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 B
Explanation
Choice A reason: Antidotes counteract specific toxins or drugs (e.g., naloxone for opioids). Antihistamines don’t neutralize allergens but block histamine receptors to reduce allergic symptoms like itching or sneezing. They target H1 or H2 receptors, not a toxin, making this choice incorrect for describing antihistamine mechanism of action.
Choice B reason: Antihistamines are antagonists, binding to histamine receptors (H1 or H2) without activating them, preventing histamine from triggering allergic responses like vasodilation or bronchoconstriction. This competitive inhibition reduces symptoms such as itching, sneezing, or gastric acid secretion, making this the correct choice for their pharmacological action.
Choice C reason: Agonists activate receptors to produce a response. Antihistamines block histamine receptors, not activate them, preventing allergic effects. Acting as agonists would mimic histamine, worsening symptoms like swelling or itching, which is opposite to their therapeutic role, making this choice incorrect.
Choice D reason: Activators is a vague term not used in pharmacology to describe drug action. Antihistamines specifically act as receptor antagonists, not general activators. They inhibit histamine effects without stimulating other pathways, making this choice inaccurate for explaining the mechanism of antihistamines in allergy management.
Correct Answer is D
Explanation
Choice A reason: NPH insulin is not mixed with insulin glargine, as glargine’s pH and formulation cause precipitation or altered pharmacokinetics when combined. NPH can be mixed with regular insulin, as they are compatible, making this choice incorrect for the patient’s reported practice.
Choice B reason: NPH and regular insulin are compatible and routinely mixed in one syringe to provide both intermediate and short-acting coverage. They don’t react chemically or lose efficacy when combined properly, making this choice incorrect, as mixing is a standard practice in diabetes management.
Choice C reason: Mixing NPH and regular insulin does not increase potency; it combines their pharmacokinetics for basal and prandial glucose control. The mixture delivers the additive effects of each insulin’s profile without enhancing overall potency, making this choice inaccurate for their combined action.
Choice D reason: Mixing NPH (intermediate-acting) and regular insulin (short-acting) is an accepted practice to manage type 1 diabetes with one injection, covering basal and prandial needs. Proper technique (drawing regular insulin first) ensures stability, making this the correct choice for the patient’s reported insulin administration.
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