A nurse is caring for a client who has chronic liver disease. Which of the following medications should the nurse recognize as appropriate for this client?

Alprazolam

Rotavirus vaccine

Niacin

Hepatitis A vaccine

Answer and Explanation

The Correct Answer is D

A. Alprazolam. Alprazolam, a benzodiazepine, is metabolized in the liver and can accumulate in clients with chronic liver disease, increasing the risk of sedation, confusion, and hepatic encephalopathy. Benzodiazepines should be used cautiously or avoided in clients with liver impairment.

B. Rotavirus vaccine. The rotavirus vaccine is a live, attenuated vaccine given to infants to prevent severe diarrhea caused by rotavirus infection. It is not recommended for adults, including those with chronic liver disease, as it is not indicated for their age group or condition.

C. Niacin. Niacin is used to lower cholesterol and treat vitamin B3 deficiency, but it can cause hepatotoxicity, especially in high doses. In clients with chronic liver disease, niacin may worsen liver function, making it an inappropriate choice unless absolutely necessary and closely monitored.

D. Hepatitis A vaccine. Clients with chronic liver disease are at higher risk of severe complications from hepatitis A infection. Vaccination provides protection against hepatitis A, which can cause acute liver failure in individuals with pre-existing liver disease. It is recommended to prevent further liver damage and protect overall health.

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Correct Answer is A

Explanation

A. Baker's yeast. The hepatitis B vaccine is contraindicated in individuals with a severe allergy to baker’s yeast. This is because the vaccine is produced using Saccharomyces cerevisiae (baker’s yeast), which can trigger an allergic reaction in susceptible individuals. Symptoms of a yeast allergy may include rash, difficulty breathing, and anaphylaxis, requiring the vaccine to be withheld and an alternative plan considered.

B. Nuts. Nut allergies are not related to the hepatitis B vaccine, as it does not contain nut-derived ingredients. While nut allergies can be severe and cause anaphylaxis, they do not pose a specific risk in the administration of this vaccine. Therefore, the presence of a nut allergy alone does not require withholding the immunization.

C. Wheat. A wheat allergy is not a contraindication for the hepatitis B vaccine. Wheat allergies primarily cause reactions to gluten-containing foods or products but do not have any connection to the components used in the production of the vaccine. The vaccine can be safely administered to individuals with wheat allergies.

D. Egg yolk. While some vaccines, such as the influenza vaccine, may be derived from egg proteins, the hepatitis B vaccine is not produced using egg-based components. An allergy to egg yolk does not pose a risk for adverse reactions to this vaccine, so it should not be withheld in individuals with an egg allergy.

A. “Limit potassium-containing foods in your diet.” B. "Withhold prednisone for 48 hours prior to receiving contrast dye.” C. "Measure your blood glucose levels periodically.” D. "Take prednisone on an empty stomach."

Correct Answer is C

Explanation

A. "Limit potassium-containing foods in your diet." Long-term prednisone use can lead to hypokalemia (low potassium levels) due to its mineralocorticoid effects, which increase potassium excretion. Clients on chronic corticosteroid therapy may actually need to consume potassium-rich foods to help maintain electrolyte balance, rather than restricting them.

B. "Withhold prednisone for 48 hours prior to receiving contrast dye." There is no general recommendation to withhold prednisone before contrast dye administration. However, clients on long-term steroid therapy may require stress-dose steroids if undergoing procedures that could trigger an adrenal crisis. Withholding prednisone without provider guidance could increase the risk of adrenal insufficiency.

C. "Measure your blood glucose levels periodically." Prednisone can cause hyperglycemia by increasing insulin resistance and promoting gluconeogenesis. Clients, especially those with diabetes or at risk for metabolic syndrome, should monitor blood glucose levels regularly to detect potential steroid-induced diabetes. Adjustments in diet or medication may be needed based on blood glucose trends.

D. "Take prednisone on an empty stomach." Taking prednisone on an empty stomach can increase the risk of gastrointestinal irritation, ulcers, and gastritis. It should be taken with food or milk to help reduce stomach irritation and minimize gastrointestinal side effects. Clients should be advised to follow this guideline to prevent discomfort and potential complications.

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A nurse is caring for a client who has chronic liver disease. Which of the following medications should the nurse recognize as appropriate for this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is C

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