A 75-year-old woman has been given a nonsteroidal anti-inflammatory drug (an NSAID) for the treatment of rheumatoid arthritis. The nurse is reviewing the patient‘s medication history and notes that which types of medications could have an interaction with the NSAID? (Select all that apply.)
a. Antibiotics
b. Decongestants
c. Anticoagulants
d. Beta blockers
e. Diuretics
f. Corticosteroids

c. Anticoagulants
e. Diuretics
f. Corticosteroids

The nurse is reviewing the history of a patient who has a new order for a nonsteroidal anti-inflammatory drug (NSAID) to treat tendonitis. Which conditions are contraindications to the use of NSAIDs? (Select all that apply.)
a. Vitamin K deficiency
b. Arthralgia
c. Peptic ulcer disease
d. Documented aspirin allergy
e. Pericarditis

a. Vitamin K deficiency
c. Peptic ulcer disease
d. Documented aspirin allergy

A patient calls the clinic to ask about taking a glucosamine-chondroitin supplement for arthritis. The nurse reviews the medication history and notes that there will be a concern for drug interactions if the patient is also taking medications for which disorder?
a. Type 2 diabetes mellitus
b. Hypothyroidism
c. Hypertension
d. Angina

a. Type 2 diabetes mellitus

The nurse notes in a patient‘s medication history that the patient is taking allopurinol. Based on this finding, the nurse interprets that the patient has which disorder?
a. Rheumatoid arthritis
b. Gout
c. Osteoarthritis
d. Systemic lupus erythematosus

b. Gout

During assessment of a patient with osteoarthritis pain, the nurse knows that which condition is a contraindication to the use of nonsteroidal anti-inflammatory drugs (NSAIDs)?
a. Renal disease
b. Diabetes mellitus
c. Headaches
d. Rheumatoid arthritis

a. Renal disease

A patient who has a history of coronary artery disease has been instructed to take one 81-mg aspirin tablet a day. The patient asks about the purpose of this aspirin. Which response by the nurse is correct?
a. ―Aspirin is given reduce anxiety.
b. ―It helps to reduce inflammation.
c. ―Aspirin is given to relieve pain.
d. ―It will help to prevent clot formation

d. ―It will help to prevent clot formation

A patient has used enteric aspirin for several years as treatment for osteoarthritis. However, the symptoms are now worse and she is given a prescription for a nonsteroidal anti-inflammatory drug and misoprostol, also called Cytotec. The patient asks the nurse, ―Why am I now taking two pills for arthritis? What is the nurse‘s best response?
a. ―Cytotec will also reduce the symptoms of your arthritis.
b. ―Cytotec helps the action of the NSAID so that it will work better.
c. ―Cytotec reduces the mucous secretions in the stomach, which reduces gastric irritation.
d. ―Cytotec may help to prevent gastric ulcers that may occur in patients taking NSAIDs

d. ―Cytotec may help to prevent gastric ulcers that may occur in patients taking NSAIDs.

A 6-year-old child who has chickenpox also has a fever of 102.9°F (39.4°C). The child‘s mother asks the nurse if she should use aspirin to reduce the fever. What is the best response by the nurse?
a. ―It‘s best to wait to see if the fever gets worse.
b. ―You can use the aspirin, but watch for worsening symptoms.
c. ―Acetaminophen should be used to reduce his fever, not aspirin.
d. ―You can use aspirin, but be sure to follow the instructions on the bottle

c. ―Acetaminophen should be used to reduce his fever, not aspirin.

A mother brings her toddler into the emergency department and tells the nurse that she thinks the toddler has eaten an entire bottle of chewable aspirin tablets. The nurse will assess for which most common signs of salicylate intoxication in children?
a. Photosensitivity and nervousness
b. Tinnitus and hearing loss
c. Acute gastrointestinal bleeding
d. Hyperventilation and drowsiness

d. Hyperventilation and drowsiness

The nurse is teaching a patient who is taking colchicine for the treatment of gout. Which instruction will the nurse include during the teaching session?
a. ―Fluids should be restricted while on colchicine therapy.
b. ―Take colchicine with meals.
c. ―The drug will be discontinued when symptoms are reduced.
d. ―Call your doctor if you have increased joint pain or blood in the urine

d. ―Call your doctor if you have increased joint pain or blood in the urine

A patient with gout has been treated with allopurinol for 2 months. The nurse will monitor laboratory results for which therapeutic effect?
a. Decreased uric acid levels
b. Decreased prothrombin time
c. Decreased white blood cell count
d. Increased hemoglobin and hematocrit levels

