Lehne's Pharmacology for Nursing Care 9th Edition by Jacqueline Burchum
Lehne's Pharmacology for Nursing Care 9th Edition by Jacqueline Burchum
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Chapter 71: Cyclooxygenase Inhibitors: Nonsteroidal Anti-inflammatory Drugs and Acetaminophen
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
| a. | “COX-1 inhibitors protect against colorectal cancer.” |
| b. | “COX-1 inhibitors protect against myocardial infarction and stroke.” |
| c. | “COX-1 inhibitors reduce fever.” |
| d. | “COX-1 inhibitors suppress inflammation.” |
ANS: B
COX-1 inhibitors have beneficial effects of reducing platelet aggregation and thus reducing the risk of myocardial infarction and stroke. COX-2 inhibitors protect against colorectal cancer, reduce inflammation, and reduce fever.
PTS: 1 DIF: Cognitive Level: Analysis REF: p. 849
TOP: Nursing Process: Evaluation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
| a. | continue to use aspirin as scheduled. |
| b. | reduce the aspirin dosage by half until after surgery. |
| c. | stop using aspirin immediately. |
| d. | stop using aspirin 3 days before surgery. |
ANS: C
Aspirin must be withdrawn at least 1 week before surgery. Aspirin cannot be continued as scheduled, because the risk for bleeding is too great. An interval of 3 days is not long enough for the bleeding effects of aspirin to be reversed. Cutting the dose in half would not reduce the effects of bleeding associated with aspirin use.
PTS: 1 DIF: Cognitive Level: Application REF: p. 853
TOP: Nursing Process: Implementation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
| a. | It does not inhibit cyclooxygenase. |
| b. | It has minimal effects at peripheral sites. |
| c. | It is more similar to opioids than to nonsteroidal anti-inflammatory drugs (NSAIDs). |
| d. | It is selective for cyclooxygenase-2. |
ANS: B
The differences between the effects of acetaminophen and aspirin are thought to result from selective inhibition of cyclooxygenase; acetaminophen has only minimal effects on cyclooxygenase at peripheral sites, which may explain why acetaminophen does not have adverse GI, renal, and antiplatelet effects. Acetaminophen is a selective COX inhibitor. It is not more similar to opioids than NSAIDs. It is not selective for COX-2.
PTS: 1 DIF: Cognitive Level: Application REF: p. 861
TOP: Nursing Process: Evaluation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
| a. | The patient should avoid any type of COX inhibitor because of the risk of Reye’s syndrome. |
| b. | The patient should increase the dose to a level that suppresses inflammation. |
| c. | The patient should use a first-generation nonsteroidal anti-inflammatory medication instead. |
| d. | The patient should use acetaminophen because of its selective effects on uterine smooth muscle. |
ANS: C
Aspirin (ASA) has analgesic effects for joint pain, muscle pain, and headache, but it is relatively ineffective against visceral pain, including uterine smooth muscle pain, for which NSAIDs are indicated. The risk of Reye’s syndrome is associated with the use of ASA in children to treat fever. Increasing the ASA dose to anti-inflammatory levels is useful for rheumatic fever, tendonitis, and bursitis. Acetaminophen is not effective for dysmenorrhea.
PTS: 1 DIF: Cognitive Level: Application REF: p. 850 | pp. 851-852
TOP: Nursing Process: Implementation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
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