A client diagnosed with liver disease asks the nurse why the health care provider is changing the dose of the client’s medications. Which statement is the nurse’s best response?
You should really ask your health care provider
The health care provider is afraid you will become dependent on the medications
The usual dose of medication may be too large for your liver
The affinity of the medication changes with liver disease
The Correct Answer is C
Choice A reason: Redirecting the client to the provider avoids addressing the question and misses an educational opportunity. Liver disease affects drug metabolism, and the nurse can explain this. This response is inappropriate, as it fails to provide the client with accurate information about their medication adjustments.
Choice B reason: Medication dose changes in liver disease are due to impaired metabolism, not dependency concerns. Dependency is unrelated to hepatic function or pharmacokinetics. This statement is inaccurate, as it misrepresents the reason for dose adjustments in the context of liver disease.
Choice C reason: Liver disease impairs drug metabolism via cytochrome P450 enzymes, reducing clearance and increasing drug levels, risking toxicity. Dose adjustments prevent adverse effects. This statement is accurate, as it directly addresses how liver dysfunction necessitates lower doses for safe and effective medication use.
Choice D reason: Medication affinity (binding to receptors) is not significantly altered by liver disease. Instead, impaired hepatic metabolism affects drug clearance, not receptor interactions. This statement is inaccurate, as it misattributes dose changes to a pharmacological property unrelated to liver function.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder, not primarily an inflammatory disease. While low-grade inflammation may be present in some cases, IBS is characterized by altered gut motility and visceral hypersensitivity without significant inflammatory markers, unlike inflammatory bowel diseases like Crohn’s or ulcerative colitis. This statement is inaccurate.
Choice B reason: Stress is a well-documented trigger for IBS symptoms. The brain-gut axis, involving the hypothalamic-pituitary-adrenal axis, modulates gut motility and sensitivity. Psychological stress can exacerbate visceral pain, diarrhea, or constipation by altering neurotransmitter release and gut microbiome interactions, making this statement accurate for IBS pathophysiology.
Choice C reason: IBS treatment focuses on symptom relief, as there is no cure. Strategies include dietary modifications (e.g., low FODMAP diet), antispasmodics, laxatives, or antidiarrheals to manage pain, bloating, and bowel irregularities. This statement is accurate, reflecting the symptomatic approach to improving quality of life in IBS patients.
Choice D reason: IBS symptoms commonly include constipation, diarrhea, or alternating patterns, along with abdominal pain and bloating. These result from dysregulated gut motility and visceral hypersensitivity, affecting the enteric nervous system. This statement is accurate, as variable bowel habits are a hallmark of IBS diagnostic criteria.
Correct Answer is B
Explanation
Choice A reason: Crohn’s disease does not always spread to the liver. While it can cause liver complications like primary sclerosing cholangitis or fatty liver in some cases, this is not universal. This statement is inaccurate, as liver involvement is a complication, not a defining feature of Crohn’s disease.
Choice B reason: Crohn’s disease is characterized by a patchy, or “skip lesion,” pattern of bowel involvement, affecting any part of the gastrointestinal tract discontinuously. Inflammation is transmural, causing fistulas or strictures. This statement is accurate, as the patchy distribution is a hallmark distinguishing it from ulcerative colitis.
Choice C reason: Continuous bowel involvement is characteristic of ulcerative colitis, not Crohn’s disease. Crohn’s affects the bowel in a segmental, patchy manner, with healthy areas between lesions. This statement is inaccurate, as it incorrectly describes Crohn’s tissue involvement pattern, which is distinctly non-continuous.
Choice D reason: Crohn’s disease increases cardiovascular risk due to chronic inflammation, but stroke is not a well-established direct complication. Inflammatory markers may contribute to atherosclerosis, but stroke risk is less specific than patchy bowel involvement. This statement is inaccurate, as it overstates a specific stroke association.
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