NR 508 Chapter 25. Drugs Used to Treat Inflammatory Processes – With 100% Correct Answers

NR 508 Chapter 25. Drugs Used to Treat Inflammatory Processes – With 100% Correct Answers Multiple Choice 1) A patient who has been taking 10 mg per day of prednisone for the past six months sho uld be assessed for: 1. Gout 2. Iron deficiency anemia 3. Osteoporosis 4. Renal dysfunction 2) Patients whose total dose of prednisone exceeds 1 g will most likely need a second prescription for: 1. Metformin, a biguanide to prevent diabetes. 2. Omeprazole, a proton pump inhibitor to prevent peptic ulcer disease. 3. Naproxen, a nonsteroidal anti-inflammatory drug (NSAID) to treat joint pain 4. Furosemide, a diuretic to treat fluid retention. 3) A patient has been on 60 mg of prednisone for 10 days to treat a severe asthma exacerbation. It is time to discontinue the prednisone. How is prednisone discontinued? 1. Patients with asthma are transitioned directly off the prednisone onto inhaled corticosteroids. 2. Prednisone can be abruptly discontinued with no adverse effects. 3. A tapering schedule should be developed to slowly wean them of f the prednisone. 4. Prednisone should be substituted with another anti-inflammatory such as ibuprofen. 4) Patients with rheumatoid arthritis who are on chronic low-dose prednisone will need cotreatment with which medication to prevent adverse effects? 1. A bisphosphonate 2. Calcium supplementation 3. Vitamin D 4. All of the above 5) Patients who are on or who will be starting chronic corticosteroid therapy need monitoring of: 1. Serum glucose 2. Stool cultures 3. Folate levels 4. Vitamin B12 6) Patients who are on chronic long-term corticosteroid therapy need education regarding: 1. Receiving all vaccinations, especially the live flu vaccine 2. Reporting black tarry stools or abdominal pain 3. Eating a high carbohydrate diet with plenty of fluids 4. Small amounts of alcohol are generally tolerated. 7) All NSAIDs have a U.S. Food and Drug Administration (FDA) black box warning regarding: 1. Potential for causing life-threatening gastrointestinal (GI) bleeds 2. Increased risk of developing systemic arthritis with prolonged use 3. Risk of life-threatening rashes, including Stevens-Johnson syndrome 4. Potential for transient changes in serum glucose 8) A patient has fractured their ankle and has received a prescription for acetaminophen and hydrocodone (Vicodin). Education when prescribing Vicodin includes: 1. It is okay to double the dose of Vicodin if the pain is severe. 2. Vicodin is not habit forming. 3. They should not take any other acetaminophen-containing medications. 4. Vicodin may cause diarrhea; increase fluid intake. Rationale Vicodin contains both hydrocodone and acetaminophen. The combination of these two medications is used to provide more effective pain relief than either medication alone. Acetaminophen is a common pain reliever and fever reducer that works by blocking the production of certain chemicals in the body that cause pain and inflammation. When combined with hydrocodone, it can help to enhance the pain-relieving effects of the medication. However, it is important to note that acetaminophen can be toxic to the liver in high doses, so it is important to use Vicodin only as directed by a healthcare professional and to avoid taking more than the recommended dose. 9) When prescribing NSAIDs, a complete drug history should be conducted as NSAIDs interact with these drugs: 1. Omeprazole, a proton pump inhibitor 2. Combined oral contraceptives 3. Diphenhydramine, an antihistamine 4. Warfarin, an anticoagulant 10) A 2-year-old child is diagnosed with acute otitis media and an upper respiratory infection. Along with an antibiotic they receive a recommendation to treat the ear pain with ibuprofen. What education would their parent need regarding ibuprofen? 1. They can cut an adult ibuprofen tablet in half to give the child. 2. The ibuprofen dose can be doubled for severe pain. 3. The child needs to be well hydrated while taking ibuprofen. 4. Ibuprofen is completely safe in children with no known adverse effects. Rationale: Good hydration is important when taking ibuprofen because it helps to reduce the risk of kidney damage. When you are well hydrated, your kidneys are better able to filter and excrete the drug and its byproducts from your body. This can help to prevent the accumulation of toxic substances in your kidneys, which can lead to kidney damage and even kidney failure. 11) An 82-year-old takes two aspirin every morning to treat the arthritis pain in his back. The patient states the aspirin helps him to “get going” each day. Lately the patient has had some heartburn from the aspirin. After ruling out an acute GI bleed, what would be an appropriate course of treatment for him? 1. Add an H2 blocker such as ranitidine to his therapy. 2. Discontinue the aspirin and switch him to Vicodin for the pain. 3. Decrease the aspirin dose to one tablet daily. 4. Instruct the patient to take an antacid 15 minutes before taking the aspirin each day. 12) The trial period to determine effective anti-inflammatory activity when starting a patient on aspirin for rheumatoid arthritis is: 1. 48 hours 2. 4 to 6 days 3. Four weeks 4. Two months 13) Patients prescribed aspirin therapy require education regarding the signs of aspirin toxicity. An early sign of aspirin toxicity is: 1. Black tarry stools 2. Vomiting 3. Tremors 4. Tinnitus 14) Monitoring a patient on a high-dose aspirin includes: 1. Salicylate level 2. Complete blood count 3. Urine pH 4. All of the above 15) Patients who are on long-term aspirin therapy should have annually. 1. Complete blood count 2. Salicylate level 3. Amylase 4. Urine analysis