Drugs do not metabolize the same way in all people. For what patient would a nurse expect to assess for an alteration in drug metabolism?

A 41-yr-old man with kidney stones

A 62-yr-old woman with acute renal failure

A 35-yr-old woman with cervical cancer

A 50-yr-old man with cirrhosis of the liver

Answer and Explanation

The Correct Answer is D

A) A 41-year-old man with kidney stones:
Kidney stones primarily affect the urinary system, and while the kidneys play a role in drug excretion, kidney stones themselves do not directly interfere with drug metabolism. Drug metabolism occurs mainly in the liver, so alterations due to kidney stones would be less likely. The liver is where most drug metabolism takes place, so drug metabolism in this case would likely be unaffected by kidney stones.

B) A 62-year-old woman with acute renal failure:
Acute renal failure impacts the kidneys' ability to filter and excrete drugs, but it doesn't directly affect the liver's ability to metabolize drugs. Renal failure can lead to drug accumulation due to decreased clearance, but metabolism (primarily liver function) is not usually altered unless the patient also has hepatic dysfunction.

C) A 35-year-old woman with cervical cancer:
Cervical cancer itself does not directly affect drug metabolism. While cancer treatments like chemotherapy or radiation therapy can affect liver and kidney function (which could impact drug metabolism), cervical cancer itself does not typically alter the metabolic pathways that drugs undergo in the body.

D) A 50-year-old man with cirrhosis of the liver:
Cirrhosis of the liver significantly impacts the liver's ability to metabolize drugs. The liver is the primary organ responsible for drug metabolism, and cirrhosis can lead to a decreased ability to break down medications, potentially resulting in drug toxicity or suboptimal therapeutic effects.

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Free Nursing Study Resources

Correct Answer is ["A","C","E","F"]

Explanation

A) Bradycardia: Bradycardia is a common symptom of a cholinergic crisis. It results from excessive acetylcholine at the neuromuscular junction, which can overstimulate the parasympathetic nervous system, leading to a decrease in heart rate.

B) Rash: A rash is not a typical symptom of a cholinergic crisis. Rash might occur as a side effect of medications or other conditions, but it is not a hallmark feature of a cholinergic crisis in myasthenia gravis.

C) Vomiting: Vomiting is a potential symptom of a cholinergic crisis. It occurs due to the excessive stimulation of the parasympathetic nervous system, which can cause gastrointestinal distress and nausea.

D) Fever: Fever is not typically associated with a cholinergic crisis, but it can occur if there is an underlying infection or other condition. A cholinergic crisis itself usually leads to symptoms like weakness and excessive salivation, not fever.

E) Weakness: Weakness is a hallmark symptom of a cholinergic crisis, as it results from overstimulation at the neuromuscular junction, leading to muscle fatigue and paralysis. This is similar to the symptoms of myasthenia gravis, but in a cholinergic crisis, the weakness is more profound.

F) Drooling: Drooling is another common symptom of a cholinergic crisis. Excessive acetylcholine can lead to excessive salivation due to overstimulation of the parasympathetic nervous system.

A. Tacrine (Cognex) B. Rivastigmine (Exelon) C. Carbidopa-levodopa (Sinemet) D. Donepezil (Aricept)

Correct Answer is C

Explanation

A) Tacrine (Cognex): Tacrine is an acetylcholinesterase inhibitor used in the treatment of Alzheimer's disease to improve cognitive function. It is not typically used for Parkinson's disease, which is characterized by motor symptoms such as tremors, shuffling gait, and rigidity.

B) Rivastigmine (Exelon): Rivastigmine is another acetylcholinesterase inhibitor, similar to Tacrine, primarily used to treat Alzheimer's disease or dementia-related symptoms. While it helps with cognitive symptoms, it is not effective in treating the motor symptoms of Parkinson's disease.

C) Carbidopa-levodopa (Sinemet): This is the correct answer. Carbidopa-levodopa (Sinemet) is the gold standard treatment for Parkinson's disease. Levodopa is a precursor to dopamine, which helps address the dopamine deficiency in the brain that causes symptoms like tremors, shuffling gait, and lack of facial expression (masked facies). Carbidopa is added to prevent levodopa from being broken down before it reaches the brain, enhancing its effectiveness.

D) Donepezil (Aricept): Donepezil is also an acetylcholinesterase inhibitor used primarily in Alzheimer's disease. Like Tacrine and Rivastigmine, it works to improve cognitive function but does not treat the motor symptoms seen in Parkinson's disease. It would not be appropriate for managing the patient's Parkinsonian symptoms.

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Drugs do not metabolize the same way in all people. For what patient would a nurse expect to assess for an alteration in drug metabolism?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with myasthenia gravis is experiencing a cholinergic crisis. Which symptoms are associated with this condition? (Select all that apply.)

Correct Answer is ["A","C","E","F"]

Explanation

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Correct Answer is C

Explanation

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