Following a knee injury, a football player is taking ibuprofen, a nonsteroidal anti-inflammatory drug, for the control of pain. Which drug action is most likely to result in diminished sensation of pain for the player?

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Inhibition of cyclooxygenase (COX) enzymes. Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), works by inhibiting COX enzymes, specifically COX-1 and COX-2. These enzymes are responsible for the production of prostaglandins, which are mediators of pain and inflammation. By inhibiting COX enzymes, ibuprofen reduces the synthesis of prostaglandins, leading to decreased pain perception. Option B) Activation of opioid receptors is incorrect because ibuprofen does not directly affect opioid receptors. Opioid medications work through a different mechanism to relieve pain. Option C) Blocking of NMDA receptors is incorrect as well since ibuprofen does not act on NMDA receptors, which are involved in the transmission of pain signals in the central nervous system. Option D) Stimulation of serotonin receptors is also incorrect as ibuprofen does not target serotonin receptors for pain relief. In an educational context, understanding the mechanism of action of common pain medications like NSAIDs such as ibuprofen is crucial for healthcare professionals to make informed decisions regarding pain management for patients. Knowing how different classes of drugs work can help in choosing the most appropriate medication based on the type and severity of pain experienced by the patient.

Correct Answer: B

Rationale: In this scenario, the correct answer is option B) Red blood cell levels and morphology. Lead poisoning can have detrimental effects on the hematopoietic system. Lead interferes with heme synthesis, leading to anemia. By prioritizing the evaluation of red blood cell levels and morphology, the care team can assess the extent of anemia and any associated changes in red blood cell appearance due to lead toxicity. Option A) White blood cell levels with differential is incorrect because lead poisoning primarily affects the red blood cells and not typically the white blood cells. Option C) Urea and creatinine levels are related to kidney function and are not the primary focus when assessing lead poisoning in this case. Option D) Liver function panel is not the priority in this situation as lead poisoning predominantly affects the hematopoietic system. Educationally, understanding the specific effects of lead poisoning on different organ systems is crucial in pharmacology. This case highlights the importance of recognizing the hematological implications of lead exposure and the need to prioritize appropriate lab tests to assess and manage such cases effectively.

Correct Answer: A

Rationale: In response to an increased workload, cardiac myocardial cells will increase in size (option A). This process is known as cardiac hypertrophy, which is an adaptive mechanism to enhance the heart's contractile strength in order to meet the increased demand. As the workload on the heart increases, such as in conditions like hypertension or valvular heart disease, the myocardial cells undergo hypertrophy to generate more forceful contractions. The other options are incorrect: - Decreasing in length (option B) is not a typical response to increased workload in cardiac cells. - Increasing in excitability (option C) is not a direct response to increased workload but rather relates to the electrical properties of the cells. - Increasing in number (option D) is not a common response in cardiac cells; instead, hypertrophy is the more common response to increased workload. Understanding how cardiac cells adapt to increased workload is crucial for nurses caring for cardiac patients. Recognizing cardiac hypertrophy as a response to increased workload helps nurses anticipate complications related to cardiac function and implement appropriate interventions to support the heart's adaptation while preventing further damage.

Correct Answer: A

Rationale: In the context of chemotherapy, colony-stimulating factors play a crucial role in stimulating the production of white blood cells (leukocytes) in the bone marrow. White blood cells are essential components of the immune system and are particularly important in fighting infections. Chemotherapy often suppresses bone marrow function, leading to decreased levels of white blood cells, which can increase the risk of infections. Colony-stimulating factors help to counteract this effect by promoting the production of white blood cells, thereby supporting the immune system. In this scenario, option A (White blood cells) is the correct answer because colony-stimulating factors are specifically designed to stimulate the production of these cells. Red blood cells (option B) are not directly affected by colony-stimulating factors in response to chemotherapy. Phagocytes (option C) are a type of white blood cell involved in engulfing and destroying pathogens but are not the primary target of colony-stimulating factors. Myocardial cells (option D) are cardiac muscle cells and are not directly involved in the immune response to chemotherapy. It is crucial for healthcare professionals to understand the impact of chemotherapy on different blood cells and the role of colony-stimulating factors in maintaining the immune system during cancer treatment. By recognizing the specific effects of chemotherapy on blood cell production, healthcare providers can better manage potential complications such as infections in patients undergoing cancer treatment.

Correct Answer: B

Rationale: In a patient with renal failure, the correct nursing diagnosis that would provide the most plausible indication for the use of epoetin alfa (Epogen) is "B) Activity intolerance related to decreased oxygen-carrying capacity." Epoetin alfa is a synthetic form of erythropoietin, a hormone produced by the kidneys that stimulates red blood cell production in bone marrow. In renal failure, the kidneys are unable to produce enough erythropoietin, leading to decreased red blood cell production and subsequently decreased oxygen-carrying capacity in the blood. By administering epoetin alfa, we can stimulate red blood cell production and improve oxygen delivery to tissues, thus alleviating activity intolerance caused by tissue hypoxia. Regarding the other options: A) Risk for infection related to decreased erythropoiesis - While decreased red blood cell count can contribute to impaired immune function, epoetin alfa is not used to directly address infection risk. C) Powerlessness-related sequelae of renal failure - This is more related to psychological and emotional aspects of care and not directly linked to the physiological effects of epoetin alfa. D) Ineffective breathing pattern related to inadequate erythropoietin synthesis - While inadequate erythropoietin synthesis can lead to anemia and tissue hypoxia, the use of epoetin alfa would address the oxygen-carrying capacity concern rather than directly impacting breathing patterns. Understanding the rationale behind selecting the correct nursing diagnosis in this context is crucial for nurses to provide optimal care for patients with renal failure and associated anemia. By linking the pathophysiology of renal failure to the therapeutic action of epoetin alfa, nurses can make informed clinical decisions and improve patient outcomes.