Adams4e Tif Ch33

Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 4/E Chapter 33
Question 1 Type: MCSA The client receives a nonsteroidal anti-inflammatory drug (NSAID) for treatment of arthritis. for the nurse to include "hen doing medication education# 1. $Consti!ation is common% include roughage in your diet.$ 2. $Drin& at least eight glasses of "ater a day.$ 3. $Ta&e your medication "ith food.$ 4. $Ta&e your medication on an em!ty stomach.$ Correct Answer: ' Rationa e 1( Consti!ation is not an issue "ith nonsteroidal anti-inflammatory drugs (NSAIDS). Rationa e 2( Nonsteroidal anti-inflammatory drugs (NSAIDS) are ne!hroto)ic% &ee!ing the client "ell hydrated "ill hel! !revent &idney damage. Rationa e 3( Ta&ing the medication "ith food "ill decrease gastrointestinal (*I) irritation+ ,ut &idney damage is more of a !riority. Rationa e 4( Ta&ing the medication on an em!ty stomach "ill increase gastrointestinal (*I) irritation. ! o"a Rationa e: Co#niti$e %e$e : Analy-ing C ient &eed: .hysiological Integrity C ient &eed 'u": .harmacological and .arenteral Thera!ies &ursin#/(nte#rated Concepts: Nursing .rocess( Im!lementation %earnin# )utcome: //-0 Question 2 Type: MCSA A mother calls the clinic and tells the nurse that her 1-month-old ,a,y has a fever. The mother as&s if she can use the li2uid acetamino!hen (Tylenol) that is used for her 34-year-old child. hat is the ,est res!onse ,y the nurse# 1. $Infants should not have acetamino!hen (Tylenol) ,ecause it damages the liver.$ 2. $It is ,est if the !ediatrician is called% he can ,e as&ed this 2uestion.$
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 156 Co!yright '431 ,y .earson 6ducation+ Inc.
hat is a !riority
3. $It is fine to use the same medicine for ,oth children.$ 4. $Infant dro!s should ,e used for the ,a,y% they are different from li2uid medicine.$ Correct Answer: 1 Rationa e 1( Acetamino!hen (Tylenol) is the !referred anti!yretic drug for infants and children. Rationa e 2( The nurse can ans"er the mother7s 2uestion% it is not necessary to refer to the !ediatrician. Rationa e 3( It is not fine to use the same medicine for ,oth children ,ecause the concentration of medication is different. Rationa e 4( Infant dro!s should ,e used for the ,a,y% they have a different concentration of medication than the li2uid !re!arations. ! o"a Rationa e: Co#niti$e %e$e : Analy-ing C ient &eed: .hysiological Integrity C ient &eed 'u": .harmacological and .arenteral Thera!ies &ursin#/(nte#rated Concepts: Nursing .rocess( Im!lementation %earnin# )utcome: //-8 Question 3 Type: MCMA The nurse is managing care for clients "ho "ill receive i,u!rofen (Advil) for long term thera!y. !rimary la,oratory tests the nurse "ill assess !rior to initiation of thera!y# Note: Credit will be given only if all correct choices and no incorrect choices are selected. 'tandard Te*t: Select all that a!!ly. 1. 6lectrolytes 2. 9emoglo,in and hematocrit 3. :leeding times 4. ;iver function tests +. Serum amylase Correct Answer: '+/+1 Rationa e 1( There is no s!ecific reason to monitor the clients< electrolytes.
hat are the
Rationa e 2( I,u!rofen may result in a decrease in hemoglo,in and hematocrit. :aseline levels should ,e documented. Rationa e 3( I,u!rofen may increase ,leeding times. :aseline values should ,e documented. Rationa e 4( AST and A;T may ,e increased so it is im!ortant to document ,aseline levels. Rationa e +( It is not necessary to dra" ,aseline serum amylase levels. ! o"a Rationa e: Co#niti$e %e$e : Analy-ing C ient &eed: .hysiological Integrity C ient &eed 'u": .harmacological and .arenteral Thera!ies &ursin#/(nte#rated Concepts: Nursing .rocess( Assessment %earnin# )utcome: //-8 Question 4 Type: MCMA The client e)!erienced a s!orts-related in=ury to his leg. During the morning assessment+ "hat signs of inflammation "ill the nurse most li&ely assess# Note: Credit will be given only if all correct choices and no incorrect choices are selected. 'tandard Te*t: Select all that a!!ly. 1. S"elling 2. .ain 3. armth
4. .allor +. .itting edema Correct Answer: 3+'+/ Rationa e 1( S"elling is a sign of inflammation. Rationa e 2( .ain is a sign of inflammation. Rationa e 3( armth is a sign of inflammation.
