NSAIDs & Opioids
DMARDs
Corticosteroids
Immunosuppressive Drugs
Surprise!
100
The nurse recognizes the need to hold opioid analgesics when patients exhibit these findings .
What are bradypnea and hypotension.
Alternative acceptable answer: decreased level of consciousness/oversedation.
100
This drug is the first-line DMARD of choice
What is methotrexate?
100
The nurse must include this in their education for the client with diabetes taking a systemic steroid.
What is the importance of glucose monitoring r/t the risk for hyperglycemia?
100
Name this adverse effect of immunosuppressive drugs:
What is thrush?
Acceptable alternatives: oral thrush, candidiasis, oral candidiasis.
100
This is the most concerning adverse reaction or side effect of oxycodone.
What is respiratory depression?
200
The client is prescribed ibuprofen for osteoarthritis. This drug in the client's medication reconciliation would alert the nurse to contact the provider.
What is warfarin sodium (Coumadin)?
200
The nurse is concerned an adolescent client with RA is developing a side effect of methotrexate and recommends this test as a priority to monitor.
What is a complete blood count (CBC)?
200
This important administration timing instruction should be included for the client taking prednisone.
What is administer with meals to minimize GI irritation?
200
Biologically male patients should continue to wear condoms for at least four (4) months after completion of drug therapy.
What is cyclophosphamide?
200
This medication requires assessment of risk for opioid addiction, abuse, or misuse before administration.
What is oxycodone?
300
The nurse knows that ibuprofen should be avoided entirely or used cautiously in this vulnerable population.
Who are people who are pregnant or breastfeeding?
Also acceptable: infants <6 months, geriatric pt's r/t increased r/f adverse reactions.
300
Patient teaching for this drugs should include advising the patient of risk of malignancies (e.g., hepatosplenic T-cell lymphoma). The patient should be instructed to report signs such as splenomegaly, hepatomegaly, abdominal pain, persistent fever, night sweats, or weight loss) to their provider immediately.
What is infliximab?
300
Stopping corticosteroids abruptly may result in adrenal insufficiency. List two (2) symptoms of this adverse effect.
What are anorexia, nausea, weakness, fatigue, dyspnea, hypotension, and hypoglycemia?
300
Name this side effect of immunosuppressive drugs:
Phrase your answer to include the following:
"___________ secondary to ______________."
What is petechiae secondary to thrombocytopenia?
300
Biologically female patients taking this immunosuppressant should be advised to notify they are breastfeeding-- the infant should be monitored for diarrhea, vomiting, or rash.
What is azathioprine?
400
Clients taking ibuprofen are at risk for this organ dysfunction (list 2).
What are:
- Renal failure
- Liver failure?
Also acceptable: anemia, prolonged bleeding time, MI, HF
400
This adverse effect of hydroxychloroquine results in the rash pictured below. It may result in flares and a prolonged course of recovery. 
What is drug reaction with eosinophilia and systemic systems (DRESS) syndrome?
400
The client taking corticosteroids should be instructed to inform their provider promptly if this symptom occurs.
What is severe abdominal pain or tarry stools? (Evidence of peptic ulceration.)
Alternative acceptable answer is s/sx of adrenal insufficiency.
400
Biologically female patients taking this drug should use highly effective contraceptive measures up to 1 year after completion of drug therapy.
What is cyclophosphamide?
400
This DMARD is considered potentially teratogenic.
What is methotrexate?
***Infliximab is not considered teratogenic, but pregnant patients who take it should avoid breast feeding, and infants exposed to infliximab in utero should wait at least 6 months before any live vaccine; may be at increased r/f infection***
500
Name this adverse effect of ibuprofen:
What is Stevens-Johnson Syndrome?
500
The nurse is teaching a client prescribed methotrexate; they will be sure to include these points in their teaching (list five [5]).
What are:
1) Drink fluids to prevent acute renal failure;
2) This medication suppresses the immune system;
3) Report a dry, nonproductive cough
4) Assess for rash periodically
5) Monitor hepatic function?
Rationale: Adverse effects of methotrexate include acute renal failure, bone marrow suppression, pulmonary fibrosis, Stevens-Johnson syndrome, and hepatotoxicity.
500
The nurse is teaching a client prescribed prednisone; they will be sure to include these points in their client education (list four [4]).
What are:
1) Monitor for weight gain;
2) Do not stop this medication abruptly;
3) This drug can cause immune suppression;
4) This drug may cause hyperglycemia?
Rationale: Long-term steroid use can cause fat deposits in the back, face, and trunk; corticosteroids can cause immunosuppression; steroids may cause adrenal suppression if stopped abruptly; a side effect is hyperglycemia
500
This immunosuppressive drug may cause sterility & menstrual irregularities or cessation. This drug is teratogenic.
What cyclophosphamide?
500
When assessing the client with OA of the knees and fingers, the nurse expects these manifestations (list three [3]).
What are:
1) Heberden's nodes;
2) Enlarged joint size;
3) A limp while walking?