Drugs do not metabolize the same way in all people. For what patient would a nurse expect to assess for an alteration in drug metabolism?

A 41-yr-old man with kidney stones

A 62-yr-old woman with acute renal failure

A 35-yr-old woman with cervical cancer

A 50-yr-old man with cirrhosis of the liver

Answer and Explanation

The Correct Answer is D

A) A 41-year-old man with kidney stones:
Kidney stones primarily affect the urinary system, and while the kidneys play a role in drug excretion, kidney stones themselves do not directly interfere with drug metabolism. Drug metabolism occurs mainly in the liver, so alterations due to kidney stones would be less likely. The liver is where most drug metabolism takes place, so drug metabolism in this case would likely be unaffected by kidney stones.

B) A 62-year-old woman with acute renal failure:
Acute renal failure impacts the kidneys' ability to filter and excrete drugs, but it doesn't directly affect the liver's ability to metabolize drugs. Renal failure can lead to drug accumulation due to decreased clearance, but metabolism (primarily liver function) is not usually altered unless the patient also has hepatic dysfunction.

C) A 35-year-old woman with cervical cancer:
Cervical cancer itself does not directly affect drug metabolism. While cancer treatments like chemotherapy or radiation therapy can affect liver and kidney function (which could impact drug metabolism), cervical cancer itself does not typically alter the metabolic pathways that drugs undergo in the body.

D) A 50-year-old man with cirrhosis of the liver:
Cirrhosis of the liver significantly impacts the liver's ability to metabolize drugs. The liver is the primary organ responsible for drug metabolism, and cirrhosis can lead to a decreased ability to break down medications, potentially resulting in drug toxicity or suboptimal therapeutic effects.

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Correct Answer is A

Explanation

A) Reducing some of the tremors: Benztropine (Cogentin) is an anticholinergic medication commonly used in the treatment of Parkinson's disease to help manage symptoms. It works by blocking the effects of acetylcholine, which can help to restore the balance between acetylcholine and dopamine in the brain. This helps reduce symptoms like tremors and rigidity, which are common in Parkinson’s disease. Although it may not completely eliminate these symptoms, it can significantly reduce tremors, making this the most accurate effect of the drug.

B) Improving mental function: Benztropine is not intended to improve mental function. In fact, anticholinergic medications like benztropine can sometimes cause cognitive side effects, including memory problems or confusion, particularly in older patients. While the drug is effective in reducing motor symptoms, it is not used to enhance cognitive abilities in Parkinson’s disease.

C) Helping the patient to walk faster: Benztropine does not directly improve gait speed or help a patient walk faster. The drug primarily targets motor symptoms like tremors and rigidity rather than improving bradykinesia (slowness of movement), which is often the cause of walking difficulty in Parkinson’s patients. Medications such as levodopa or dopamine agonists are typically used to address issues related to bradykinesia and movement speed.

D) Minimizing symptoms of bradykinesia: While benztropine can help manage tremors and rigidity, it is not particularly effective for bradykinesia, which is the hallmark symptom of Parkinson’s disease. Bradykinesia is best addressed with dopaminergic medications like levodopa or dopamine agonists. Therefore, benztropine would not be the first choice for minimizing bradykinesia symptoms.

A. Proteins B. Enzymes C. Hormones D. Electrolytes

Correct Answer is C

Explanation

A) Proteins:
Proteins are generally too large to diffuse freely across the cell membrane. They require specific transport mechanisms, such as endocytosis or transport proteins, to move in and out of cells. The hydrophilic nature of most proteins further complicates their passage across the lipid bilayer.

B) Enzymes:
Like proteins, enzymes are large molecules that do not freely diffuse across cell membranes. Enzymes, being proteins, also need specialized transport mechanisms or need to be secreted or endocytosed to enter or exit cells.

C) Hormones:
Many hormones, particularly lipid-soluble ones like steroid hormones, can diffuse freely across the cell membrane. These hormones pass through the lipid bilayer due to their hydrophobic nature and bind to intracellular receptors, initiating cellular responses. However, water-soluble hormones (e.g., insulin) typically do not diffuse freely but interact with receptors on the cell surface.

D) Electrolytes:
Electrolytes (such as sodium, potassium, calcium, and chloride ions) are charged particles that cannot pass freely through the lipid bilayer due to the hydrophobic interior of the cell membrane. They require specific ion channels or transporters to move in and out of the cell. Diffusion of electrolytes is facilitated through these channels, but it is not a simple diffusion process as seen with small, uncharged molecules.

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Drugs do not metabolize the same way in all people. For what patient would a nurse expect to assess for an alteration in drug metabolism?

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Naxlex Comprehensive Predictor Exams

A patient who has Parkinson disease is being treated with the anticholinergic medication benztropine (Cogentin). The nurse will tell the patient that this drug will have which effect?

Correct Answer is A

Explanation

What substance move freely in and out of a cell by diffusion?

Correct Answer is C

Explanation

The nurse is preparing to administer a first dose of benztropine (Cogentin) to a patient diagnosed with parkinsonism. The nurse would notify the patient’s provider if the patient had a history of which condition?

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