a. Decreased uric acid levels

A patient is taking the nonsteroidal anti-inflammatory drug indomethacin (Indocin) as treatment for pericarditis. The nurse will teach the patient to watch for which adverse effect?
a. Tachycardia
b. Nervousness
c. Nausea and vomiting
d. Dizziness

c. Nausea and vomiting

The nurse is reviewing the therapeutic effects of nonsteroidal anti-inflammatory drugs (NSAIDs), which include which effect?
a. Anxiolytic
b. Sedative
c. Antipyretic
d. Antimicrobial

c. Antipyretic

A patient who has a helminthic infection has a prescription for pyrantel. Which is one of the common adverse effects that the patient may experience while on this therapy?
a. Insomnia
b. Seizures
c. Diarrhea
d. Dark discoloration of the urine

c. Diarrhea

A patient has an infestation with flukes (trematodes). The nurse anticipates the use of which drug to treat this infestation?
a. Praziquantel
b. Pyrantel
c. Metronidazole
d. Ivermectin

a. Praziquantel

A patient who is being treated for malaria has started therapy with quinine and tetracycline. He asks the nurse why he is on an antibiotic when malaria is caused by a parasite. Which response by the nurse is correct?
a. ―The tetracycline prevents reinfection by the malarial parasite.
b. ―The antibiotic is combined with quinine to reduce the side effects of the quinine.
c. ―An antibacterial drug prevents the occurrence of superinfection during antimalarial therapy.
d. ―The two drugs are more effective against malaria when given together

d. ―The two drugs are more effective against malaria when given together

A woman is traveling to a country where she will be at high risk for malarial infection. What will the nurse teach her regarding prophylactic therapy with hydroxychloroquine?
a. Hydroxychloroquine is better absorbed and has fewer adverse effects if taken on
an empty stomach.
b. The drug is started 3 weeks before exposure but can be discontinued once she
leaves the area.
c. The medication is taken only when she observes mosquito bites because it can
have toxic effects if taken unnecessarily.
d. The drug is usually started 1 to 2 weeks before traveling to endemic areas and is
continued for 4 weeks after leaving the area.

d. The drug is usually started 1 to 2 weeks before traveling to endemic areas and is
continued for 4 weeks after leaving the area.

A patient with late-stage HIV infection also has Pneumocystis jirovecii pneumonia. The nurse anticipates treatment with which medication for this pneumonia?
a. Ivermectin
b. Atovaquone
c. Praziquantel
d. Metronidazole

b. Atovaquone

A patient with an intestinal infection that is positive for the Giardia lamblia organism will be taking an antiprotozoal drug. The nurse will include which information in the teaching plan for this patient?
a. The urine may become dilute and pale during therapy.
b. Taking the medications with food reduces gastrointestinal upset.
c. The medications should be taken on an empty stomach.
d. The drugs may be discontinued once the diarrhea subsides.

b. Taking the medications with food reduces gastrointestinal upset.

The nurse is reviewing antimalarial drug therapy with a patient and instructs the patient to watch for and report which potential adverse reactions?
a. Drowsiness
b. Insomnia
c. Dizziness
d. Constipation

c. Dizziness

A patient is being evaluated for a possible helminthic infection. The nurse knows that which statement about anthelmintic therapy is true?
a. The drugs may cause severe drowsiness.
b. Anthelmintics are very specific in their actions.
c. Anthelmintics are effective against broad classes of infestations.
d. The drugs are used to treat protozoal infections such as intestinal amebiasis.

b. Anthelmintics are very specific in their actions.

A patient is experiencing the exoerythrocytic phase of malaria. The nurse expects which drug to be used for this patient?
a. Quinine
b. Chloroquine
c. Mefloquine
d. Primaquine

d. Primaquine

A patient is receiving hydroxychloroquine therapy but tells the nurse that she has never traveled out of her city. The nurse knows that a possible reason for this drug therapy is which of these conditions?
a. Lyme disease
b. Toxoplasmosis
c. Systemic lupus erythematosus
d. Intestinal tapeworms

c. Systemic lupus erythematosus

Hydroxychloroquine is prescribed as part of malaria prophylaxis for a patient who will be traveling. The nurse will discuss which potential adverse effects with the patient? (Select all that apply.)
a. Diarrhea
b. Myalgia
c. Insomnia
d. Dizziness
e. Vomiting
f. Headache

a. Diarrhea
d. Dizziness
e. Vomiting
f. Headache

The nurse is discussing adverse effects of antitubercular drugs with a patient who has active tuberculosis. Which potential adverse effect of antitubercular drug therapy should the patient report to the prescriber?
a. Gastrointestinal upset
b. Headache and nervousness
c. Reddish-orange urine and stool
d. Numbness and tingling of extremities

