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. 1630 and 1930: Peak and trough levels are used to monitor drug effectiveness and prevent toxicity. Trough levels (lowest drug concentration) are drawn right before the next dose-1745 would be slightly too late. Peak levels (highest drug concentration) are drawn 30-60 minutes after administration (for IV drugs). Since the next dose is at 1800, the trough should be drawn just before the dose (1630) and the peak should be drawn 30-60 minutes after the dose (1930).

B. 1100 and 1700- Incorrect timing, not close to dose administration.

C. 1400 and 2200- Too far from the scheduled 1800 dose.

D. 1745 and 1830- Trough is too close to administration, peak is too early.

A. Place the patient on a cardiac monitor and check the patency of the IV B. Administer potassium intravenously in an IV push bolus C. Discontinue other medications that may affect potassium levels D. Avoid potassium rich foods in the diet

Correct Answer is A

Explanation

A. Place the patient on a cardiac monitor and check the patency of the IV: Hypokalemia (K+ = 2.5 mEq/L) can cause life-threatening cardiac dysrhythmias, so cardiac monitoring is essential. Additionally, potassium is highly irritating to veins, so IV patency must be confirmed to prevent extravasation and tissue damage.

B. Administer potassium intravenously in an IV push bolus- NEVER give potassium IV push as it can cause fatal cardiac arrest. Potassium must always be diluted and infused slowly.

C. Discontinue other medications that may affect potassium levels- Adjusting medications may be necessary, but not an immediate priority over cardiac monitoring.

D. Avoid potassium-rich foods in the diet - Incorrect because the client needs potassium replacement, not restriction.

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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:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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