Rationa e 4( .allor is not a sign of inflammation% redness is.

Rationa e +( .itting edema is not a sign of inflammation. ! o"a Rationa e: Co#niti$e %e$e : A!!lying C ient &eed: .hysiological Integrity C ient &eed 'u": .hysiological Ada!tation &ursin#/(nte#rated Concepts: Nursing .rocess( Assessment %earnin# )utcome: //-3 Question + Type: MCSA The client has e)!erienced a s!orts-related in=ury. 9e as&s the nurse ho" long it "ill ta&e for him to heal and feel ,etter. hat is the ,est res!onse ,y the nurse# 1. $ ith !ro!er care+ it "ill ta&e a,out a month for sym!toms to resolve.$ 2. $It "ill de!end on your res!onse to the medications.$ 3. $It "ill ta&e a,out a "ee& and a half for sym!toms to resolve.$ 4. $The inflammatory !rocess is too com!le) to !redict a time frame for healing.$ Correct Answer: / Rationa e 1( A month is longer than it ta&es for acute sym!toms to resolve. Rationa e 2( Medications "ill relieve some sym!toms+ ,ut the time frame for re!air to ,egin is the same. Rationa e 3( During acute inflammation+ 8 to 34 days are normally needed for the sym!toms to resolve and re!air to ,egin. Rationa e 4( The inflammatory !rocess is com!le)+ ,ut the time frame is still 8 to 34 days. ! o"a Rationa e: Co#niti$e %e$e : A!!lying C ient &eed: .hysiological Integrity C ient &eed 'u": .hysiological Ada!tation &ursin#/(nte#rated Concepts: Nursing .rocess( Im!lementation %earnin# )utcome: //-' Question , Type: MCSA
The nurse conducts grou! education for clients "ith seasonal allergies+ and teaches a,out the role of histamine. The nurse evaluates that the education has ,een effective "hen the clients ma&e "hich statement# 1. $9istamine is inhi,ited ,y nonsteroidal anti-inflammatory drugs (NSAIDs). 2. $9istamine dilates the vessels in the nose+ so it is congested and stuffy.$ 3. $9istamine constricts vessels+ causing ca!illaries to ,ecome more !ermea,le.$ 4. $9istamine is !rimarily stored in !hagocyte cells in the s&in.$ Correct Answer: ' Rationa e 1( Nonsteroidal anti-inflammatory drugs (NSAIDs) inhi,it the synthesis of !rostaglandins+ and do not affect histamine. Rationa e 2( 9istamine dilates ,lood vessels causing ca!illaries to ,ecome more !ermea,le. The affected area may ,ecome congested "ith ,lood. Rationa e 3( 9istamine dilates+ not constricts+ vessels+ causing ca!illaries to ,ecome more !ermea,le. Rationa e 4( 9istamine is !rimarily stored in mast cells+ not !hagocyte cells. ! o"a Rationa e: Co#niti$e %e$e : Analy-ing C ient &eed: .hysiological Integrity C ient &eed 'u": .hysiological Ada!tation &ursin#/(nte#rated Concepts: Nursing .rocess( 6valuation %earnin# )utcome: //-/ Question Type: MCSA The client receives !rednisone as treatment for his inflammatory disease. 9e has e)!erienced great relief and as&s the nurse if he can =ust &ee! ta&ing this medication. hat is the ,est res!onse ,y the nurse# 1. $No+ ,ecause this medication has serious adverse effects.$ 2. $No+ your doctor said the ,est treatment for your illness is to alternate medications.$ 3. $No+ your ,ody "ould get used to it and it "ould lose its effectiveness.$ 4. $No+ ,ecause your illness is in remission and you don7t need medication no".$ Correct Answer: 3
Rationa e 1( Systemic glucocorticoids are reserved for the short-term treatment of severe disease ,ecause of !otentially serious adverse effects. Rationa e 2( Medications are alternated due to the serious effects of glucocorticoids+ not ,ecause this is the ,est treatment for the illness. Rationa e 3( The ,ody does not get used to systemic glucocorticoids. Rationa e 4( There is no evidence that the client7s illness is in remission. ! o"a Rationa e: Co#niti$e %e$e : Analy-ing C ient &eed: .hysiological Integrity C ient &eed 'u": .harmacological and .arenteral