Nokea
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.
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During assessment of a patient with osteoarthritis pain, the nurse knows that which condition is a contraindication to the use of nonsteroidal anti-inflammatory drugs (NSAIDs)?
- A. Renal disease
- B. Diabetes mellitus
- C. Headaches
- D. Rheumatoid arthritis
Correct Answer: A
Rationale: Contraindications to NSAIDs include known drug allergy and conditions that place a patient at risk for bleeding, such as vitamin K deficiency, and peptic ulcer disease. Patients with documented aspirin allergy must not receive NSAIDs. Other common contraindications are those that apply to most drugs, including severe renal or hepatic disease.
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 who has a history of coronary artery disease has been instructed to take one 81-mg aspirin tablet a day. The patient asks about the purpose of this aspirin. Which response by the nurse is correct?
- A. Aspirin is given to reduce anxiety.
- B. It helps to reduce inflammation.
- C. Aspirin is given to relieve pain.
- D. It will help to prevent clot formation.
Correct Answer: D
Rationale: Aspirin can reduce platelet aggregation; low doses of aspirin (81 to 325 mg once daily) are used for thromboprevention. Higher doses are required for pain relief, reduction of inflammation, and reduction of fever.
A 6-year-old child who has chickenpox also has a fever of 102.9?°F (39.4?°C). The child's mother asks the nurse if she should use aspirin to reduce the fever. What is the best response by the nurse?
- A. It's best to wait to see if the fever gets worse.
- B. You can use the aspirin, but watch for worsening symptoms.
- C. Acetaminophen should be used to reduce his fever, not aspirin.
- D. You can use aspirin, but be sure to follow the instructions on the bottle.
Correct Answer: C
Rationale: Aspirin is contraindicated in children with flu-like symptoms because the use of this drug has been strongly associated with Reye syndrome. This is an acute and potentially life-threatening condition involving progressive neurologic deficits that can lead to coma and may also involve liver damage. Acetaminophen is appropriate for this patient.
The nurse is teaching a patient who is taking colchicine for the treatment of gout. Which instruction will the nurse include during the teaching session?
- A. Fluids should be restricted while on colchicine therapy.
- B. Take colchicine with meals.
- C. The drug will be discontinued when symptoms are reduced.
- D. Call your doctor if you have increased joint pain or blood in the urine.
Correct Answer: D
Rationale: Colchicine may cause renal effects; therefore, the presence of blood in the urine must be reported immediately. In addition, the therapeutic effect should be decreased joint pain, not increased pain. The drug is taken on an empty stomach for better absorption, and fluids should be increased unless contraindicated. Successful treatment depends upon continuing the medication as ordered.