Chapter 39 Histamine and Serotonin
1. A nurse has admitted a 10-year-old child to the short-stay unit. The child has
complained of chronic headaches and his or her mother reports that he or she gives him
or her acetaminophen (Tylenol) at least twice a day. What will the nurse evaluate?
A) Renal function
B) Hepatic function
C) Respiratory function
D) Cardiac function
Ans B
Feedback
The nurse should evaluate the patients hepatic function. Severe hepatotoxicity can
occur from overuse of acetaminophen. Significant interferences do not occur in the
kidney, heart, or lung with acetaminophen.
2. The nurse is discussing ethnic differences in response to medication with your nursing
students. What group of people would the nurse tell the students may have a decreased
sensitivity to pain-relieving effects of anti-inflammatory drugs and should be educated
concerning signs and symptoms of gastrointestinal bleeding from use of these drugs?
A) African Americans
B) White Americans
C) Hispanics
D) Asians
Ans A
Feedback
African Americans have a documented decreased sensitivity to pain-relieving effects of
many anti-inflammatory drugs. They also have an increased risk of developing GI
adverse effects to these drugs. In general, White Americans, Hispanics, and Asians are at
lower risk for these problems.
3. A patient, newly diagnosed with ulcerative colitis, has been admitted to the short-stay
unit. What salicylates does the nurse anticipate will be ordered for this patient?
A) Balsalazide (Colazal)
, B) Sodium thiosalicylate (generic)
C) Choline magnesium trisalicylate (Tricosal)
D) Salsalate (Argesic)
Ans A
Feedback
Balsalazide is delivered intact to the colon, where it delivers a local anti-inflammatory
effect that is most effective for patients with ulcerative colitis. Choline salicylate and
salsalate are used to treat pain, fever, and inflammation. Sodium thiosalicylate is used
mainly for episodes of acute gout, for muscular pain, and to treat rheumatic fever.
4. The nurse is caring for a 66-pound child with orders for choline magnesium
trisalicylate (Tricosal). The orders read 50 mg/kg/d PO in two divided doses. How
many milligram will the patient receive per dose?
A) 250 mg
B) 500 mg
C) 750 mg
D) 1,000 mg
Ans C
Feedback
First, the nurse must determine the childs weight in kilogram. One kg is equal to 2.2
pounds. Divide 2.2 into 66 to equal 30 kg. Multiply 50 mg times 30 kg to equal 1,500
mg. Divide 1,500 by 2 for the divided doses, which will equal 750 mg per dose.
5. A nurse is caring for a patient with severe rheumatoid arthritis who takes anti-
inflammatory agents on a regular basis. What medication should the nurse question
if ordered by the physician to be taken in addition to the anti-inflammatory agent?
A) Oral antidiabetic agent
B) Calcium channel blocker
C) Beta-blocker
D) Antibiotic
Ans C
Feedback
, Nonsteroidal anti-inflammatory drugs have the potential to decrease antihypertensive
effects from beta blockers if these drugs are taken at the same time. Patients who receive
these combinations should be monitored closely and appropriate dosage adjustments
made if needed. Drug interactions do not usually occur with oral antidiabetic agents,
calcium channel blocking medications, or antibiotics.
6. A nurse is assessing a patient who has been taking nonsteroidal anti-inflammatory drugs
(NSAID). What statement by the patient indicates to the nurse that the patient has a
good understanding of the use of this therapy?
A) I drink a glass of wine just about every night.
B) I asked my doctor to check for blood in my stool regularly.
C) I do not like to swallow tablets so I crush them.
D) I drink as little water as possible when I take my medication.
Ans B
Feedback
Taking certain anti-inflammatory drugs can irritate the gastric mucosa and increase
the risk of bleeding; therefore, by asking his or her doctor to check his or her stool for
bleeding, the nurse knows that the patient is aware of this. Alcohol and crushing the
tablets can interfere with anti-inflammatory metabolism. A full glass of water should
be taken with this medication to increase absorption.
7. A salicylate has been prescribed for a 15-year-old patient who has been diagnosed with
arthritis. The mother is concerned about giving her child a salicylate. What salicylates
could the nurse tell this mother are recommended for use in children?
A) Salsalate (Argesic)
B) Olsalazine (Dipentum)
C) Sodium thiosalicylate (generic)
D) Choline magnesium trisalicylate (Tricosal)
Ans D
Feedback
Aspirin and choline magnesium trisalicylate are the only salicylates recommended for
use in children. They should not be used when any risk of Reyes syndrome exists.
Salsalate (Argesic), olsalazine (Dipentum), and sodium thiosalicylate (generic) have not
been approved for pediatric use and do not provide pediatric dosing guidelines as a
result.