Thera!ies &ursin#/(nte#rated Concepts: Nursing .rocess( Im!lementation %earnin# )utcome: //-8 Question . Type: MCSA The nurse in the emergency de!artment fre2uently sees clients "ho have overdosed on acetamino!hen (Tylenol). hich client is at highest ris& for develo!ing hemolysis# 1. A Native American client 2. A >e"ish client 3. An African American client 4. A Caucasian client Correct Answer: / Rationa e 1( Native Americans are not &no"n to have a *?.D en-yme deficiency so they are not at ris& for develo!ing hemolysis after ingestion of acetamino!hen (Tylenol). Rationa e 2( >e"ish clients are not &no"n to have a *?.D en-yme deficiency so they are not at ris& for develo!ing hemolysis after ingestion of acetamino!hen (Tylenol). Rationa e 3( African Americans have higher rates of *?.D en-yme deficiency. Clients "ith this deficiency are at ris& for develo!ing hemolysis after ingestion of certain drugs+ including acetamino!hen (Tylenol). Rationa e 4( Caucasians are not &no"n to have a *?.D en-yme deficiency so they are not at ris& for develo!ing hemolysis after ingestion of acetamino!hen (Tylenol). ! o"a Rationa e:
Co#niti$e %e$e : A!!lying C ient &eed: .hysiological Integrity C ient &eed 'u": .hysiological Ada!tation &ursin#/(nte#rated Concepts: Nursing .rocess( Assessment %earnin# )utcome: //-@ Question / Type: MCSA The nurse teaches a grou! of clients "ith arthritis a,out the use of i,u!rofen (Motrin)+ em!hasi-ing the ma)imum daily amount. The nurse evaluates that education has ,een most effective "hen the clients ma&e "hich statement# 1. $ e cannot ta&e over 1+444 mg5day.$ 2. $ e cannot ta&e over /+?44 mg5day.$ 3. $ e cannot ta&e over /+'44 mg5day.$ 4. $ e cannot ta&e over /+444 mg5day.$ Correct Answer: / Rationa e 1( The ma)imum amount of i,u!rofen (Motrin) to ,e ta&en in '1 hours is /+'44 mg+ not 1+444 mg. Rationa e 2( The ma)imum amount of i,u!rofen (Motrin) to ,e ta&en in '1 hours is /+'44 mg+ not /+?44 mg. Rationa e 3( The ma)imum amount of i,u!rofen (Motrin) to ,e ta&en in '1 hours is /+'44 mg. Rationa e 4( The ma)imum amount of i,u!rofen (Motrin) to ,e ta&en in '1 hours is /+'44 mg+ not /+444 mg. ! o"a Rationa e: Co#niti$e %e$e : Analy-ing C ient &eed: .hysiological Integrity C ient &eed 'u": .harmacological and .arenteral Thera!ies &ursin#/(nte#rated Concepts: Nursing .rocess( 6valuation %earnin# )utcome: //-@ Question 10 Type: MCSA The nurse !lans to teach a class on acetamino!hen (Tylenol) to mothers "ith young children. !lan ,y the nurse include# 1. $It is ,est to give your child acetamino!hen (Tylenol) "ith a high-car,ohydrate meal.$ hat "ill the ,est
2. $Aead the la,els of all over-the-counter (BTC) medications for the amount of acetamino!hen (Tylenol) in them.$ 3. $Acetamino!hen (Tylenol) "ill only need to ,e given once a day ,ecause it is long-lasting.$ 4. $It is o&ay to su,stitute a ,a,y as!irin for acetamino!hen (Tylenol) if you run out of acetamino!hen (Tylenol).$ Correct Answer: ' Rationa e 1( There is no indication that Tylenol should ,e given "ith high-car,ohydrate foods. Rationa e 2( It is very easy for !arents of young children to overdose them "ith acetamino!hen (Tylenol). All medication la,els should ,e read. Rationa e 3( The duration of action of acetamino!hen (Tylenol) is only /C1 hours. Rationa e 4( As!irin is not recommended for children due to the !ossi,ility of Aeye7s Syndrome. ! o"a Rationa e: Co#niti$e %e$e : Analy-ing C ient &eed: .hysiological Integrity C ient &eed 'u": .harmacological and .arenteral Thera!ies &ursin#/(nte#rated Concepts: Nursing .rocess( .lanning %earnin# )utcome: //-@ Question 11 Type: MCSA The nurse !lans care for the elderly client receiving nonsteroidal anti-inflammatory drug (NSAID) thera!y. hat is the ,est outcome for this client as it relates to side effects of nonsteroidal anti-inflammatory drugs (NSAIDs)# 1. The client "ill refrain from ta&ing other medications "ith the nonsteroidal anti-inflammatory drug (NSAID). 