A patient taking ibuprofen (Motrin) for treatment of OA has good pain relief but is experiencing increased dyspepsia and nausea with the drug's use. The nurse consults the patient's primary care provider about doing what?

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Adding misoprostol (Cytotec) to the patient's drug regimen. Misoprostol is a prostaglandin analog that helps protect the stomach lining from the irritating effects of NSAIDs like ibuprofen. By adding misoprostol, the patient can continue to benefit from the pain relief of ibuprofen while reducing the risk of gastrointestinal side effects such as dyspepsia and nausea. Option B) Substituting naproxen for ibuprofen may not necessarily address the issue of dyspepsia and nausea, as naproxen is also an NSAID and can cause similar gastrointestinal side effects. Option C) Increasing the dose of acetaminophen is not a suitable solution as acetaminophen is not an NSAID and does not have the same mechanism of action as ibuprofen. Additionally, exceeding the recommended daily dose of acetaminophen can lead to liver damage. Option D) Administering ibuprofen with antacids may provide temporary relief for dyspepsia, but it does not address the underlying issue of GI irritation caused by NSAIDs. Antacids may also interfere with the absorption of ibuprofen, reducing its effectiveness in providing pain relief. In an educational context, understanding the rationale behind choosing the appropriate adjunct therapy like misoprostol is crucial in managing patients with OA who require NSAID therapy but are experiencing gastrointestinal side effects. It emphasizes the importance of considering the mechanism of action of medications and how they interact with the body to make informed decisions for optimal patient care.

Correct Answer: B

Rationale: In the context of treating a patient with an acute attack of gout, the nurse would expect to administer colchicine (Option B) due to its specific mechanism of action in reducing inflammation and pain associated with gout attacks. Colchicine works by inhibiting the inflammatory response to the deposition of urate crystals in joints, which is a hallmark of gout. Option A, aspirin, is not typically used in the treatment of acute gout attacks because it may actually exacerbate the condition by interfering with uric acid excretion. Aspirin can increase uric acid levels in the blood, worsening gout symptoms. Options C and D, allopurinol and probenecid, are drugs used for chronic management of gout by reducing uric acid levels in the body or increasing its excretion. These medications are not typically indicated for acute gout attacks like colchicine. In an educational context, understanding the appropriate pharmacological management of acute gout attacks is crucial for nurses caring for patients with this condition. By knowing the specific actions and indications of medications commonly used in gout treatment, nurses can effectively contribute to improved patient outcomes and symptom management.

Correct Answer: D

Rationale: The correct answer is D) High level of involvement of sacroiliac joints and the axial skeleton. This is a key characteristic of spondyloarthritides associated with HLA-B27. These conditions, such as ankylosing spondylitis, are characterized by inflammation primarily in the sacroiliac joints and the axial skeleton, leading to stiffness and pain in the lower back and hips. Option A) Symmetric polyarticular arthritis is more characteristic of conditions like rheumatoid arthritis, not spondyloarthritides associated with HLA-B27. Option B) Absence of extraarticular disease is not a defining feature of spondyloarthritides associated with HLA-B27 as these conditions can have extraarticular manifestations. Option C) Presence of rheumatoid factor and autoantibodies is more indicative of rheumatoid arthritis, not spondyloarthritides associated with HLA-B27. In an educational context, understanding the clinical characteristics and associations of different types of arthritis is crucial for accurate diagnosis and appropriate management. Recognizing the specific patterns of joint involvement and associated features can guide healthcare providers in formulating treatment plans and improving patient outcomes.

Correct Answer: D

Rationale: The correct answer is D) Use stress management techniques such as biofeedback, meditation, or cognitive behavioral therapy. Rationale: Patients with fibromyalgia often experience chronic pain and psychological distress, and stress can exacerbate their symptoms. Teaching stress management techniques is crucial for managing fibromyalgia because it helps patients cope with pain, reduces muscle tension, and improves overall well-being. Biofeedback, meditation, and cognitive behavioral therapy are evidence-based interventions that have been shown to be effective in reducing pain and improving quality of life in patients with fibromyalgia. Why the other options are wrong: A) Resting the muscles as much as possible is not recommended for fibromyalgia patients as it can lead to deconditioning and increased pain sensitivity. B) While sleep is important for fibromyalgia patients, aiming for 12 to 14 hours of sleep a day is not a practical or evidence-based recommendation. C) Food supplements like glucosamine and chondroitin have not been proven to be effective in managing fibromyalgia pain in research studies, so it is not the most appropriate intervention to teach patients. Educational context: Teaching patients with fibromyalgia about stress management techniques empowers them to take an active role in managing their condition. By providing education on these strategies, nurses can help patients improve their quality of life, reduce reliance on medications, and enhance their overall coping skills. It is essential for nurses to stay informed about evidence-based interventions for fibromyalgia to provide the best care and support to their patients.

Correct Answer: A

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.