A 70-year-old man with a history of osteoarthritis has been taking Ibuprofen 600 mg three times daily for chronic knee pain. During a routine check-up, his blood pressure is found to be elevated at 160/95 mmHg, up from his usual 135/85 mmHg. Laboratory tests reveal an elevation in his kidney function tests and serum potassium level. Which of the following adverse effects of NSAIDS best explains these findings?
Cardiotoxicity
Nephrotoxicity
Neurotoxicity
Hepatotoxicity
The Correct Answer is B
A. Cardiotoxicity: While NSAIDs can contribute to cardiovascular risks such as hypertension and fluid retention, nephrotoxicity is the more direct explanation for the elevated kidney function tests and potassium level. Cardiotoxicity typically presents with symptoms like heart failure or arrhythmias rather than kidney-related lab abnormalities.
B. Nephrotoxicity: NSAIDs inhibit prostaglandin synthesis, which plays a key role in maintaining renal blood flow, especially in older adults or those with preexisting renal impairment. Chronic NSAID use can reduce glomerular filtration, leading to elevated creatinine, hyperkalemia, and worsening blood pressure control, all of which are evident in this patient.
C. Neurotoxicity: Neurotoxic effects are not commonly associated with NSAID use. Symptoms of neurotoxicity include confusion or seizures, which are not relevant to the clinical findings in this scenario.
D. Hepatotoxicity: NSAID-induced liver injury is rare and would typically present with elevated liver enzymes (AST, ALT), not elevated creatinine or potassium. The current lab findings and blood pressure changes are more consistent with kidney involvement.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["02.03"]
Explanation
Given time = 2:03 am
For times between 12:00 am (midnight) and 9:59 am, military time uses a leading zero for the hour.
Hour in traditional time = 2
Military time hour = 02
The minutes remain the same.
Minutes = 03
Military time = 02:03
Correct Answer is B
Explanation
A. Intramuscular Phenobarbital: While effective as an anticonvulsant, phenobarbital has a slower onset of action and is not the preferred first-line treatment for acute seizures. It is more commonly used in refractory cases or for long-term seizure control.
B. Intravenous Lorazepam: Lorazepam is a benzodiazepine and the first-line treatment for active seizures, especially status epilepticus. Given IV, it acts quickly by enhancing GABA activity, which calms neuronal excitability and stops seizure activity efficiently.
C. Oral Phenytoin: Phenytoin is used for long-term seizure prevention but is not effective for terminating ongoing seizures due to its slow onset when taken orally. It may be used after benzodiazepines to prevent seizure recurrence but not as the initial agent.
D. Subcutaneous Sumatriptan: Sumatriptan is used for treating acute migraines and has no role in managing seizures. It acts on serotonin receptors to relieve migraine symptoms, not to control abnormal neuronal discharges.
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