1. A nurse has admitted a 10-year-old child to the short-stay unit. The child has
complained of chronic headaches and his or her mother reports that he or she gives him
or her acetaminophen (Tylenol) at least twice a day. What will the nurse evaluate?
A) Renal function
B) Hepatic function
C) Respiratory function
D) Cardiac function
Ans B
Feedback
The nurse should evaluate the patients hepatic function. Severe hepatotoxicity can
occur from overuse of acetaminophen. Significant interferences do not occur in the
kidney, heart, or lung with acetaminophen.
2. The nurse is discussing ethnic differences in response to medication with your nursing
students. What group of people would the nurse tell the students may have a decreased
sensitivity to pain-relieving effects of anti-inflammatory drugs and should be educated
concerning signs and symptoms of gastrointestinal bleeding from use of these drugs?
A) African Americans
B) White Americans
C) Hispanics
D) Asians
Ans A
Feedback
African Americans have a documented decreased sensitivity to pain-relieving effects of
many anti-inflammatory drugs. They also have an increased risk of developing GI
adverse effects to these drugs. In general, White Americans, Hispanics, and Asians are at
lower risk for these problems.
3. A patient, newly diagnosed with ulcerative colitis, has been admitted to the short-stay
unit. What salicylates does the nurse anticipate will be ordered for this patient?
A) Balsalazide (Colazal)
, B) Sodium thiosalicylate (generic)
C) Choline magnesium trisalicylate (Tricosal)
D) Salsalate (Argesic)
Ans A
Feedback
Balsalazide is delivered intact to the colon, where it delivers a local anti-inflammatory
effect that is most effective for patients with ulcerative colitis. Choline salicylate and
salsalate are used to treat pain, fever, and inflammation. Sodium thiosalicylate is used
mainly for episodes of acute gout, for muscular pain, and to treat rheumatic fever.
4. The nurse is caring for a 66-pound child with orders for choline magnesium
trisalicylate (Tricosal). The orders read 50 mg/kg/d PO in two divided doses. How
many milligram will the patient receive per dose?
A) 250 mg
B) 500 mg
C) 750 mg
D) 1,000 mg
Ans C
Feedback
First, the nurse must determine the childs weight in kilogram. One kg is equal to 2.2
pounds. Divide 2.2 into 66 to equal 30 kg. Multiply 50 mg times 30 kg to equal 1,500
mg. Divide 1,500 by 2 for the divided doses, which will equal 750 mg per dose.
5. A nurse is caring for a patient with severe rheumatoid arthritis who takes anti-
inflammatory agents on a regular basis. What medication should the nurse question
if ordered by the physician to be taken in addition to the anti-inflammatory agent?
A) Oral antidiabetic agent
B) Calcium channel blocker
C) Beta-blocker
D) Antibiotic
Ans C
Feedback
, Nonsteroidal anti-inflammatory drugs have the potential to decrease antihypertensive
effects from beta blockers if these drugs are taken at the same time. Patients who receive
these combinations should be monitored closely and appropriate dosage adjustments
made if needed. Drug interactions do not usually occur with oral antidiabetic agents,
calcium channel blocking medications, or antibiotics.
6. A nurse is assessing a patient who has been taking nonsteroidal anti-inflammatory drugs
(NSAID). What statement by the patient indicates to the nurse that the patient has a
good understanding of the use of this therapy?
A) I drink a glass of wine just about every night.
B) I asked my doctor to check for blood in my stool regularly.
C) I do not like to swallow tablets so I crush them.
D) I drink as little water as possible when I take my medication.
Ans B
Feedback
Taking certain anti-inflammatory drugs can irritate the gastric mucosa and increase
the risk of bleeding; therefore, by asking his or her doctor to check his or her stool for
bleeding, the nurse knows that the patient is aware of this. Alcohol and crushing the
tablets can interfere with anti-inflammatory metabolism. A full glass of water should
be taken with this medication to increase absorption.
7. A salicylate has been prescribed for a 15-year-old patient who has been diagnosed with
arthritis. The mother is concerned about giving her child a salicylate. What salicylates
could the nurse tell this mother are recommended for use in children?
A) Salsalate (Argesic)
B) Olsalazine (Dipentum)
C) Sodium thiosalicylate (generic)
D) Choline magnesium trisalicylate (Tricosal)
Ans D
Feedback
Aspirin and choline magnesium trisalicylate are the only salicylates recommended for
use in children. They should not be used when any risk of Reyes syndrome exists.
Salsalate (Argesic), olsalazine (Dipentum), and sodium thiosalicylate (generic) have not
been approved for pediatric use and do not provide pediatric dosing guidelines as a
result.
