The nurse is caring for a patient who has multiple sclerosis. The patient is experiencing an acute attack. Which drug does the nurse anticipate the provider will order?

Interferon-B (IFN-B)

Mitoxantrone

Glatiramer acetate (Copaxone)

Methylprednisolone (Solu-Medrol)

Answer and Explanation

The Correct Answer is D

A) Interferon-B (IFN-B): Interferon-beta is a disease-modifying therapy (DMT) used for multiple sclerosis (MS) to reduce the frequency and severity of attacks and slow disease progression. However, it is not typically used during an acute exacerbation of MS. It is more commonly prescribed for long-term management of the disease.
B) Mitoxantrone: Mitoxantrone is an immunosuppressive agent that is used as a disease-modifying therapy for patients with more aggressive forms of MS. While it can be helpful in reducing the frequency of attacks, it is not the first-line treatment during an acute relapse. Mitoxantrone is often considered for long-term use when other therapies are not effective.
C) Glatiramer acetate (Copaxone): Glatiramer acetate is another disease-modifying therapy for MS. It works by altering the immune response to protect the myelin sheath. Like interferon-beta, it is used for long-term management, not for acute attacks. It is not typically used during an exacerbation of MS.
D) Methylprednisolone (Solu-Medrol): Methylprednisolone, a corticosteroid, is the standard treatment for acute exacerbations of multiple sclerosis. It works by reducing inflammation, which helps to decrease the severity of symptoms during an MS relapse. The nurse would anticipate this drug being prescribed to manage the acute inflammatory episode and speed recovery from the attack. This medication is often administered intravenously in high doses and then tapered as the patient stabilizes.

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Free Nursing Study Resources

Correct Answer is A

Explanation

A) Parkinson disease is characterized by an imbalance of dopamine and acetylcholine:
The decrease in dopamine results in an imbalance between dopamine and acetylcholine. Normally, dopamine and acetylcholine work in a balanced manner to regulate motor control. As dopamine levels decrease in Parkinson's disease, acetylcholine's effects become more prominent, leading to motor symptoms such as tremors, rigidity, and bradykinesia (slowness of movement).

B) Parkinson disease involves increased dopamine production and decreased acetylcholine:
This statement is incorrect. In Parkinson's disease, there is actually a decrease in dopamine production, not an increase. The disease is characterized by the degeneration of dopamine-producing neurons, leading to the motor symptoms typical of Parkinsonism. The imbalance in Parkinson's disease is primarily one of decreased dopamine and relatively increased acetylcholine activity.

C) Alzheimer disease is caused by decreased amounts of dopamine and degeneration of cholinergic neurons:
While Alzheimer's disease does involve a degeneration of cholinergic neurons (specifically those that release acetylcholine), the primary pathology is related to the accumulation of amyloid plaques and tau tangles, not primarily a decrease in dopamine. Alzheimer's disease is primarily associated with a deficiency in acetylcholine, not dopamine, leading to cognitive impairments, rather than motor deficits.

D) Alzheimer disease involves a possible excess of acetylcholine and neuritic plaques:
This statement is incorrect. Alzheimer's disease is characterized by a deficiency of acetylcholine, which plays a crucial role in memory and cognitive function. The hallmark pathologic features of Alzheimer's disease include the presence of neuritic plaques (formed from amyloid beta) and neurofibrillary tangles (composed of tau protein), not an excess of acetylcholine.

A. Celecoxib (Celebrex) B. Enteric-coated aspirin C. Nabumetone (Relafen) D. A COX-2 inhibitor

Correct Answer is A

Explanation

A) Celecoxib (Celebrex):
Celecoxib is a selective COX-2 inhibitor that targets the cyclooxygenase-2 enzyme, which is primarily responsible for inflammation, pain, and fever. COX-2 inhibitors tend to cause less gastrointestinal irritation compared to nonselective NSAIDs like aspirin, which block both COX-1 and COX-2 enzymes. Because aspirin is causing gastrointestinal upset, switching to Celecoxib, which is less likely to irritate the stomach lining, may be an appropriate option to prevent myocardial infarction while minimizing gastrointestinal discomfort.

B) Enteric-coated aspirin:
Enteric-coated aspirin is designed to dissolve in the small intestine rather than the stomach, which may reduce some gastrointestinal irritation. However, it does not eliminate the risk entirely, and it still functions as a COX-1 inhibitor. If the patient is already experiencing gastrointestinal upset, simply switching to enteric-coated aspirin may not be sufficient to alleviate the discomfort, and other options should be considered.

C) Nabumetone (Relafen):
Nabumetone is a nonsteroidal anti-inflammatory drug (NSAID) with some COX-2 selectivity. While it may cause less gastrointestinal upset than non-selective NSAIDs like aspirin, it is still an NSAID and carries a risk of gastrointestinal side effects, especially with prolonged use.
D) A COX-2 inhibitor:
While COX-2 inhibitors, including Celecoxib, are typically effective in reducing inflammation and pain with fewer gastrointestinal side effects than traditional NSAIDs, the term "a COX-2 inhibitor" could refer to various drugs, and Celecoxib (Celebrex) is the most commonly used.

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Explanation

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