Inflammation Exam Questions |
NCLEX-RN NGN Pharmacology Practice
Test Bank |
Original Nursing MCQs with Detailed
Rationales |
Medication Safety, Opioids, NSAIDs,
Corticosteroids & DMARDs
Question 1
Clinical Scenario
A 72-year-old client with osteoarthritis reports increasing knee
pain. The provider prescribes ibuprofen 400 mg orally every 6
hours as needed. The client has a history of chronic kidney
disease stage 3 and hypertension controlled with lisinopril.
Question Stem
Which action should the nurse take before administering the
first dose of ibuprofen?
,A.
Assess the client's pain level
B.
Review the client's serum creatinine level
C.
Check the client's blood glucose level
D.
Encourage the client to ambulate
Correct Answer: B. Review the client's serum creatinine level
Detailed Rationale
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that
can reduce renal blood flow by inhibiting prostaglandin
synthesis. Clients with chronic kidney disease are at increased
risk for NSAID-induced nephrotoxicity, especially when taking
an ACE inhibitor such as lisinopril. Reviewing the serum
creatinine level before administration is the priority nursing
action because it helps determine current renal function and
whether the medication is safe to give.
Option A is important but not the priority because pain
assessment does not address the significant renal safety
concern. Option C is incorrect because ibuprofen does not
routinely require blood glucose monitoring. Option D may be
,appropriate for osteoarthritis management but does not
address the immediate medication safety issue.
The nurse should also monitor urine output, blood pressure,
and signs of fluid retention. Patient teaching should include
avoiding additional over-the-counter NSAIDs and reporting
decreased urine output, swelling, or shortness of breath.
Learning Objective
• Identify renal considerations before administering NSAIDs.
• Recognize increased nephrotoxicity risk in older adults.
• Prioritize laboratory review before medication
administration.
• Educate clients about safe NSAID use.
Medication Safety Focus
Monitoring
Question 2
Clinical Scenario
A 28-year-old client is prescribed acetaminophen 650 mg every
6 hours as needed for postoperative pain. The nurse notes the
client has been taking an over-the-counter cold medication at
home.
Question Stem
, Which statement by the nurse is most appropriate?
A.
"You can take both medications without concern."
B.
"Take the acetaminophen only when your temperature is above
38°C (100.4°F)."
C.
"Check whether the cold medication also contains
acetaminophen."
D.
"Double the acetaminophen dose if your pain becomes severe."
Correct Answer: C. Check whether the cold medication also
contains acetaminophen.
Detailed Rationale
Many over-the-counter cold and flu products contain
acetaminophen. Concurrent use can unintentionally exceed the
recommended daily maximum dose and increase the risk of
hepatotoxicity. The nurse should teach the client to read
medication labels carefully and include all sources of
acetaminophen when calculating the total daily intake.