NURSING 6005 Chapter 71: Cyclooxygenase Inhibitors: Nonsteroidal Anti-inflammatory Drugs and Acetaminophen Test Bank

NURSING 6005 Chapter 71: Cyclooxygenase Inhibitors: Nonsteroidal Anti-inflammatory Drugs and Acetaminophen Test Bank MULTIPLE CHOICE 1. A nurse is teaching a group of nursing students about cyclooxygenase inhibitors. Which statement by a student indicates understanding of the teaching? a. “Cyclooxygenase-2 inhibition causes gastrointestinal side effects.” b. “Cyclooxygenase-2 is considered the ‘bad COX.’” c. “Inhibition of cyclooxygenase-1 promotes myocardial infarction and stroke.” d. “Inhibition of cyclooxygenase-1 results in suppression of inflammation.” ANS: B Because cyclooxygenase-2 (COX-2) primarily mediates harmful processes in the body, it is called the “bad COX”; suppression of COX-2 results in largely beneficial effects. The gastrointestinal (GI) side effects of COX inhibitors are the result of COX-1 inhibition. One of two harmful side effects of COX-2 inhibition is suppression of vasodilation, which leads to an increased risk of myocardial infarction (MI) and stroke. Inhibition of COX-2 causes suppression of inflammation. DIF: Cognitive Level: Analysis REF: Mechanism of Action TOP: Nursing Process: Evaluation MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies 2. A patient who takes daily doses of aspirin is scheduled for surgery next week. The nurse should advise the patient to: 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 ANS: C Aspirin must be withdrawn at least 1 week before surgery.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. DIF: Cognitive Level: Application REF: Aspirin | Adverse Effects | Bleeding TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies 3. A patient who is taking acetaminophen for pain wants to know why it does not cause gastrointestinal upset, as do other over-the-counter pain medications. The nurse will explain that this is most likely because of which property of acetaminophen? 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.