d. Numbness and tingling of extremities

A patient who has been taking isoniazid has a new prescription for pyridoxine. She is wondering why she needs this medication. The nurse explains that pyridoxine is often given concurrently with the isoniazid to prevent which condition?
a. Hair loss
b. Renal failure
c. Peripheral neuropathy
d. Heart failure

c. Peripheral neuropathy

The nurse will assess the patient for which potential contraindication to antitubercular therapy?
a. Glaucoma
b. Anemia
c. Heart failure
d. Hepatic impairment

d. Hepatic impairment

When monitoring patients on antitubercular drug therapy, the nurse knows that which drug may cause a decrease in visual acuity?
a. Rifampin
b. Isoniazid
c. Ethambutol
d. Streptomycin

c. Ethambutol

A patient has been taking antitubercular therapy for 3 months. The nurse will assess for what findings that indicate a therapeutic response to the drug therapy?
a. The chronic cough is gone.
b. There are two consecutive negative purified protein derivative (PPD) results over 2 months.
c. There is increased tolerance to the medication therapy, and there are fewer reports of adverse effects.
d. There is a decrease in symptoms of tuberculosis along with improved chest radiographs and sputum cultures.

D. There is a decrease in symptoms of tuberculosis along with improved chest radiographs and sputum cultures.

The nurse is counseling a woman who will be starting rifampin as part of antitubercular therapy. The patient is currently taking oral contraceptives. Which statement is true regarding rifampin therapy for this patient?
a. Women have a high risk for thrombophlebitis while on this drug.
b. A higher dose of rifampin will be necessary because of the contraceptive.
c. Oral contraceptives are less effective while the patient is taking rifampin.
d. The incidence of adverse effects is greater if the two drugs are taken together.

c. Oral contraceptives are less effective while the patient is taking rifampin.

The nurse is reviewing the medication administration record of a patient who is taking isoniazid. Which drug or drug class has a significant drug interaction with isoniazid?
a. Pyridoxine
b. Penicillins
c. Phenytoin
d. Benzodiazepines

c. Phenytoin

A patient who has started drug therapy for tuberculosis wants to know how long he will be on the medications. Which response by the nurse is correct?
a. ―Drug therapy will last until the symptoms have stopped.
b. ―Drug therapy will continue until the tuberculosis develops resistance.
c. ―You should expect to take these drugs for as long as 12 months.
d. ―You will be on this drug therapy for the rest of your life.

c. ―You should expect to take these drugs for as long as 12 months.

The nurse is preparing to administer morning medications to a patient who has been newly diagnosed with tuberculosis. The patient asks, ―Why do I have to take so many different drugs? Which response by the nurse is correct?
a. ―Your prescriber hopes that at least one of these drugs will work to fight the tuberculosis.
b. ―Taking multiple drugs is recommended because more drugs are becoming resistant to TB drug therapy.
c. ―Using more than one drug can help to reduce side effects.
d. ―Using multiple drugs enhances the effect of each drug.

b. ―Taking multiple drugs is recommended because more drugs are becoming resistant to TB drug therapy.

A patient newly diagnosed with tuberculosis (TB) has been taking antitubercular drugs for 1 week calls the clinic and is very upset. He says, ―My urine is dark orange! What‘s wrong with me? Which response by the nurse is correct?
a. ―You will need to stop the medication, and it will go away.
b. ―It‘s possible that the TB is worse. Please come in to the clinic to be checked.
c. ―This is not what we usually see with these drugs. Please come in to the clinic to be checked.
d. ―This is an expected side effect of the medicine. Let‘s review what to expect.

d. ―This is an expected side effect of the medicine. Let‘s review what to expect.

The nurse is providing patient teaching for a patient who is starting antitubercular drug therapy. Which of these statements should be included? (Select all that apply.)
a. ―Take the medications until the symptoms disappear.
b. ―Take the medications at the same time every day.
c. ―You will be considered contagious during most of the illness and must take
precautions to avoid spreading the disease.
d. ―Stop taking the medications if you have severe adverse effects.
e. ―Avoid alcoholic beverages while on this therapy.
f. ―If you notice reddish-brown or reddish-orange urine, stop taking the drug and
contact your doctor right away.
g. ―If you experience a burning or tingling in your fingers or toes, report it to your prescriber immediately.
h. ―Oral contraceptives may not work while you are taking these drugs, so you will have to use another form of birth control.

b. ―Take the medications at the same time every day.
e. ―Avoid alcoholic beverages while on this therapy.
g. ―If you experience a burning or tingling in your fingers or toes, report it to your prescriber immediately.
h. ―Oral contraceptives may not work while you are taking these drugs, so you will have to use another form of birth control.