2. The client "ill avoid the use of caffeine "hile ta&ing the nonsteroidal anti-inflammatory drug (NSAID). 3. The client "ill re!ort any ,leeding or ,ruising "hile ta&ing the nonsteroidal anti-inflammatory drug (NSAID). 4. The client "ill re!ort any mood changes "hile ta&ing the nonsteroidal anti-inflammatory drug (NSAID). Correct Answer: / Rationa e 1( 6lderly clients are often on several medications+ and refraining from ta&ing them "ith nonsteroidal anti-inflammatory drugs (NSAIDs) is an unrealistic outcome. Rationa e 2( There is no reason for avoiding use of caffeine "hile using a nonsteroidal anti-inflammatory drug (NSAID).
Rationa e 3( 6lderly clients are at ris& for increased ,leeding "ith nonsteroidal anti-inflammatory drug (NSAID) thera!y. Rationa e 4( Mood changes are not a side effect of nonsteroidal anti-inflammatory drug (NSAID) thera!y. ! o"a Rationa e: Co#niti$e %e$e : Analy-ing C ient &eed: .hysiological Integrity C ient &eed 'u": &ursin#/(nte#rated Concepts: Nursing .rocess( .lanning %earnin# )utcome: //-@ Question 12 Type: MCSA The client has ,een ta&ing hydrocortisone (Cortef) for a month+ and a,ru!tly sto!s it. assessment ,y the nurse include# 1. Datigue and anore)ia 2. 9y!erglycemia and de!ression 3. Dilated !u!ils and auditory hallucinations 4. Tachycardia and "eight gain Correct Answer: 3 Rationa e 1( *lucocorticoids must ,e discontinued gradually. A,ru!t "ithdra"al can result in acute lac& of adrenal function. Datigue and anore)ia are signs of adrenal insufficiency. Rationa e 2( 9y!erglycemia and de!ression are not signs of adrenal insufficiency. Rationa e 3( Dilated !u!ils and auditory hallucinations are not signs of adrenal insufficiency. Rationa e 4( Tachycardia and "eight gain are not signs of adrenal insufficiency. ! o"a Rationa e: Co#niti$e %e$e : Analy-ing C ient &eed: .hysiological Integrity C ient &eed 'u": &ursin#/(nte#rated Concepts: Nursing .rocess( Assessment %earnin# )utcome: //-? Question 13
hat "ill the ,est
Type: MCSA The !hysician orders acetamino!hen (Tylenol) for a client "ith a fever. The nurse "ould !lan to validate "hich other order "ith the !hysician# 1. 9e!arin 0+444 units su,cutaneously every 8 hours 2. arfarin (Coumadin) ' mg orally every day
3. .enicillin * ,en-athine (:icillin ;A) '.1 million units IM one time 4. .aro)etine (.a)il) /@.0 mg orally every day Correct Answer: ' Rationa e 1( There is no contraindication to the use of he!arin and acetamino!hen (Tylenol). Rationa e 2( Acetamino!hen (Tylenol) inhi,its "arfarin (Coumadin) meta,olism. Concomitant use of these t"o medications could result in a to)ic accumulation of "arfarin (Coumadin). Rationa e 3( There is no contraindication to the use of !enicillin * ,en-athine (:icillin ;A) and acetamino!hen (Tylenol). Rationa e 4( There is no contraindication to the use of !aro)etine (.a)il) and acetamino!hen (Tylenol). ! o"a Rationa e: Co#niti$e %e$e : Analy-ing C ient &eed: .hysiological Integrity C ient &eed 'u": &ursin#/(nte#rated Concepts: Nursing .rocess( .lanning %earnin# )utcome: //-@ Question 14 Type: MCSA The nurse teaches clients "ith rheumatoid arthritis a,out the side effects of nonsteroidal anti-inflammatory drugs (NSAIDs). The nurse evaluates that education has ,een effective "hen the clients ma&e "hich statement# 1. $ e must have our ,lood tests monitored "ith this medication.$ 2. $ e must ,e careful a,out falling "ith this medication.$ 3. $ e must ta&e the medicine =ust as the doctor said to ta&e it.$ 4. $ e must ,e sure and &ee! all scheduled doctors7 a!!ointments$.
