A patient is taking aspirin to help prevent myocardial infarction and is experiencing moderate gastrointestinal upset. The nurse will contact the patient’s provider to discuss changing from aspirin to which drug?

Celecoxib (Celebrex)

Enteric-coated aspirin

Nabumetone (Relafen)

A COX-2 inhibitor

Answer and Explanation

The Correct Answer is A

A) Celecoxib (Celebrex):
Celecoxib is a selective COX-2 inhibitor that targets the cyclooxygenase-2 enzyme, which is primarily responsible for inflammation, pain, and fever. COX-2 inhibitors tend to cause less gastrointestinal irritation compared to nonselective NSAIDs like aspirin, which block both COX-1 and COX-2 enzymes. Because aspirin is causing gastrointestinal upset, switching to Celecoxib, which is less likely to irritate the stomach lining, may be an appropriate option to prevent myocardial infarction while minimizing gastrointestinal discomfort.

B) Enteric-coated aspirin:
Enteric-coated aspirin is designed to dissolve in the small intestine rather than the stomach, which may reduce some gastrointestinal irritation. However, it does not eliminate the risk entirely, and it still functions as a COX-1 inhibitor. If the patient is already experiencing gastrointestinal upset, simply switching to enteric-coated aspirin may not be sufficient to alleviate the discomfort, and other options should be considered.

C) Nabumetone (Relafen):
Nabumetone is a nonsteroidal anti-inflammatory drug (NSAID) with some COX-2 selectivity. While it may cause less gastrointestinal upset than non-selective NSAIDs like aspirin, it is still an NSAID and carries a risk of gastrointestinal side effects, especially with prolonged use.
D) A COX-2 inhibitor:
While COX-2 inhibitors, including Celecoxib, are typically effective in reducing inflammation and pain with fewer gastrointestinal side effects than traditional NSAIDs, the term "a COX-2 inhibitor" could refer to various drugs, and Celecoxib (Celebrex) is the most commonly used.

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Correct Answer is C

Explanation

A) Monoamine oxidase:
Monoamine oxidase (MAO) is an enzyme, not a neurotransmitter. It is responsible for breaking down certain neurotransmitters, such as dopamine, serotonin, and norepinephrine, in the brain and other parts of the body. While it plays a crucial role in regulating neurotransmitter levels, it is not itself a neurotransmitter.

B) Cholinesterase:
Cholinesterase is also an enzyme, not a neurotransmitter. It breaks down acetylcholine (ACh) at synaptic junctions to terminate its action after it has transmitted a nerve impulse. This enzyme is important for the proper functioning of cholinergic synapses but does not function as a neurotransmitter.

C) Acetylcholine (ACh):
Acetylcholine (ACh) is a neurotransmitter. It is released by nerve cells at cholinergic synapses and plays a key role in both the peripheral and central nervous systems. ACh is involved in transmitting nerve impulses to muscles (muscle contraction) and is also important in cognitive functions like memory and learning in the brain.

D) Calcium:
Calcium is a vital ion involved in many cellular processes, including muscle contraction and neurotransmitter release. However, it is not a neurotransmitter. It plays a role in the function of neurotransmitters but does not act as one itself.

A. Decrease in heart rate and perfusion, and an increase in inflammatory response B. Increase motility and secretion in the GI tract, constriction of bronchi and pupils C. Increase in blood pressure, bronchodilation, and decrease bowel sounds D. Decrease in sweating, decrease in respiration, and pupil constriction

Correct Answer is C

Explanation

A) Decrease in heart rate and perfusion, and an increase in inflammatory response: These manifestations suggest parasympathetic nervous system activation, not the sympathetic response. The sympathetic system generally increases heart rate and perfusion to support "fight or flight" responses. Additionally, inflammatory responses are more immune-related and are not a direct effect of sympathetic activation.

B) Increase motility and secretion in the GI tract, constriction of bronchi and pupils: This is characteristic of parasympathetic nervous system activity. The parasympathetic system stimulates digestion (increased motility and secretion) and causes bronchoconstriction and pupil constriction (miosis). The sympathetic nervous system, in contrast, inhibits GI motility and causes bronchodilation and pupil dilation.

C) Increase in blood pressure, bronchodilation, and decrease bowel sounds: These are hallmark signs of sympathetic nervous system activation. When the sympathetic system is activated during stress or danger, it leads to vasoconstriction, which increases blood pressure. Bronchodilation occurs to allow more oxygen intake, and GI motility decreases (manifested as reduced bowel sounds) to redirect energy to more vital functions, like increased circulation to muscles.

D) Decrease in sweating, decrease in respiration, and pupil constriction: These signs suggest parasympathetic or a relaxed state. The sympathetic nervous system typically increases sweating, respiration, and causes pupil dilation to prepare the body for increased activity. Decreased sweating and respiration, along with pupil constriction, would not be consistent with the sympathetic response.

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A patient is taking aspirin to help prevent myocardial infarction and is experiencing moderate gastrointestinal upset. The nurse will contact the patient’s provider to discuss changing from aspirin to which drug?

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Naxlex Comprehensive Predictor Exams

Which of these is a neurotransmitter?

Correct Answer is C

Explanation

The nurse assess that the patient is having a sympathetic response when noting what manifestation?

Correct Answer is C

Explanation

A patient is taking aspirin to help prevent myocardial infarction and is experiencing moderate gastrointestinal upset. The nurse will contact the patient’s provider to discuss changing from aspirin to which drug?

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