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.

Answer and Explanation

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.

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Correct Answer is C

Explanation

Choice A reason: Pentazocine is less effective for severe, chronic pain and has mixed agonist-antagonist effects. Fentanyl is stronger for opioid-tolerant patients, so this is incorrect.

Choice B reason: Hydrocodone is weaker than oxycodone and inadequate for severe, resistant pain. Fentanyl’s potency suits chronic cancer pain, so this is incorrect.

Choice C reason: Fentanyl transdermal is potent, long-acting, and ideal for severe, chronic cancer pain in opioid-tolerant patients. It’s appropriate here, making it the correct choice.

Choice D reason: Meperidine is not recommended for chronic pain due to neurotoxic metabolites. Fentanyl is safer and more effective, so this is incorrect.

A. 1.4 mL B. 1.8 mL C. 1.2 mL D. 1.6 mL

Correct Answer is D

Explanation

Choice A reason: To calculate the volume, divide the ordered dose (8 mg) by the concentration (5 mg/mL): 8 ÷ 5 = 1.6 mL. Choice A (1.4 mL) underestimates the volume, delivering only 7 mg (1.4 × 5), which is insufficient for the prescribed dose, making it incorrect for accurate medication administration.

Choice B reason: Calculating 8 mg ÷ 5 mg/mL yields 1.6 mL. Choice B (1.8 mL) would deliver 9 mg (1.8 × 5), exceeding the ordered dose. This overdose could increase the risk of sedation or respiratory depression, as Valium (diazepam) is a benzodiazepine with potent CNS effects, making this choice incorrect.

Choice C reason: The correct volume is 8 mg ÷ 5 mg/mL = 1.6 mL. Choice C (1.2 mL) delivers only 6 mg (1.2 × 5), which is below the prescribed dose. This underdose could result in inadequate therapeutic effects, such as insufficient anxiety relief or seizure control, making it an incorrect choice.

Choice D reason: Dividing the ordered dose (8 mg) by the concentration (5 mg/mL) gives 8 ÷ 5 = 1.6 mL. This volume accurately delivers the prescribed 8 mg of Valium, ensuring therapeutic efficacy for conditions like anxiety or seizures while minimizing risks of over- or under-dosing, making it the correct choice.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A cancer patient asks the nurse what can be given to alleviate severe, chronic pain of several months’ duration. The patient has been taking oxycodone (OxyContin) and states it is no longer effective. The nurse will suggest discussing which medication with the provider?

Correct Answer is C

Explanation

The healthcare provider orders Valium 8 mg IV now. The concentration available is 5 mg/mL. How many mL will the patient receive?

Correct Answer is D

Explanation

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