Maryville NUR 615 Exam3
Mr. Holloway presents to your clinic with a significantly swollen, painful big toe and you diagnose him
with gout. Of the following options which would be the best treatment for Mr. Holloway? - Answer-
Low-dose colchicine
How is low dose colchicine prescribed? - Answer-1.2 mg followed by 0.6 mg one hour later or 1.8 mg
total
How is high dose colchicine prescribed? - Answer-1.2 mg followed by 0.6 mg Q4/Q6 or 4.8 mg total
Patient education when prescribing colchicine includes? - Answer-Colchicine always causes some
degree of diarrhea
You have a patient who is taking allopurinol to prevent gout. What labs will you monitor for this patient
on allopurinol? - Answer-BUN, creatinine, and creatinine clearance
Mr. Thompson has just started taking febuxostat (Uloric) to treat his gout and he needs to be educated
on what to expect. - Answer-Gout may worsen with therapy
,Ms. Jensen has been on prednisone for 6 months. Patients who have been on prednisone for some time
should be assessed for what - Answer-Osteoporosis
What dose predinisone do in diabetics? - Answer-Worsen blood glucose control
What teaching do you given patients taking prednisone? - Answer-report and black, tarry stools or
abdominal pain
When you place a patient on prednisone and the total dose exceeds 1 gram, what additional drug
should you prescribe - Answer-Omeprazole, a proton-pump inhibitor to prevent PUD
Janet has fractured her ankle and you give her a prescription for Vicodin (acetaminophen
+hydrocodone). What education should you provide before they leave your clinic? - Answer-Patient
should not take any other medications that contain acetaminophen
What is the first line of pain control? - Answer-NSAIDS
Margaret has been on 60 mg of prednisone for 10 days for her severe asthma exacerbation. Since she is
breathing much better it is time to discontinue the medication. What should you know when
discontinuing this drug? - Answer-Develop a tapering schedule to slowly wean Margaret off the
prednisone
Why must steroids be tapered? - Answer-avoid both recurrent activity of the underlying disease process
and possible cortisol deficiency resulting from the hypothalamic-pituitary-adrenal axis (HPA) suppression
during the period of steroid therapy.
Patients who are currently on or will start chronic corticosteroid therapy should be monitored for what?
- Answer-serum glucose
, Patients with rheumatoid arthritis who are on a chronic low-dose prednisone will need co-treatment
with which medications to prevent further adverse effects - Answer-Vitamin D, calcium supplement,
and bisphosphate
What is the FDA Black Box Warning for ALL nonsteroidal anti-inflammatory drugs (NSAIDS)? - Answer-
Increased risk of CV thrombotic events, Stroke, MI Potential for causing life-threatening gastrointestinal
bleeds
What do NSAIDs increase the risk of? - Answer-CV thrombotic events, MI, stroke
If you are getting ready to prescribe an NSAID, a complete drug history should be conducted as NSAIDs
interact with which drug? - Answer-Warfarin
Gabriella is a 3-year old diagnosed with otitis media and an upper respiratory infection. You prescribe
her an antibiotic (probably amoxicillin) and ibuprofen. What education should the parents receive? -
Answer-Need to keep well hydrated while taking ibuprofen
William is a 78-year old who takes two aspirin every morning while he reads his newspaper to treat
arthritis pain in his back. He states the aspirin helps him to "get moving" each day. Lately he has had
some heartburn from the aspirin. After you rule out an acute GI bleed, what would be an appropriate
course of treatment for William? - Answer-Add an H2 blocker such as ranitidine to his therapy
Patients prescribed aspirin therapy require education regarding the signs of aspirin toxicity. An early sign
of aspirin toxicity is? - Answer-Tinnitus
You have a patient that is on long-tern aspirin therapy and what lab should be conducted annually? -
Answer-CBC
Monitoring a patient on a high-dose aspirin level includes - Answer-Salicylate level, CBC, Urine pH
