A patient who is taking aspirin for arthritis pain asks the nurse why it also causes gastrointestinal upset. The nurse understands that this is because aspirin:

Correct Answer: C

Rationale: Aspirin causes gastrointestinal upset because it inhibits both cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) enzymes. These enzymes are responsible for the production of prostaglandins, which are important in protecting the stomach lining. Inhibition of COX-1 reduces the production of protective prostaglandins that help maintain the integrity of the stomach lining, leading to irritation and potential damage, which can manifest as gastrointestinal upset. This is why patients taking aspirin may experience gastrointestinal side effects such as stomach pain, ulcers, or bleeding.

Correct Answer: B

Rationale: Gout stems from uric acid buildup-hyperuricemia-crystallizing in joints, per pathophysiology-not increased excretion, cartilage loss (OA), or low levels. Buildup drives pain, per disease.

Correct Answer: A

Rationale: In the case of a hypovolemic shock due to significant blood loss, the primary concern is to restore the lost blood volume quickly. Packed Red Blood Cells (PRBCs) contain a high concentration of red blood cells and are used to replenish oxygen-carrying capacity in cases of hemorrhage. PRBCs are the most appropriate blood product in this scenario as they can effectively increase the oxygen-carrying capacity of the blood without overloading the patient with excess fluid volume like whole blood. Whole blood contains not only red blood cells but also plasma and other components, which may not be necessary for immediate volume resuscitation. Cryoprecipitate and Fresh Frozen Plasma (FFP) are usually indicated for specific coagulation factor deficiencies and are not the primary choice for treating hypovolemic shock. Thus, in this case, PRBCs are the most suitable blood product to address the acute blood loss and restore

Correct Answer: C

Rationale: Phenobarbital, a barbiturate, binds to a distinct site on the GABA_A receptor, enhancing GABA's inhibitory effects by prolonging chloride channel opening. At high doses, it uniquely can directly open these channels without GABA, leading to profound CNS depression—useful in anesthesia or seizure control but risky due to overdose potential. Diazepam, a benzodiazepine, also acts on GABA_A receptors but only enhances GABA's effect, not independently opening channels, limiting its action to GABA availability. Ethanol affects GABA_A receptors indirectly and lacks this specific high-dose capability. Baclofen targets GABA_B receptors, influencing potassium channels, not chloride, and is unrelated to this mechanism. Dronabinol, a cannabinoid, has no GABA_A activity. Phenobarbital's ability to independently activate chloride channels at high doses distinguishes it, aligning with the scenario described and explaining its utility and risks in clinical settings.

Correct Answer: D

Rationale: The patient shows opioid overdose signs (drowsiness, respiratory depression, bradycardia, miosis) from fentanyl and morphine. Calling the resuscitation team delays specific treatment unless unresponsive. Atropine treats bradycardia but not respiratory depression. Neostigmine reverses neuromuscular blockers, not opioids. Flumazenil reverses benzodiazepines. IV naloxone, an opioid antagonist, rapidly reverses these effects, restoring breathing and consciousness, the best immediate action. Its specificity and speed are vital in postoperative opioid toxicity, ensuring patient safety.