Which of the following patients is most at risk for liver damage after taking acetaminophen regularly for arthritis pain?
Patient with a history of alcohol abuse and hepatitis C
Patient with COPD and a 20 pack-year history of smoking
Patient with type 2 diabetes and end-stage renal disease
Patient with prostate enlargement and urinary frequency
The Correct Answer is A
Choice A reason: Alcohol and hepatitis C impair liver function; acetaminophen’s metabolite NAPQI accumulates, causing hepatotoxicity in an already compromised organ.
Choice B reason: COPD and smoking affect lungs, not liver; acetaminophen metabolism is minimally impacted, posing lower hepatic risk compared to liver disease states.
Choice C reason: Renal disease affects drug excretion, not liver metabolism; acetaminophen’s hepatic load is unchanged, making liver damage less likely here.
Choice D reason: Prostate issues involve urinary tract; liver metabolism of acetaminophen remains intact, with no heightened risk of hepatotoxicity from this condition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: 31 gtts/min assumes 250 mL over 4 hours with 15 gtts/mL; this halves the rate, underdelivering vancomycin, risking subtherapeutic levels and ineffective bacterial killing over the prescribed 2-hour infusion time.
Choice B reason: 62 gtts/min is correct; 250 mL over 2 hours is 125 mL/hr, times 15 gtts/mL equals 1875 gtts total, divided by 120 minutes yields 62 gtts/min, ensuring proper antibiotic delivery.
Choice C reason: 125 gtts/min doubles the rate; 250 mL in 1 hour with 15 gtts/mL is too fast, risking vancomycin toxicity, including renal damage, and exceeding safe infusion guidelines for IVPB.
Choice D reason: 250 gtts/min assumes 250 mL in 30 minutes; this dangerously rapid rate could cause vancomycin-induced red man syndrome or cardiovascular overload, far beyond the ordered 2-hour infusion duration.
Correct Answer is D
Explanation
Choice A reason: PRN is as needed; EKGs here are routine, not symptom-driven, making this inapplicable to a standard admission protocol for all patients.
Choice B reason: One-time is a single event; this order applies to all admissions ongoing, not a one-off, distinguishing it from limited-duration directives.
Choice C reason: STAT is immediate; routine EKGs aren’t urgent, occurring as part of standard care, not requiring the priority of acute intervention orders.
Choice D reason: Standing orders apply automatically to all qualifying patients; this EKG protocol fits, ensuring consistent cardiac assessment unless overridden.
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