Mr. Holloway presents to your clinic with a significantly swollen, painful big toe and you diagnose him
with gout. Of the following options which would be the best treatment for Mr. Holloway? - Answer-
Low-dose colchicine
How is low dose colchicine prescribed? - Answer-1.2 mg followed by 0.6 mg one hour later or 1.8 mg
total
How is high dose colchicine prescribed? - Answer-1.2 mg followed by 0.6 mg Q4/Q6 or 4.8 mg total
Patient education when prescribing colchicine includes? - Answer-Colchicine always causes some
degree of diarrhea
You have a patient who is taking allopurinol to prevent gout. What labs will you monitor for this patient
on allopurinol? - Answer-BUN, creatinine, and creatinine clearance
Mr. Thompson has just started taking febuxostat (Uloric) to treat his gout and he needs to be educated
on what to expect. - Answer-Gout may worsen with therapy
,Ms. Jensen has been on prednisone for 6 months. Patients who have been on prednisone for some time
should be assessed for what - Answer-Osteoporosis
What dose predinisone do in diabetics? - Answer-Worsen blood glucose control
What teaching do you given patients taking prednisone? - Answer-report and black, tarry stools or
abdominal pain
When you place a patient on prednisone and the total dose exceeds 1 gram, what additional drug
should you prescribe - Answer-Omeprazole, a proton-pump inhibitor to prevent PUD
Janet has fractured her ankle and you give her a prescription for Vicodin (acetaminophen
+hydrocodone). What education should you provide before they leave your clinic? - Answer-Patient
should not take any other medications that contain acetaminophen
What is the first line of pain control? - Answer-NSAIDS
Margaret has been on 60 mg of prednisone for 10 days for her severe asthma exacerbation. Since she is
breathing much better it is time to discontinue the medication. What should you know when
discontinuing this drug? - Answer-Develop a tapering schedule to slowly wean Margaret off the
prednisone
Why must steroids be tapered? - Answer-avoid both recurrent activity of the underlying disease process
and possible cortisol deficiency resulting from the hypothalamic-pituitary-adrenal axis (HPA) suppression
during the period of steroid therapy.
Patients who are currently on or will start chronic corticosteroid therapy should be monitored for what?
- Answer-serum glucose
, Patients with rheumatoid arthritis who are on a chronic low-dose prednisone will need co-treatment
with which medications to prevent further adverse effects - Answer-Vitamin D, calcium supplement,
and bisphosphate
What is the FDA Black Box Warning for ALL nonsteroidal anti-inflammatory drugs (NSAIDS)? - Answer-
Increased risk of CV thrombotic events, Stroke, MI Potential for causing life-threatening gastrointestinal
bleeds
What do NSAIDs increase the risk of? - Answer-CV thrombotic events, MI, stroke
If you are getting ready to prescribe an NSAID, a complete drug history should be conducted as NSAIDs
interact with which drug? - Answer-Warfarin
Gabriella is a 3-year old diagnosed with otitis media and an upper respiratory infection. You prescribe
her an antibiotic (probably amoxicillin) and ibuprofen. What education should the parents receive? -
Answer-Need to keep well hydrated while taking ibuprofen
William is a 78-year old who takes two aspirin every morning while he reads his newspaper to treat
arthritis pain in his back. He states the aspirin helps him to "get moving" each day. Lately he has had
some heartburn from the aspirin. After you rule out an acute GI bleed, what would be an appropriate
course of treatment for William? - Answer-Add an H2 blocker such as ranitidine to his therapy
Patients prescribed aspirin therapy require education regarding the signs of aspirin toxicity. An early sign
of aspirin toxicity is? - Answer-Tinnitus
You have a patient that is on long-tern aspirin therapy and what lab should be conducted annually? -
Answer-CBC
Monitoring a patient on a high-dose aspirin level includes - Answer-Salicylate level, CBC, Urine pH
