A client with hepatitis C has been experiencing symptoms of gastroesophageal reflux.
What H antagonist would be most appropriate for this client’s needs?
Nizatidine.
Ranitidine.
Cimetidine.
Famotidine.
The Correct Answer is D
Famotidine is a histamine type 2 receptor antagonist (H blocker) which is commonly used for treatment of acid-peptic disease and heartburn. Famotidine has been linked to rare instances of clinically apparent acute liver injury, but it is less likely to cause hepatotoxicity than cimetidine, another H blocker. Famotidine also has fewer drug interactions than cimetidine.
Choice A is wrong because nizatidine is another H blocker that can cause mild and transient serum aminotransferase elevations.
Nizatidine has not been linked to cases of clinically apparent liver injury, but it has not been widely used.
Choice B is wrong because ranitidine is another H blocker that can cause mild and transient serum aminotransferase elevations.
Ranitidine has also been associated with rare instances of clinically apparent liver injury, some of which were fatal or required liver transplantation.
Choice C is wrong because cimetidine is another H blocker that can cause mild and transient serum aminotransferase elevations.
Cimetidine has also been implicated in several cases of clinically apparent acute liver injury, some of which were severe and led to acute liver failure and death.
Cimetidine also has many drug interactions due to its inhibition of cytochrome P enzymes.
Normal ranges for serum aminotransferases are 7 to 56 U/L for alanine aminotransferase (ALT) and 10 to 40 U/L for as
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
This is because antiemetics should be given to prevent motion sickness rather than after nausea or vomiting develop. Taking the medication 30 minutes before departing allows enough time for the drug to be absorbed and reach its peak effect.
Choice A is wrong because avoiding eating or drinking for 6 hours before the trip may cause dehydration and low blood sugar, which can worsen nausea and vomiting.
It is better to eat a light meal or snack before the trip and avoid spicy, greasy, or acidic foods.
Choice C is wrong because taking two doses if relief is not achieved may cause overdose and adverse effects.
Antiemetics should be taken as prescribed and not exceeded without consulting a doctor.
Choice D is wrong because increasing fluid intake to prevent urinary retention is not relevant for motion sickness.
Urinary retention is a possible side effect of some antiemetics, such as anticholinergics, but it is not a common problem for most people.
Fluid intake should be moderate and not excessive to avoid stomach distension.
Correct Answer is C
Explanation
The correct answer is c. The importance of consuming adequate amounts of water.
Rationale for Choice A:
- Statement:The need to monitor for systemic side effects.
- Rationale:It's not accurate to prioritize monitoring for systemic side effects when teaching a patient about psyllium (Metamucil).Psyllium is a bulk-forming laxative that primarily acts within the gastrointestinal tract,and systemic side effects are rare.While it's essential to be aware of potential side effects,focusing on them during initial teaching might cause unnecessary anxiety.
Rationale for Choice B:
- Statement:The need to use the dry form of Metamucil to prevent cramping.
- Rationale:This statement is incorrect.It's generally recommended to mix psyllium with water or another liquid before ingestion.Consuming the dry form can increase the risk of choking and might not adequately hydrate stool.
Rationale for Choice C:
- Statement:The importance of consuming adequate amounts of water.
- Rationale:This is the most crucial information to emphasize when teaching about psyllium.Psyllium works by absorbing water and forming a bulky gel that softens stool and promotes bowel movements.Without sufficient water intake,psyllium can cause constipation to worsen or lead to intestinal obstruction.
Rationale for Choice D:
- Statement:The onset of action of 30 to 60 minutes after administration.
- Rationale:This statement is inaccurate.Psyllium is not a fast-acting laxative.It typically takes 12-72 hours to produce a bowel movement.Informing patients about the expected time frame for results is essential to manage expectations and prevent unnecessary medication overuse.
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