Introduction to the Inflammatory Response and Anti-inflammatory Drugs

Every question here, with the answer

1. A 72-year-old client with a history of peptic ulcer disease asks for ibuprofen for knee pain. Which concern should the nurse raise with the provider?

   1. Ibuprofen is a DMARD and takes months to work.
   2. The client is at greater risk for serious GI events such as bleeding.
   3. Ibuprofen will cause hypoglycemia.
   4. Ibuprofen increases uric acid and causes gout.

   Answer: The client is at greater risk for serious GI events such as bleeding.

   Older clients and those with prior peptic ulcer disease or GI bleeding are at greater risk for serious GI events with NSAIDs. The other options are not effects of NSAIDs described in the section.

2. A client with rheumatoid arthritis started methotrexate two weeks ago and says it is not working. What should the nurse explain?

   1. Methotrexate works only for fever.
   2. The client should add grapefruit juice to speed it up.
   3. DMARDs may take weeks to months to achieve their disease-modifying effects.
   4. The drug should be stopped because it has failed.

   Answer: DMARDs may take weeks to months to achieve their disease-modifying effects.

   DMARDs such as methotrexate may take weeks to months to modify the disease, so a lack of effect at two weeks is expected. Stopping is not indicated, and the other options are not supported by the section.

3. A nurse is teaching a client who has been prescribed an antigout drug. Which instructions should the nurse include? Select all that apply.

   1. Limit fluids when taking probenecid.
   2. Report rash, diarrhea, muscle pain or weakness.
   3. Drink plenty of water throughout the day.
   4. Avoid red meats, organ meats and seafood.
   5. Drink grapefruit juice with colchicine.

   Answer: Report rash, diarrhea, muscle pain or weakness., Drink plenty of water throughout the day., Avoid red meats, organ meats and seafood.

   Clients should stay hydrated, avoid purine-rich foods and report adverse effects such as rash, diarrhea and muscle pain. Grapefruit should be avoided with colchicine, and dehydration on probenecid increases the risk of kidney stones.

4. A client asks why celecoxib was prescribed instead of a traditional NSAID. Which explanation is correct?

   1. Celecoxib selectively inhibits COX-2 to reduce some gastrointestinal side effects.
   2. Celecoxib inhibits only COX-1 to protect the stomach.
   3. Celecoxib has no cardiovascular risk.
   4. Celecoxib is a DMARD that slows joint damage.

   Answer: Celecoxib selectively inhibits COX-2 to reduce some gastrointestinal side effects.

   COX-2 inhibitors were developed to relieve pain and inflammation while minimizing some GI side effects of non-selective NSAIDs, which block both COX-1 and COX-2. NSAIDs, including celecoxib, still carry cardiovascular risk.

5. Which findings are cardinal signs of inflammation? Select all that apply.

   1. Redness
   2. Loss of function
   3. Heat
   4. Hair loss
   5. Swelling

   Answer: Redness, Loss of function, Heat, Swelling

   The five cardinal signs are redness, swelling, heat, pain and loss of function. Hair loss is not one of them.

6. Which client history is a contraindication to NSAIDs such as ibuprofen?

   1. Seasonal fever
   2. A sprained ankle
   3. Mild headache
   4. Asthma or hives after taking aspirin

   Answer: Asthma or hives after taking aspirin

   A history of allergies, asthma or urticaria after aspirin or other NSAIDs is a contraindication. Pain, headache and fever are conditions NSAIDs are used to treat.