A nurse is reviewing the medical record of a client who has beers taking a medication that can cause hepatoxicity. Which of the following data should the nurse report to the provider?

HbA1C 5.9%

Albumin 3.8 g/dl

Alanine aminotransferase (ALT) 67 units/l

Aspartate aminotransferase (AST) 39 units/l

Answer and Explanation

The Correct Answer is C

Here is the rationale for each choice:

A. HbA1C 5.9%: HbA1C is a measure of long-term glucose control in patients, often used in diabetes management. A value of 5.9% is slightly above the normal range (4–5.7%) but does not indicate hepatotoxicity.

B. Albumin 3.8 g/dl: Albumin is a protein produced by the liver, and its levels can reflect liver function. A normal range is 3.5–5 g/dl, and 3.8 g/dl falls within this range. Thus, it does not indicate hepatotoxicity.

C. Alanine aminotransferase (ALT) 67 units/l: ALT is an enzyme primarily found in the liver and is a key marker for liver injury. The normal range for ALT is approximately 7–56 units/l. A value of 67 units/l is slightly elevated, which may suggest mild liver damage or hepatotoxicity. This result should be reported to the provider, as it could be associated with the medication’s impact on the liver.

D. Aspartate aminotransferase (AST) 39 units/l: AST is another enzyme used to evaluate liver function, though it is less specific to the liver than ALT, as AST is also found in other tissues such as the heart and muscles. The normal range for AST is roughly 10–40 units/l.

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Free Nursing Study Resources

Correct Answer is B

Explanation

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.

A. BUN 11 mg/dl serum creatinine 0.8 mg/dl B. BUN 15 mg/dl serum creatine 1.0 mg/dl C. BUN 10 mg/dl, serum creatinine 0.6 mg/dL D. BUN 25 mg/dL serum creatinine 2.3 mg/dl

Correct Answer is D

Explanation

A. BUN 11 mg/dL, serum creatinine 0.8 mg/dL: These values are normal (BUN: 7-20 mg/dL, creatinine: 0.6-1.2 mg/dL), which are not expected in chronic kidney disease (CKD).

B. BUN 15 mg/dL, serum creatinine 1.0 mg/dL: Also within normal limits.

C. BUN 10 mg/dL, serum creatinine 0.6 mg/dL : These values suggest normal kidney function, not CKD.

D. BUN 25 mg/dL, serum creatinine 2.3 mg/dL : Both elevated BUN and creatinine indicate impaired kidney function, which is expected in CKD.

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A nurse is reviewing the medical record of a client who has beers taking a medication that can cause hepatoxicity. Which of the following data should the nurse report to the provider?

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