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 D

Explanation

Choice A reason: Decreased blood pressure triggers the baroreceptor reflex, increasing sympathetic activity to raise heart rate and vasoconstriction to restore pressure. A decreased heart rate would occur with increased blood pressure, not hypotension, as parasympathetic activation dominates. This choice is incorrect as it opposes the body’s compensatory response to low blood pressure.

Choice B reason: Erythema, or skin redness, results from vasodilation or inflammation, not directly from hypotension. While compensatory vasoconstriction occurs in hypotension, it reduces skin perfusion, potentially causing pallor, not erythema. This manifestation is unrelated to the cardiovascular response to decreased blood pressure, making this choice incorrect.

Choice C reason: Increased temperature is not a direct response to decreased blood pressure. Hypotension triggers sympathetic activation, prioritizing heart rate and vasoconstriction to maintain perfusion. Temperature changes may occur in shock states, but they’re not primary manifestations of routine hypotension, making this choice irrelevant to the expected clinical response.

Choice D reason: Decreased blood pressure activates the baroreceptor reflex, stimulating sympathetic nervous system activity. This increases heart rate (tachycardia) to enhance cardiac output, compensating for low pressure to maintain tissue perfusion. This is a primary physiological response to hypotension, making it the correct clinical manifestation expected in this scenario.

A. It binds to different types of receptors in the body B. It can cause constipation in toxic doses C. It is selective to receptors that regulate more than one body process D. It causes only one type of response, and the constipation is coincidental

Correct Answer is A

Explanation

Choice A reason: Morphine, an opioid, binds to mu, kappa, and delta receptors in the brain, spinal cord, and gastrointestinal tract. Mu receptors in the gut slow peristalsis, causing constipation, while central receptors relieve pain. This multi-receptor binding explains both therapeutic and side effects, making this the correct choice.

Choice B reason: Constipation from morphine occurs at therapeutic, not just toxic, doses due to mu receptor activation in the gastrointestinal tract, which reduces motility. Toxicity may worsen side effects, but constipation is a common effect at standard doses, making this choice inaccurate for explaining morphine’s mechanism.

Choice C reason: Morphine’s receptors (e.g., mu) regulate multiple processes, but the drug itself isn’t selective to multifunctional receptors. It binds broadly to opioid receptors, causing both analgesia and side effects like constipation. This choice misrepresents morphine’s non-selective binding, making it less accurate than choice A.

Choice D reason: Morphine’s effects, including analgesia and constipation, result from specific receptor binding, not coincidental processes. It activates opioid receptors in the brain for pain relief and in the gut for reduced motility. This choice incorrectly suggests constipation is unrelated to morphine’s pharmacological action, making it incorrect.

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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 patient with a history of hypertension is admitted for a procedure. If the patient’s blood pressure decreases, which clinical manifestation would the nurse expect to see?

Correct Answer is D

Explanation

A patient who is taking morphine for pain asks the nurse how a pain medication can also cause constipation. What does the nurse know about morphine?

Correct Answer is A

Explanation

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