A client with hepatitis C has been experiencing symptoms of gastroesophageal reflux.
What H antagonist would be most appropriate for this client’s needs?
Nizatidine.
Ranitidine.
Cimetidine.
Famotidine.
The Correct Answer is D
Famotidine is a histamine type 2 receptor antagonist (H blocker) which is commonly used for treatment of acid-peptic disease and heartburn. Famotidine has been linked to rare instances of clinically apparent acute liver injury, but it is less likely to cause hepatotoxicity than cimetidine, another H blocker. Famotidine also has fewer drug interactions than cimetidine.
Choice A is wrong because nizatidine is another H blocker that can cause mild and transient serum aminotransferase elevations.
Nizatidine has not been linked to cases of clinically apparent liver injury, but it has not been widely used.
Choice B is wrong because ranitidine is another H blocker that can cause mild and transient serum aminotransferase elevations.
Ranitidine has also been associated with rare instances of clinically apparent liver injury, some of which were fatal or required liver transplantation.
Choice C is wrong because cimetidine is another H blocker that can cause mild and transient serum aminotransferase elevations.
Cimetidine has also been implicated in several cases of clinically apparent acute liver injury, some of which were severe and led to acute liver failure and death.
Cimetidine also has many drug interactions due to its inhibition of cytochrome P enzymes.
Normal ranges for serum aminotransferases are 7 to 56 U/L for alanine aminotransferase (ALT) and 10 to 40 U/L for as
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Glargine is a long-acting insulin that can provide a steady level of insulin for up to 24 hours. This would be suitable for a client who does not want to administer insulin on the plane, as they would only need one injection per day.
Choice A. Aspart is wrong because aspart is a rapid-acting insulin that has a peak effect within 1 to 3 hours and lasts for 3 to 5 hours.
This would require frequent injections and monitoring of blood glucose levels.
Choice B. Lispro is wrong because lispro is also a rapid-acting insulin that has a similar onset and duration as aspart.
It would not provide adequate coverage for a long international flight.
Choice C. Glulisine is wrong because glulisine is another rapid-acting insulin that has an onset of 15 minutes and a duration of 2 to 4 hours.
It would also require multiple injections and frequent blood glucose checks.
Normal ranges for blood glucose levels are 70 to 130 mg/dL before meals and less than 180 mg/dL after meals.
Correct Answer is B
Explanation
Metoclopramide is a medication that increases muscle contractions in the upper digestive tract and speeds up the rate at which the stomach empties into the intestines. It is used to treat gastroparesis (slow stomach emptying) in people with diabetes, which can cause heartburn and stomach discomfort after meals.
Choice A is wrong because impaction is a condition where a large mass of dry, hard stool becomes stuck in the rectum and cannot be passed.
Metoclopramide does not treat impaction, but laxatives or enemas may be used instead.
Choice C is wrong because encopresis is a condition where a child over the age of 4 has involuntary bowel movements, usually due to chronic constipation.
Metoclopramide does not treat encopresis, but behavioral therapy, laxatives, or dietary changes may be used instead.
Choice D is wrong because metoclopramide is not used for clients requiring diagnostic procedures involving the stomach or intestines.
However, it may be used to prevent nausea and vomiting caused by chemotherapy or surgery.
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