A 74-year-old man with cirrhosis is admitted to the hospital and he has started taking a diuretic. Which age-related change may result in decreased drug clearance in this patient?
Decreased blood flow to the liver
Increased body fat
Decreased serum albumin
Decreased body water
The Correct Answer is A
A. Decreased blood flow to the liver: Aging reduces hepatic perfusion, impairing the liver’s ability to metabolize drugs, especially in patients with liver disease.
B. Increased body fat: This affects the distribution of fat-soluble drugs but not clearance.
C. Decreased serum albumin: This affects protein binding and distribution of certain drugs but not clearance directly.
D. Decreased body water: This influences water-soluble drug distribution, not drug clearance.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Obtain an order from the primary caregiver for a sedative
Not appropriate as a first step; sedatives in the elderly increase the risk of falls and confusion and should only be used after thorough evaluation.
B. Ask the patient if he is sleeping well at night
This helps identify underlying sleep disturbances, such as nocturia or insomnia, which may be the cause of daytime fatigue.
C. Tell the patient that he cannot take any more naps
Restricting naps without assessing the cause of tiredness is inappropriate and may worsen fatigue.
D. Plan activities to keep the patient awake during the day
May be helpful after assessing nighttime sleep habits and determining the cause of daytime drowsiness.
Correct Answer is A
Explanation
A. Decreased blood flow to the liver: Aging reduces hepatic perfusion, impairing the liver’s ability to metabolize drugs, especially in patients with liver disease.
B. Increased body fat: This affects the distribution of fat-soluble drugs but not clearance.
C. Decreased serum albumin: This affects protein binding and distribution of certain drugs but not clearance directly.
D. Decreased body water: This influences water-soluble drug distribution, not drug clearance.
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