric distress, nausea, vomiting, anorexia, abdominal pain, and others.
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The nurse is reviewing the history of a patient who has a new order for a nonsteroidal anti-inflammatory drug (NSAID). Which conditions, if present, are contraindications to the use of NSAIDs? (Select all that apply.)
- A. Vitamin K deficiency
- B. Arthralgia
- C. Peptic ulcer disease
- D. Documented aspirin allergy
Correct Answer: A,C,D
Rationale: Contraindications to NSAIDs include known drug allergy as well as conditions that place the patient at risk for bleeding, such as vitamin K deficiency and peptic ulcer disease. Patients with documented aspirin allergy should not receive NSAIDs. NSAIDs may be used to treat arthralgia.
A patient has used enteric aspirin for several years as treatment for osteoarthritis. However, the symptoms are now worse and she is given a prescription for a nonsteroidal anti-inflammatory drug and misoprostol, also called Cytotec. The patient asks the nurse, 'Why am I now taking two pills for arthritis?' What is the nurse's best response?
- A. Cytotec will also reduce the symptoms of your arthritis.
- B. Cytotec helps the action of the NSAID so that it will work better.
- C. Cytotec reduces the mucous secretions in the stomach, which reduces gastric irritation.
- D. Cytotec may help to prevent gastric ulcers that may occur in patients taking NSAIDs.
Correct Answer: D
Rationale: Cytotec inhibits gastric acid secretions and stimulates mucous secretions; it has proved successful in preventing the gastric ulcers that may occur in patients taking NSAIDs.
A patient calls the clinic to ask about taking a glucosamine-chondroitin supplement for arthritis. The nurse reviews the medication history and notes that there will be a concern for drug interactions if the patient is also taking medications for which disorder?
- A. Type 2 diabetes mellitus
- B. Hypothyroidism
- C. Hypertension
- D. Angina
Correct Answer: A
Rationale: Glucosamine may reduce the effectiveness of antidiabetic drugs by worsening insulin resistance, necessitating closer monitoring of blood glucose levels in patients with type 2 diabetes mellitus.
A mother brings her toddler into the emergency department and tells the nurse that she thinks the toddler has eaten an entire bottle of chewable aspirin tablets. The nurse will assess for which most common signs of salicylate intoxication in children?
- A. Photosensitivity and nervousness
- B. Tinnitus and hearing loss
- C. Acute gastrointestinal bleeding
- D. Hyperventilation and drowsiness
Correct Answer: D
Rationale: The most common manifestations of chronic salicylate intoxication in children are hyperventilation and CNS effects, such as dizziness, drowsiness, and behavioral changes.
The nurse notes in a patient's medication history that the patient is taking allopurinol. Based on this finding, the nurse interprets that the patient has which disorder?
- A. Rheumatoid arthritis
- B. Gout
- C. Osteoarthritis
- D. Systemic lupus erythematosus
Correct Answer: B
Rationale: Allopurinol is indicated for the treatment of gout but is not indicated for the other disorders listed.