Correct Answer: 3 Rationa e 1( Nonsteroidal anti-inflammatory drugs (NSAIDs) can cause ,leeding+ so ,lood tests must ,e monitored. Rationa e 2( Nonsteroidal anti-inflammatory drugs (NSAIDs) do not cause sedation+ so falling is not a concern. Rationa e 3( Ta&ing the medication as !rescri,ed is im!ortant+ ,ut this does not address the side effects. Rationa e 4( Eee!ing scheduled doctors7 a!!ointments is im!ortant+ ,ut this does not address the side effects. ! o"a Rationa e: Co#niti$e %e$e : Analy-ing C ient &eed: .hysiological Integrity C ient &eed 'u": &ursin#/(nte#rated Concepts: Nursing .rocess( 6valuation %earnin# )utcome: //-8 Question 1+ Type: MCSA hich of the follo"ing is a sign or sym!tom of inflammation# 1. Aedness 2. Cyanosis 3. Di--iness 4. Cold s&in Correct Answer: 3 Rationa e 1( Aedness occurs from antigen reaction. Rationa e 2( Cyanosis is not a sign of inflammation. Rationa e 3( Di--iness is not a sym!tom of inflammation. Rationa e 4( arm s&in+ not cold s&in+ is a sign of inflammation.
! o"a Rationa e: Co#niti$e %e$e : Fnderstanding C ient &eed: .hysiological Integrity C ient &eed 'u":
&ursin#/(nte#rated Concepts: %earnin# )utcome: //-3 Question 1, Type: MCSA 9istamine release !roduces "hich of the follo"ing# 1. :ronchodilation 2. Gasoconstriction 3. Diarrhea 4. Gasodilatation Correct Answer: 1 Rationa e 1( :ronchoconstriction+ not ,ronchodilation+ occurs due to smooth muscle res!onses. Rationa e 2( Gasodilatation+ not vasoconstriction+ occurs "ith histamine release. Rationa e 3( Diarrhea is not a sign of histamine release. Rationa e 4( 9istamine release causes vasodilatation due to lea&y ca!illaries. ! o"a Rationa e: Co#niti$e %e$e : Fnderstanding C ient &eed: .hysiological Integrity C ient &eed 'u": &ursin#/(nte#rated Concepts: %earnin# )utcome: //-/ Question 1Type: MCSA hich of the follo"ing is a common adverse effect of anti-inflammatory drugs+ such as i,u!rofen# 1. Diarrhea 2. .al!itations 3. 9eart,urn 4. 9y!otension
Correct Answer: / Rationa e 1( Diarrhea is not a common adverse effect. Rationa e 2( .al!itations are not an adverse effect. Rationa e 3( 9eart,urn and other *I u!set are common adverse effects of these drugs. Rationa e 4( 9y!otension is not an adverse effect. ! o"a Rationa e: Co#niti$e %e$e : Fnderstanding C ient &eed: .hysiological Integrity C ient &eed 'u": &ursin#/(nte#rated Concepts: %earnin# )utcome: //-0 Question 1. Type: MCSA After the client ,egins ta&ing glucocorticoid medications+ the nurse "ould o,serve for adverse effects of 1. hy!oglycemia. 2. hy!otension. 3. ,ruising of the s&in. 4. "eight loss. Correct Answer: / Rationa e 1( 9y!erglycemia+ not hy!oglycemia+ can occur. Rationa e 2( 9y!ertension+ not hy!otension+ can occur as a result of Cushing7s syndrome. Rationa e 3( :ruising of the s&in can result due to de!ressed immune res!onse. Rationa e 4( eight gain+ not "eight loss+ can occur.
