The spouse of a patient newly diagnosed with mild, unilateral symptoms of Parkinson disease (PD) asks the nurse what, besides medication, can be done to manage the disease. The nurse will:

A) Phagocytosis: Phagocytosis refers to the process by which a cell engulfs large particles, such as pathogens or debris, and brings them into the cell. It is not related to the movement of hormones across the cell membrane.
B) Endocytosis: Endocytosis is the process where a cell engulfs substances from the external environment and brings them into the cell. However, this term is typically used when substances like nutrients or larger molecules are taken into the cell, not when hormones are being secreted out of the cell.
C) Pinocytosis: Pinocytosis is a type of endocytosis in which the cell engulfs extracellular fluid and dissolved substances. It is often referred to as "cell drinking" and involves the uptake of fluids, not the secretion of hormones across the membrane.
D) Exocytosis: This is the correct answer. Exocytosis is the process by which substances, such as hormones or neurotransmitters, are transported from inside the cell to the outside by vesicles that fuse with the cell membrane. In the case of hormones, they are synthesized within the cell and then released into the extracellular space via exocytosis, enabling them to reach their target sites.

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.