A patient tells the nurse that she takes aspirin for menstrual cramps, but she does not feel that it works well. What will the nurse suggest?
The patient should increase the dose until pain is controlled.
The patient should use a first-generation nonsteroidal anti-inflammatory medication instead.
The patient should use acetaminophen because of its anti-inflammatory effects.
The patient should avoid any type of COX inhibitor because of the risk of Reye’s syndrome.
The Correct Answer is B
Choice A reason: Increasing aspirin dosage without medical guidance risks toxicity, including gastrointestinal bleeding and ulceration, as aspirin inhibits COX enzymes, reducing prostaglandin production. Prostaglandins mediate pain and inflammation, but excessive inhibition can damage the stomach lining. This approach is unsafe and not recommended for managing menstrual cramps effectively, as it may exacerbate adverse effects without ensuring better pain relief.
Choice B reason: First-generation NSAIDs, like ibuprofen, are more effective for menstrual cramps due to their stronger inhibition of COX-1 and COX-2 enzymes, which reduce prostaglandin synthesis responsible for uterine contractions and pain. Unlike aspirin, ibuprofen offers better pain relief with a more favorable dosing profile, making it a suitable alternative for dysmenorrhea management in most patients.
Choice C reason: Acetaminophen lacks significant anti-inflammatory effects, as it primarily inhibits COX enzymes in the central nervous system, not peripherally. It reduces pain and fever but does not effectively target prostaglandin-mediated inflammation in menstrual cramps. Therefore, it is less effective than NSAIDs like ibuprofen for dysmenorrhea, making it an inappropriate substitute in this context.
Choice D reason: Avoiding COX inhibitors due to Reye’s syndrome risk is unwarranted here, as Reye’s syndrome is primarily associated with aspirin use in children with viral infections. Menstrual cramps are unrelated to this condition, and COX inhibitors like NSAIDs are standard treatment. This choice is overly restrictive and not clinically justified for managing dysmenorrhea.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Furosemide, a loop diuretic, promotes potassium excretion, risking hypokalemia. The patient’s potassium level (3.1 mEq/L) is below normal (3.5-5.0 mEq/L), indicating hypokalemia, which can cause arrhythmias. Administering Lasix without addressing this could worsen the electrolyte imbalance, making this choice unsafe and incorrect.
Choice B reason: Oxygen administration addresses respiratory issues, not electrolyte imbalances like hypokalemia (3.1 mEq/L) caused by furosemide. There’s no indication of hypoxia in the lab results or scenario. This action doesn’t correct the potassium deficit or prevent further depletion, making it irrelevant and incorrect.
Choice C reason: Furosemide exacerbates hypokalemia (patient’s potassium: 3.1 mEq/L), risking cardiac arrhythmias or muscle weakness. Holding the dose prevents further potassium loss, and notifying the physician allows for correction (e.g., potassium supplements) and reassessment of therapy, making this the safest and most appropriate action.
Choice D reason: A 24-hour urine collection assesses renal function or output but doesn’t address the immediate concern of hypokalemia (3.1 mEq/L) caused by furosemide. This test is irrelevant to correcting the electrolyte imbalance or preventing further depletion, making it an inappropriate action in this scenario.
Correct Answer is B
Explanation
Choice A reason: For 40 mg at 25 mg/mL: 40 ÷ 25 = 1.6 mL. Choice A (0.6 mL) delivers 15 mg (0.6 × 25), underdosing Benadryl, which could fail to relieve allergic symptoms or sedation needs, making this choice incorrect for the prescribed dose.
Choice B reason: Calculating 40 mg ÷ 25 mg/mL = 1.6 mL accurately delivers the ordered 40 mg of Benadryl (diphenhydramine) for allergy or sedation. This ensures therapeutic efficacy without overdose, aligning with safe administration for intramuscular delivery, making this the correct choice.
Choice C reason: For 40 mg, the volume is 40 ÷ 25 = 1.6 mL. Choice C (2 mL) delivers 50 mg (2 × 25), overdosing Benadryl, risking excessive sedation or anticholinergic effects like dry mouth or confusion, making this choice incorrect and potentially unsafe.
Choice D reason: The correct volume is 1.6 mL (40 ÷ 25). Choice D (1 mL) delivers 25 mg (1 × 25), underdosing Benadryl, which may not achieve therapeutic effects for allergies or sedation, making this choice inadequate for the prescribed dose.
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