A patient is taking ibuprofen. The nurse understands that COX-1 and COX-2 inhibitors are different in that ibuprofen is more likely than celecoxib to cause which adverse effect?

Correct Answer: C

Rationale: Ibuprofen is a non-selective COX inhibitor, meaning it inhibits both COX-1 and COX-2 enzymes. COX-1 is responsible for maintaining the protective lining of the stomach, and its inhibition can lead to gastrointestinal adverse effects such as peptic ulcer disease. Celecoxib, on the other hand, is a selective COX-2 inhibitor, which primarily targets inflammation and pain without significantly affecting the stomach lining. Therefore, ibuprofen is more likely to cause peptic ulcer disease compared to celecoxib. This distinction is crucial for nurses to understand when managing patients on these medications, as it impacts patient monitoring and education.

Correct Answer: B

Rationale: Pharmacokinetics is the study of how drugs are absorbed, distributed, metabolized, and excreted by the body. These processes determine the concentration of a drug at its site of action and contribute to understanding the drug's effectiveness and potential side effects. Therefore, absorption, distribution, metabolism, and excretion are key components of pharmacokinetics. Pharmacodynamics (Choice A) refers to the study of the physiological effects of drugs and their mechanisms of action, which is different from the processes involved in drug movement through the body. Therapeutic action (Choice C) refers to the desired effects of a drug in treating a specific condition, rather than the processes involved in drug processing in the body. Pharmaceutical preparation (Choice D) is related to the formulation and development of drugs before their administration, not to the processes within the body. Toxic effect (Choice E) refers to the harmful effects of drugs, which can result from various factors including pharmacokin

Correct Answer: A

Rationale: The nurse suggests that the patient takes his Digoxin medication when awakening because it is best absorbed when taken on an empty stomach. Taking Digoxin with meals can decrease its absorption, reducing its effectiveness. Therefore, to ensure optimal absorption and effectiveness of Digoxin in slowing down the heart rate, it is recommended to take it when awakening on an empty stomach.

Correct Answer: D

Rationale: In a patient with new-onset atrial fibrillation who requires rapid initiation of digoxin therapy, the fastest therapeutic effect would be achieved by administering the loading dose intravenously. Option D (Digoxin 1 mg IV push now; then 0.25 mg IV daily) includes an initial IV loading dose of 1 mg, followed by a maintenance dose of 0.25 mg IV daily. IV administration allows for quicker absorption and onset of action compared to oral administration. This loading dose increases the digoxin concentration in the bloodstream more rapidly, leading to a quicker therapeutic effect. Subsequent maintenance doses can then be given orally for long-term management.

Correct Answer: A

Rationale: The patient should call 911 immediately. Angina is characterized by chest pain or discomfort that occurs when the heart muscle does not receive enough oxygen-rich blood. The fact that the patient continued to experience chest pain even while sitting down is concerning and suggests that he may be having an acute coronary event, such as a heart attack. In this situation, prompt medical attention is crucial to assess and manage the situation appropriately. It is important not to delay seeking emergency help when experiencing chest pain, especially for a patient with a known history of angina.