A nurse is caring for a patient who has been prescribed metronidazole. The patient has elevated alanine transaminase (ALT) and aspartate transaminase (AST). What action should the nurse take concerning the administration of metronidazole to this patient?

Monitor the patient closely during administration.

Avoid giving metronidazole to the patient.

Reduce the metronidazole dose to half of the prescribed amount.

Administer metronidazole as prescribed.

Answer and Explanation

The Correct Answer is B

Choice A reason: Monitoring alone is insufficient with elevated ALT and AST, indicating liver dysfunction. Metronidazole is metabolized by the liver, and hepatotoxicity is a known risk. Administering it to a patient with pre-existing liver damage could worsen hepatic injury, making this action inadequate.

Choice B reason: Elevated ALT and AST suggest liver dysfunction, and metronidazole, metabolized hepatically, can exacerbate hepatotoxicity. Avoiding administration prevents further liver damage, as the drug’s nitroimidazole structure undergoes hepatic reduction, producing toxic metabolites that stress an already compromised liver, necessitating alternative therapy.

Choice C reason: Reducing the metronidazole dose is not recommended without medical consultation. Elevated liver enzymes indicate impaired hepatic function, and even reduced doses may worsen hepatotoxicity. Alternative antibiotics with less hepatic metabolism should be considered, making dose reduction an unsafe choice.

Choice D reason: Administering metronidazole as prescribed is dangerous with elevated ALT and AST, signaling liver dysfunction. Metronidazole’s hepatic metabolism can exacerbate liver injury, increasing the risk of severe hepatotoxicity. The nurse should withhold the drug and consult the prescriber for safer alternatives.

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Correct Answer is D

Explanation

Choice A reason: Fibric acid derivatives, like fenofibrate, lower triglycerides by activating PPAR-alpha, reducing VLDL production. They are not commonly associated with myopathy, though gastrointestinal upset or liver enzyme elevation may occur. Myopathy is more characteristic of statins, making this an incorrect class for monitoring.

Choice B reason: Niacin lowers lipids by inhibiting VLDL synthesis but is not significantly linked to myopathy. Its primary side effects include flushing and hepatotoxicity due to prostaglandin release and metabolic stress. Muscle pain is a hallmark of statins, not niacin, making this incorrect.

Choice C reason: Bile acid sequestrants, like cholestyramine, bind bile acids, reducing cholesterol absorption. They cause gastrointestinal side effects like constipation but not myopathy. Their mechanism does not affect muscle tissue, unlike statins, which inhibit HMG-CoA reductase, making this class irrelevant for myopathy monitoring.

Choice D reason: Statins, like simvastatin, inhibit HMG-CoA reductase, reducing cholesterol synthesis. They can cause myopathy by disrupting muscle cell membranes or mitochondrial function, leading to muscle pain or rare rhabdomyolysis. Monitoring for myopathy is critical, as it can progress to severe muscle damage, making this the correct class.

A. Disinfectants are used only on nonliving objects to destroy organisms. B. Antiseptics are used to sterilize surgical equipment. C. Disinfectants are used as preoperative skin preparation. D. Antiseptics are used only on living tissue to kill microorganisms.

Correct Answer is A

Explanation

Choice A reason: Disinfectants are chemical agents used on nonliving surfaces, like countertops, to kill microorganisms. They are too harsh for living tissue, unlike antiseptics, which are applied to skin or mucous membranes to reduce microbial load without causing tissue damage, making this correct.

Choice B reason: Antiseptics are not used to sterilize surgical equipment. Sterilization requires disinfectants or autoclaving to eliminate all microorganisms, including spores, on inanimate objects. Antiseptics are applied to living tissue, like skin, for microbial reduction, making this statement incorrect.

Choice C reason: Disinfectants are not used for preoperative skin preparation. Antiseptics, like chlorhexidine, are used on skin to reduce microbial load before surgery. Disinfectants are for nonliving surfaces, as they may harm tissue, making this an incorrect description of their use.

Choice D reason: Antiseptics reduce, not necessarily kill, microorganisms on living tissue. They are designed to be safe for skin or mucous membranes, unlike disinfectants, which are harsher. While antiseptics target microbes, complete killing is not guaranteed, making this statement partially inaccurate.

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A nurse is caring for a patient who has been prescribed metronidazole. The patient has elevated alanine transaminase (ALT) and aspartate transaminase (AST). What action should the nurse take concerning the administration of metronidazole to this patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse will monitor for myopathy (muscle pain) when a patient is taking which class of antilipemic drugs?

Correct Answer is D

Explanation

The nurse is preparing to use an antiseptic. Which statement is correct regarding how antiseptics differ from disinfectants?

Correct Answer is A

Explanation

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