Certified Neuroscience Registered Nurse (CNRN) Practice Exam

In which scenarios are NSAIDs contraindicated?

1. Postoperative care only

2. GI surgery, renal surgery and presence of ulcers

3. Only in patients with a history of heart problems

4. All surgeries

The correct answer is: GI surgery, renal surgery and presence of ulcers

The correct answer identifies specific scenarios where the use of non-steroidal anti-inflammatory drugs (NSAIDs) is contraindicated, particularly focusing on more critical medical conditions. NSAIDs can increase the risk of bleeding and have gastrointestinal side effects, making them particularly concerning in patients who have undergone GI surgery or who have active ulcers, as these conditions heighten the risk of gastrointestinal complications such as perforation or significant bleeding. Additionally, these medications can negatively affect renal function, especially in the context of renal surgery, where the kidneys are already vulnerable. Understanding the context is essential. For instance, while NSAIDs may be used cautiously in postoperative care, their use is limited in certain surgical scenarios due to the potential for adverse effects. The risks associated with NSAIDs are not just limited to patients with heart problems, as can be implied from the third option, since there are broader implications for patients with various gastrointestinal and renal conditions. Similarly, while it may seem overly cautious to contraindicate NSAIDs in all surgical cases, many surgeries have different considerations regarding pain management that might allow for safer alternatives. Thus, the focus on specific surgeries and conditions related to GI and renal health solidifies why this answer is correct.