When there is stimulation of the sympathetic nervous system (SNS), blood is diverted away from the gastrointestinal (GI) tract. What might the nurse assess that would indicate this diversion of blood flow to the GI tract?

Decreased bowel sound

Increased blood glucose level

Decreased immune reaction

Increased blood pressure

Answer and Explanation

The Correct Answer is A

A) Decreased bowel sounds:
When the sympathetic nervous system (SNS) is activated, such as during stress or a "fight-or-flight" response, blood is redirected away from the gastrointestinal (GI) tract to vital organs like the heart and muscles. This results in decreased gastrointestinal motility and function, which is reflected in a reduction in bowel sounds. Decreased bowel sounds are a direct consequence of reduced blood flow and decreased activity in the GI system.

B) Increased blood glucose level:
While it is true that SNS activation can lead to an increase in blood glucose due to the release of catecholamines (e.g., epinephrine), this response is related to the body’s preparation for physical exertion and not directly a result of blood being diverted from the GI tract. The increase in glucose levels is more about energy mobilization rather than an effect on blood flow to the GI tract.

C) Decreased immune reaction:
Sympathetic stimulation can indeed have effects on immune function, typically suppressing immune responses during a stress response. However, this is not directly linked to blood being diverted away from the GI tract. Immune suppression is more about the body prioritizing immediate survival (e.g., diverting energy to muscles for fight-or-flight) rather than a specific physiological consequence of GI blood flow changes.

D) Increased blood pressure:
Sympathetic nervous system activation does lead to an increase in blood pressure due to vasoconstriction and increased heart rate. However, increased blood pressure is a broader systemic response to SNS stimulation, and it is not directly related to blood being diverted from the GI tract. Blood pressure increases as part of the general "fight-or-flight" response, but it does not specifically indicate changes in GI blood flow.

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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.

A. “Alzheimer disease affects memory but not personality.” B. “With proper treatment, symptoms of this disease can be arrested.” C. “The onset of Alzheimer disease is usually between 65 and 75 years.” D. “Alzheimer disease is a chronic, progressive condition.”

Correct Answer is D

Explanation

A) “Alzheimer disease affects memory but not personality.”
While memory loss is one of the hallmark symptoms of Alzheimer’s disease, the condition also significantly impacts other cognitive functions, including personality and behavior. As the disease progresses, patients often experience changes in mood, behavior, and personality, such as increased irritability, depression, or aggression.

B) “With proper treatment, symptoms of this disease can be arrested.”
Currently, there is no cure for Alzheimer’s disease, and while some treatments (like cholinesterase inhibitors) can help manage symptoms temporarily or slow their progression, the disease itself is not arrestable. The goal of treatment is to manage symptoms and improve quality of life, but it cannot stop the disease from advancing.

C) “The onset of Alzheimer disease is usually between 65 and 75 years.”
While Alzheimer’s disease typically affects older adults, this statement is too narrow. Alzheimer’s disease can begin earlier, sometimes in individuals in their 50s or 60s, particularly in cases of early-onset Alzheimer’s. The average age of onset for most people is around 65, but there is variability.

D) “Alzheimer disease is a chronic, progressive condition.”
Alzheimer’s disease is indeed chronic (lasting for years) and progressive (it worsens over time). It gradually destroys brain cells, leading to a decline in cognitive function, including memory, thinking, and reasoning skills. This is the fundamental nature of the disease

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When there is stimulation of the sympathetic nervous system (SNS), blood is diverted away from the gastrointestinal (GI) tract. What might the nurse assess that would indicate this diversion of blood flow to the GI tract?

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