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: Metoprolol (beta-blocker) and furosemide (loop diuretic) are commonly used in heart failure. Furosemide may lower potassium, counteracting hyperkalemia (5.5 mEq/L), and metoprolol doesn’t significantly affect potassium. This combination poses less risk for hyperkalemia exacerbation, making it less concerning than potassium-sparing combinations.

Choice B reason: Furosemide promotes potassium excretion, potentially reducing hyperkalemia (5.5 mEq/L), while enalapril (ACE inhibitor) may increase potassium. However, furosemide’s effect often offsets enalapril’s, making this combination less likely to worsen hyperkalemia significantly compared to two potassium-sparing drugs, so this choice is less critical.

Choice C reason: Captopril (ACE inhibitor) and spironolactone (potassium-sparing diuretic) both increase potassium levels by reducing aldosterone activity, exacerbating hyperkalemia (5.5 mEq/L). In heart failure, this combination risks severe hyperkalemia, causing arrhythmias, making it the most concerning interaction requiring close monitoring or adjustment.

Choice D reason: Amlodipine (calcium channel blocker) and propranolol (beta-blocker) primarily affect blood pressure and heart rate, not potassium levels. Their interaction may cause bradycardia or hypotension but doesn’t worsen hyperkalemia (5.5 mEq/L), making this combination less concerning for the patient’s current electrolyte status.

A. Normal B. Isolated systolic hypertension C. Hypertension D. Prehypertension

Correct Answer is C

Explanation

Choice A reason: Normal BP is below 120/80 mm Hg. These readings, with diastolic consistently above 90 mm Hg, indicate hypertension, not normal BP, so this is incorrect.

Choice B reason: Isolated systolic hypertension involves systolic BP ≥130 mm Hg with diastolic <80 mm Hg. High diastolic readings rule this out, so this is incorrect for the pattern.

Choice C reason: BP readings above 130/80 mm Hg, especially with diastolic ≥90 mm Hg, classify as hypertension (Stage 2). This matches the patient’s pattern, making it the correct category.

Choice D reason: Prehypertension is 120–129/<80 mm Hg. These readings exceed this with high diastolic values, indicating hypertension, so this is incorrect for the BP pattern.

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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 nurse is reviewing a patient’s medications before administration. Which drug-to-drug interactions will most concern the nurse in a patient with a history of heart failure and a potassium level of 5.5 mEq/L?

Correct Answer is C

Explanation

A patient has three separate blood pressure (BP) readings of 120/100, 138/92 mm Hg, and 126/96 mm Hg. Which category describes this pattern of BP?

Correct Answer is C

Explanation

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