A client ordered grapefruit juice for breakfast. The nurse should review the client's medication record for medications metabolized by the:

Gall bladder

Liver

Kidney

Small bowel

Answer and Explanation

The Correct Answer is B

B. Liver: Grapefruit juice inhibits CYP3A4 enzymes in the liver, which metabolize many drugs (e.g., statins, calcium channel blockers). This inhibition can lead to increased drug levels and toxicity.

A. Gall bladder – The gall bladder stores bile but does not metabolize drugs.

C. Kidney – The kidneys excrete drugs, but grapefruit juice does not significantly impact renal metabolism.

D. Small bowel – Some drug metabolism occurs in the intestines, but grapefruit juice primarily affects liver enzymes.

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Correct Answer is A

Explanation

A. At the start of medication therapy: Side effects are most common when a client first begins taking a new medication because the body is not yet accustomed to the drug. Over time, tolerance may develop, and some side effects may diminish.

B. When clients take medication on an empty stomach – Some medications cause more side effects when taken on an empty stomach (e.g., NSAIDs causing gastritis), but this is not true for all medications.

C. When clients take high doses of medication – Higher doses may increase the risk of toxicity rather than routine side effects.

D. When clients take multiple medications – Drug interactions are more likely when taking multiple medications, but this does not mean that side effects are most common in this situation.

A. Glucose of 6.7 mg/dl B. WBC of 7000/mm3 C. Platelet count of 160,000/mm3 D. Hemoglobin of 6.2 g/dl

Correct Answer is D

Explanation

A. Glucose of 6.7 mg/dL: Critically low; however, this is an unrealistic value because normal fasting glucose is 70-100 mg/dL. This might be a typo—if it were 6.7 mmol/L, it would be within the normal range.

B. WBC of 7000/mm³: Normal range (4,000-11,000/mm³), so no immediate concern.

C. Platelet count of 160,000/mm³: Normal range (150,000-400,000/mm³), so no immediate concern.

D. Hemoglobin of 6.2 g/dL: Normal hemoglobin levels are 13.5-17.5 g/dL (males) and 12-15.5 g/dL (females). A hemoglobin of 6.2 g/dL is critically low, indicating severe anemia, blood loss, or bone marrow suppression, which may require blood transfusion or further investigation.

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A client ordered grapefruit juice for breakfast. The nurse should review the client's medication record for medications metabolized by the:

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Naxlex Comprehensive Predictor Exams

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Explanation

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