NCLEX : Anti-Inflammatory and Pain Treatments

Study concepts, example questions & explanations for NCLEX

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Example Questions

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Example Question #1 : Anti Inflammatory And Pain Treatments

Which of the following laboratory values would indicate toxicity in the client taking acetaminophen daily?

Possible Answers:

Direct bilirubin level of 2mg/dL

Sodium level of 140 mEq/L

Prothrombin time of 12 seconds

Platelet count of 400,000/mm3

Correct answer:

Direct bilirubin level of 2mg/dL

Explanation:

A direct bilirubin level of 2mg/dL or greater indicates acetaminophen toxicity.

Example Question #2 : Anti Inflammatory And Pain Treatments

The purpose of misoprostol in a client who chronically uses nonsteroidal anti-inflammatory drugs (NSAIDs) is:

Possible Answers:

Increased white blood cell count

Relief of epigastric pain

Decrease in serum phosphorus level

Reduction of steatorrhea

Correct answer:

Relief of epigastric pain

Explanation:

Misoprostol is used for the prevention of non steroidal anti inflammatory drug (NSAID) induced gastric ulcers. Taking this drug will prevent gastric ulcers and relieve epigastric pain.

Example Question #3 : Anti Inflammatory And Pain Treatments

Which of the following analgesics is available in "lollipop" form?

Possible Answers:

Hydrocodone

Fentanyl

Tramadol

Oxycodone

Correct answer:

Fentanyl

Explanation:

Fentanyl citrate comes in solid form on a stick (often referred to as a "fentanyl lollipop"). This form is 80-100 times more potent than morphine and intended for use by cancer patients and patients that have become tolerant to opioids. 

Example Question #4 : Anti Inflammatory And Pain Treatments

Celecoxib is what class of drug?
Possible Answers:

Nonsteroidal anti-inflammatory drug (NSAID)

Narcotic

Muscle relaxant

Corticosteroid

Correct answer:

Nonsteroidal anti-inflammatory drug (NSAID)

Explanation:

Celecoxib is a nonsteroidal anti-inflammatory drug (NSAID). These drugs work by inhibiting cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2), which reduces the synthesis of pro-inflammatory prostaglandins and thromboxane.

Example Question #5 : Anti Inflammatory And Pain Treatments

Which of the following is an antidote to opioid overdose?

Possible Answers:

Naloxone

N-acetylcysteine

Flumazenil

Glucagon

Correct answer:

Naloxone

Explanation:

Naloxone antidotes opioid overdose by competitively binding to μ-opioid receptors. Flumazenil is an antidote to benzodiazepines. Glucagon is an antidote for beta blocker overdose. N-acetylcysteine is an antidote for acetaminophen.

Example Question #6 : Anti Inflammatory And Pain Treatments

Which of the following over-the-counter analgesics is one of the most common causes of liver failure in the United States?

Possible Answers:

Acetaminophen

Ibuprofen

Naproxen

Aspirin

Correct answer:

Acetaminophen

Explanation:

Acetaminophen in doses over 3000mg per day can result in significant liver damage or liver failure. From 1998 to 2003, acetaminophen was the leading cause of acute liver failure in the United States. According to a population-based report in 2007 there are an estimated 1600 cases of acute liver failure in the United States every year, with acetaminophen being the most common etiology.

Example Question #35 : Drug Identification

Levodopa is not generally given alone due to what side effects?

Possible Answers:

Delirium

Heart palpitations

Nausea, vomiting, and anorexia

Tremor

Correct answer:

Nausea, vomiting, and anorexia

Explanation:

Levodopa (L-DOPA), a common treatment for Parkinson's disease, is generally given in combination with carbidopa or another peripheral dopa-decarboxylase inhibitor. This is because levodopa alone will stimulate dopamine receptors in the GI tract and the chemotrigger receptor zone (CTZ) in the brain, resulting in nausea, vomiting and anorexia. A peripheral dopa-decarboxylase inhibitor prevents levodopa from being prematurely converted into dopamine in the adrenal glands or other peripheral tissues.

Example Question #2 : Anti Inflammatory And Pain Treatments

How does adalimumab function to reduce inflammation in rheumatoid arthritis?

Possible Answers:

More than one of these

Monoclonal antibody

Tumor necrosis factor-alpha inhibitor

Cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) inhibitor

Correct answer:

More than one of these

Explanation:

Adalimumab is a tumor necrosis factor alpha (TNF-alpha) inhibitor. This class of drugs suppresses response to TNF-alpha, a potent pro-inflammatory cytokine. Inhibition of folic acid metabolism is the method of action of methotrexate. Reversible inhibition of cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) is the mechanism of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. Rheumatoid arthritis drugs such as rituximab, and almost all drugs that end in -mab, including adalimumab function as monoclonal antibodies.

Example Question #8 : Anti Inflammatory And Pain Treatments

Which of the following analgesic medications should be used with caution in patients with hepatic disease?

Possible Answers:

Ibuprofen

Ketorolac

Naproxen

Acetaminophen

Meloxicam

Correct answer:

Acetaminophen

Explanation:

The correct answer is "acetaminophen." This is the correct answer because acetaminophen, also known as Tylenol, is initially metabolized into a hepatotoxic intermediate (it transiently becomes a reactive oxygen species, which can cause liver hepatotoxicity). As such, in patients who already have pre-existing liver disease who are already more prone to liver injury from substances and diseases that affect the liver, it is prudent to avoid medications like acetaminophen that have a known potential to cause liver damage.

Meloxicam, ibuprofen, naproxen, and ketorolac are all examples of non-steroidal anti-inflammatory drugs (NSAIDs). These medications have the potential to cause renal damage or gastrointestinal damage if used in excess, but do not have the known hepatotoxic properties that acetaminophen does.

Example Question #9 : Anti Inflammatory And Pain Treatments

You are the nurse taking care of a patient who is started on a two-week course of oral prednisone. Which of the following is a known side effect of oral steroids?

Possible Answers:

Hyperkalemia

Insomnia

Hypotension

Hyponatremia

Decreased appetite

Correct answer:

Insomnia

Explanation:

The correct answer is "insomnia," as steroids are known to increase patients' vigilance and energy levels, thereby frequently making it difficult for patients to fall asleep and/or stay asleep while taking their steroid medication. The other choices are incorrect. Decreased appetite is not a side effect of taking steroid medications. Patients on steroids often have increased appetite. Hyponatremia and hyperkalemia both are not side effects of taking steroid medications. Hypernatremia and hypokalemia are more common side effects of steroids. Hypertension, rather than hypotension is a known side effect of steroid use.

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