! o"a Rationa e: Co#niti$e %e$e : Fnderstanding C ient &eed: .hysiological Integrity C ient &eed 'u": &ursin#/(nte#rated Concepts:
%earnin# )utcome: //-@ Question 1/ Type: MCSA Acetamino!hen reduces fever ,y 1. directly acting on the hy!othalamus. 2. inhi,iting !rostaglandins. 3. ,loc&ing im!ulses to the ,rain. 4. affecting nerve fi,ers. Correct Answer: 3 Rationa e 1( Acetamino!hen (Tylenol) directly acts on the fever center of the hy!othalamus and dilates !eri!heral ,lood vessels. Rationa e 2( Anti-inflammatory drugs such as i,u!rofen (Advil) inhi,it !rostaglandins. Rationa e 3( :loc&ing im!ulses to the ,rain is not a mechanism of action of drugs for inflammation and fever. Rationa e 4( Acetamino!hen dilates ,lood vessels+ not nerve fi,ers. ! o"a Rationa e: Co#niti$e %e$e : Aemem,ering C ient &eed: .hysiological Integrity C ient &eed 'u": &ursin#/(nte#rated Concepts: %earnin# )utcome: //-@ Question 20 Type: MCSA A client is ta&ing as!irin (ASA) for arthritis. The nurse "ill advise the client to ta&e the medication 1. "ith a glass of mil&. 2. "ith other medications. 3. "ith orange =uice at ,edtime. 4. on an em!ty stomach in the morning.
Correct Answer: 3 Rationa e 1( As!irin is an acid+ "hich can cause *I distress+ so it is ,est to ta&e it "ith mil& or food. Rationa e 2( Several medications can interact "ith as!irin. Rationa e 3( Brange =uice is highly acidic+ and so can increase the ris& for *I distress. Rationa e 4( Ta&ing as!irin on an em!ty stomach can increase the ris& of gastric acid !roduction. ! o"a Rationa e: Co#niti$e %e$e : A!!lying C ient &eed: .hysiological Integrity C ient &eed 'u": &ursin#/(nte#rated Concepts: Nursing .rocess( Im!lementation %earnin# )utcome: //-8 Question 21 Type: MCSA A client is !laced on as!irin. A to)ic reaction to this medication that the nurse "ill teach the client to re!ort is 1. ,lurred vision. 2. muscle cram!s. 3. tinnitus. 4. =oint !ain. Correct Answer: / Rationa e 1( :lurred vision is not a sign of to)icity. Rationa e 2( Muscle cram!s are not a sign of to)icity. Rationa e 3( Tinnitus+ or ringing in the ears+ is a common early sign of as!irin to)icity. Rationa e 4( >oint !ain is not a sign of to)icity. ! o"a Rationa e: Co#niti$e %e$e : A!!lying C ient &eed: .hysiological Integrity C ient &eed 'u": &ursin#/(nte#rated Concepts: Nursing .rocess( Im!lementation
%earnin# )utcome: //-8 Question 22 Type: MCMA A client !resents "ith a rash and is !rescri,ed an over-the-counter ointment for treatment. The client says+ HI thought I "ould need a shot or an e)!ensive !rescri!tion.I 9o" should the nurse res!ond# Note: Credit will be given only if all correct choices and no incorrect choices are selected. 'tandard Te*t: Select all that a!!ly. 1. HMedications that go on your s&in don<t usually have as many side effects.I 2. HMild rashes often res!ond "ell to to!ical ointments.I 3. HMany of the !roducts used on the s&in are availa,le over-the-counter.I 4. HJou should try to discover "hat caused your rash.I +. H.rescri!tion ointments are usually ,etter at healing.I Correct Answer: 3+'+/+1 Rationa e 1( To!ical drugs should ,e used "hen a!!lica,le ,ecause they cause fe" adverse effects. Rationa e 2( Inflammation of the s&in is ,est treated "ith to!ical medication if !ossi,le. Rationa e 3( Many !roducts used on the s&in are fairly ine)!ensive and are availa,le over-the-counter. Rationa e 4( Inflammation is not a disease+ ,ut is a sym!tom. The cause of the inflammation should ,e identified and treated. In this case+ the client should avoid the offending su,stance. Rationa e +( Many over-the-counter anti-inflammatory medications e)ist and do a good =o, of hel!ing the client heal. ! o"a Rationa e: Co#niti$e %e$e : A!!lying C ient &eed: .hysiological Integrity C ient &eed 'u": .hysiological Ada!tation &ursin#/(nte#rated Concepts: Nursing .rocess( Im!lementation %earnin# )utcome: //.1 Question 23 Type: MCMA
