The nurse cares for a patient with osteoarthritis and obesity.The patient has been taking ibuprofen for the past five years. The nurse should educate the patient about the risk for developing which of these conditions?

Choice A rationale There is no established direct causal link between long-term, routine therapeutic use of Ibuprofen (a non-selective NSAID) at standard doses and the development of dementia or significant cognitive decline. The primary risks of prolonged NSAID use center on the cardiovascular and gastrointestinal systems, not typically on neurodegenerative disorders. Choice B rationale Extrapyramidal symptoms (EPS), such as tardive dyskinesia, akathisia, and dystonia, are motor side effects most commonly associated with dopamine receptor blocking agents, such as typical antipsychotics. Ibuprofen does not act on the dopamine system and is therefore not associated with the development of EPS. Choice C rationale Long-term use of Nonsteroidal Anti-inflammatory Drugs (NSAIDs), including ibuprofen, is associated with an increased risk of cardiovascular events, such as stroke and myocardial infarction. NSAIDs can promote sodium and water retention, increase blood pressure, and potentially shift the hemostatic balance toward thrombosis, especially with prolonged use in vulnerable patients. Choice D rationale Urinary tract infections (UTIs) are generally caused by bacterial colonization of the urinary tract, most commonly E. coli. There is no direct pharmacological mechanism by which ibuprofen would increase the susceptibility to bacterial growth or recurrent UTIs; renal effects are primarily related to acute kidney injury.