Joseph Marshall is a 55 year old who is being seen in the doctor's office for an acute exacerbation of rheumatoid arthritis. He has swelling of the hands so severely that he cannot currently make a fist. The doctor prescribes Motrin 300 mg TID. Mr. Marshall has a history of a hiatal hernia and obesity. The nurse tells him to take the medication with meals and to avoid taking any pain relievers containing aspirin.