A client !resents "ith severe inflammation of the &nee. The !hysician !rescri,es a corticosteroid and as&s the client to return to the office in 34 days for follo"-u!. 9o" does the nurse e)!lain these instructions# Note: Credit will be given only if all correct choices and no incorrect choices are selected. 'tandard Te*t: Select all that a!!ly. 1. H e need to chec& to see if this is the correct treatment.I 2. H e need to re-e)amine the &nee after a fe" days of treatment.I 3. HCorticosteroids should only ,e ta&en for 3 to / "ee&s.I 4. HJou may ,e a,le to change to an NSAID at that visit.I +. HJou may need a / month !rescri!tion for a stronger corticosteroid at that time.I Correct Answer: '+/+1 Rationa e 1( There is no evidence that treatment is not correct. Rationa e 2( It is necessary to see if the treatment is "or&ing. Rationa e 3( Corticosteroid thera!y can have serious adverse effects if ta&en for e)tended !eriods of time. Rationa e 4( The client should ,e s"itched to an NSAID as 2uic&ly as !ossi,le. Rationa e +( Corticosteroid thera!y should ,e discontinued after 3C/ "ee&s. ! o"a Rationa e: Co#niti$e %e$e : A!!lying C ient &eed: .hysiological Integrity C ient &eed 'u": .harmacological and .arenteral Thera!ies &ursin#/(nte#rated Concepts: Nursing .rocess( Im!lementation %earnin# )utcome: //.1 Question 24 Type: MCMA A client has =ust ,een !rescri,ed i,u!rofen for a mild an&le s!rain. the nurse to 2uestion this !rescri!tion# hich health history information should alert
Note: Credit will be given only if all correct choices and no incorrect choices are selected. 'tandard Te*t: Select all that a!!ly.
1. The client has asthma. 2. The client had a similar an&le strain a year ago. 3. The client re!orts getting a rash "hen eating stra",erries. 4. The client is allergic to as!irin. +. The client re!orts having a !e!tic ulcer ? months ago. Correct Answer: 3+1+0 Rationa e 1( Clients "ith asthma are more li&ely to have hy!ersensitivity to i,u!rofen. Rationa e 2( There is no reason a !revious in=ury "ould change the decision to !rescri,e i,u!rofen. Rationa e 3( There is no cross-sensitivity ,et"een i,u!rofen and stra",erries. Rationa e 4( Clients "ho have an allergy to as!irin are more li&ely to ,e hy!ersensitive to i,u!rofen. Rationa e +( I,u!rofen increases the ris& of serious gastrointestinal ,leeding+ es!ecially in someone "ith a recent history of this !ro,lem. ! o"a Rationa e: Co#niti$e %e$e : Analy-ing C ient &eed: .hysiological Integrity C ient &eed 'u": &ursin#/(nte#rated Concepts: Nursing .rocess( Im!lementation %earnin# )utcome: //.@ Question 2+ Type: MCMA hich client statement "ould the nurse evaluate as indicating the goal of treatment "ith an anti-inflammatory drug has ,een met# Note: Credit will be given only if all correct choices and no incorrect choices are selected. 'tandard Te*t: Select all that a!!ly. 1. HMy fever "ent a"ay yesterday.I 2. HI<ve not ,een coughing u! so much !hlegm.I 3. HThe s&in over my &nee is red and hot to the touch.I
4. HThe !ain in my shoulder is much relieved.I +. HMy rash is s!reading.I Correct Answer: 3+1 Rationa e 1( Dever reduction is a goal of treatment "ith anti-inflammatory drugs. Rationa e 2( Aeduction of secretions is not a goal of treatment "ith anti-inflammatory drugs. Rationa e 3( Aedness and heat are sym!toms of inflammation. The thera!y may not ,e "or&ing in this client. Rationa e 4( .ain is a sign of inflammation. Aeduction of !ain indicates that the anti-inflammatory medication is "or&ing. Rationa e +( The goal of anti-inflammatory medications "ould ,e that the rash resolved. Since it is s!reading+ the goal has not ,een met. ! o"a Rationa e: Co#niti$e %e$e : Analy-ing C ient &eed: .hysiological Integrity C ient &eed 'u": &ursin#/(nte#rated Concepts: Nursing .rocess( 6valuation %earnin# )utcome: //.1

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Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 4/E Chapter 33

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