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 D
Explanation
Choice A reason: Allergic reactions typically present with symptoms like rash, itching, or anaphylaxis, not jaundice, dark urine, or light stools. These symptoms indicate hepatobiliary dysfunction, not an immune-mediated response. Allergic reactions don’t typically affect liver function or bile excretion, making this choice inconsistent with the patient’s clinical presentation.
Choice B reason: Idiosyncratic drug effects on bone marrow cause hematologic issues like anemia or leukopenia, not jaundice or light stools. These symptoms suggest liver dysfunction, as bile pigment changes cause dark urine and pale stools. Bone marrow effects don’t explain the hepatobiliary symptoms, making this choice incorrect.
Choice C reason: Iatrogenic skin disease might involve rashes or lesions, but jaundice, dark urine, and light stools point to liver or bile duct issues. These symptoms result from impaired bilirubin metabolism, not cutaneous pathology. This choice doesn’t align with the systemic hepatobiliary symptoms described, making it incorrect.
Choice D reason: Drug-induced liver toxicity, such as from acetaminophen or statins, impairs bilirubin metabolism, causing jaundice, dark urine (bilirubinuria), and light stools (reduced bile). Malaise, nausea, and vomiting reflect systemic effects of liver dysfunction. This matches the patient’s symptoms, making it the most likely diagnosis and correct choice.
Correct Answer is ["A","D","E"]
Explanation
Choice A reason: Electronic order entry systems reduce errors by standardizing prescriptions and flagging issues. This enhances safety, making it a correct preventive strategy.
Choice B reason: Naming and shaming create fear, discouraging error reporting and learning. Nonpunitive approaches are effective, so this is incorrect for preventing errors.
Choice C reason: Prosecuting caregivers deters transparency, hindering error analysis. Supportive tracking systems prevent errors, so this is incorrect for effective strategies.
Choice D reason: Engaging patients as informed team members improves adherence and catches errors. This collaborative approach is effective, making it a correct choice.
Choice E reason: Nonpunitive error tracking encourages reporting, identifying patterns to prevent future mistakes. This is a proven method, making it a correct choice.
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