Nokea
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.
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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.
A nurse is caring for a client who is required to take NSAIDS on an outpatient basis. Which of the following would the nurse include in the teaching plan for the client and family?
- A. Take aspirin if necessary strictly with a full glass of water.
- B. Use the drug on a very regular basis during treatment.
- C. Call your primary care provider if you have no relief after 2 weeks.
- D. Take the drugs strictly with a glass of milk or juice.
Correct Answer: C
Rationale: The nurse should instruct the patient to consult the primary health care provider if the pain, swelling, inflammation, or tendemess is not relieved after 2 weeks. The drug takes several days to relieve the discomfort, so it is important for the patient to give the drug time to work. The nurse should instruct the patient to avoid the use of aspirin. The drug should be taken with a full glass of water or with food. It is not necessary to take NSAIDs strictly with a glass of juice or milk. These drugs are not to be used on a regular basis unless the patient is strictly instructed to do so by the primary health care provider.
After teaching a client about his prescribed NSAID therapy, the nurse determines that the teaching was successful when the client states which of the following?
- A. I will take the drug with high-fiber foods.
- B. I must take the drug on an empty stomach.
- C. I should take the drug with food and milk.
- D. I need to take it with a calcium supplement.
Correct Answer: C
Rationale: The client should take the drug with food and milk to promote an optimal response to NSAID therapy, this helps minimize the risk of GI effects. The client does not need to take an NSAID with fiber-rich food or with calcium supplements. He should not take it on an empty stomach.
A client is prescribed tolmetin to be taken at home. The nurse would instruct the client to monitor for which of the following? Select all that apply.
- A. Dark, tarry stools
- B. Jaundice
- C. Hot, dry, flushed skin
- D. Increased urine output
- E. Unusual or prolonged bleeding
Correct Answer: A,C,E
Rationale: The nurse should instruct the client or caregiver to monitor for dark, tarry stools; hot, dry, flushed skin; decreased urine output, and unusual or prolonged bleeding.
A nurse is describing the actions of NSAIDs to a client. Which of the following would the nurse integrate into the description as a mechanism by which NSAIDs elicit their effects? Select all that apply.
- A. Inhibition of prostaglandins
- B. Inhibition of cyclooxygenase-1
- C. Synthesis of cyclooxygenase-2
- D. Synthesis of cyclooxygenase-3
- E. Inhibition of platelet aggregation
Correct Answer: A,B,C
Rationale: NSAIDs exert their effects by inhibition of prostaglandin synthesis via inhibition of cyclooxygenase-1 and -2.