A 52-year-old man with chronic low back pain following an automobile accident desires pain relief. He has significant gastroesophageal reflux and abdominal pain. Which of the following agents may improve his pain but worsen his gastrointestinal symptoms?

Correct Answer: D

Rationale: Chronic pain with GERD limits NSAID use. Naproxen sodium -relieves pain but worsens GI symptoms via COX-1 inhibition, increasing acid and ulcers. Trisalicylate and Celecoxib are GI-sparing. Ketorolac is short-term. Salsalate (E) is milder. Naproxen fits the risk profile.

Correct Answer: B

Rationale: Morphine, an opioid, improves chronic diarrhea by increasing intestinal circular muscle tone . Opioids slow GI motility via μ-receptors, enhancing tone and reducing peristalsis. Option , improved motility, opposes this. Options , , and (E) weaken continence or motility, not fitting. This constipating effect explains the improvement, a common opioid side effect.

Correct Answer: D

Rationale: Chronic pain with GERD limits NSAID use. Naproxen sodium -relieves pain but worsens GI symptoms via COX-1 inhibition, increasing acid and ulcers. Trisalicylate and Celecoxib are GI-sparing. Ketorolac is short-term. Salsalate (E) is milder. Naproxen fits the risk profile.

Correct Answer: D

Rationale: Peripheral mediators of pain can sensitize nociceptors and contribute to the perception of pain. Histamine, bradykinin, and prostaglandins are all examples of peripheral mediators that can induce pain. Amino acids, on the other hand, are not typically considered peripheral mediators of pain. While amino acids are important for many physiological processes in the body, they are not generally associated with the direct modulation of pain signaling pathways in the periphery.

Correct Answer: C

Rationale: Potassium chloride corrects hypokalemia but is caustic IV, risking phlebitis or tissue damage if it infiltrates. Monitoring the IV site prevents complications, a key precaution. Undiluted or rapid infusion causes burns or arrhythmias'standard is diluted, <10 mEq/hour. A syringe pump isn't required'IV pumps suffice. Site monitoring aligns with potassium's administration risks, critical in hypokalemia where cardiac effects (e.g., arrhythmias) are at stake, making C the nurse's priority to ensure safe delivery.