For the patient who is taking acetaminophen (Tylenol), what should the nurse do? Select all that apply

Monitor routine liver enzyme tests.

Encourage the patient to check package labels of OTC drugs to avoid overdosing.

Teach the diabetic patient taking acetaminophen to check blood glucose more frequently.

Teach the female patient that oral contraceptives can increase the effect of acetaminophen.

Teach the patient that caffeine decreases the effects of acetaminophen.

Answer and Explanation

Correct Answer : A,B,C

Acetaminophen (Tylenol) is one of the most widely used analgesics and antipyretics. While generally safe at therapeutic doses, overdose or long-term use can cause hepatotoxicity. Nurses play a key role in teaching patients how to safely use acetaminophen, especially because it is present in many combination OTC medications. Patients with comorbid conditions, such as diabetes, also require specific teaching.

Rationale for correct answers:
A. Monitor routine liver enzyme tests:
Acetaminophen is metabolized by the liver, and excessive use can cause severe liver damage. Routine monitoring of liver enzymes (AST, ALT) is important, especially for patients on long-term therapy or with existing liver disease.

B. Encourage the patient to check package labels of OTC drugs to avoid overdosing:
Many cold, flu, and pain relief medications contain acetaminophen. Without careful attention, patients may unknowingly exceed the maximum daily dose (usually 4 g for adults), increasing the risk of hepatotoxicity.

C. Teach the diabetic patient taking acetaminophen to check blood glucose more frequently:
Acetaminophen may cause false readings with certain blood glucose monitors, particularly those using the glucose oxidase-peroxidase method. This makes frequent monitoring important for diabetic patients.

Rationale for incorrect answers:
D. Teach the female patient that oral contraceptives can increase the effect of acetaminophen:
Oral contraceptives actually increase the metabolism of acetaminophen, potentially decreasing its effectiveness, not increasing it.

E. Teach the patient that caffeine decreases the effects of acetaminophen:
Caffeine actually enhances the analgesic effect of acetaminophen and is sometimes included in combination medications (e.g., Excedrin).

Take-home points:

Monitor liver function closely during acetaminophen therapy.
Diabetic patients should check blood glucose more often while taking acetaminophen.
Caffeine enhances, not decreases, acetaminophen’s pain-relieving action.

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Free Nursing Study Resources

Correct Answer is ["B","C","D"]

Explanation

Opioid analgesics are effective for moderate to severe pain but have significant central nervous system and respiratory depressant effects. Nurses must assess for conditions that increase the risk of respiratory compromise or intracranial pressure before administration.

Rationale for correct answers:

B. Severe asthma:
Opioids can depress respiratory drive and reduce the body’s response to hypoxia and hypercapnia. In patients with severe asthma, this can precipitate life-threatening respiratory compromise.

C. Sleep apnea:
Patients with sleep apnea already have intermittent airway obstruction during sleep. Opioids can worsen hypoventilation and apnea episodes, increasing the risk of severe hypoxia.

D. Severe head injury:
Opioids can increase intracranial pressure and mask changes in neurological status, making monitoring of head injury patients more difficult and potentially dangerous.

Rationale for incorrect answers:

A. Renal insufficiency:
Opioids can be used with caution in renal impairment, adjusting doses if necessary. They are not strictly contraindicated.

E. Liver disease:
Most opioids are metabolized by the liver, so caution and dose adjustment may be needed, but they are not absolute contraindications unless there is severe hepatic failure.

Take-home points:

Opioids can depress respiration, so avoid in severe asthma, sleep apnea, and head injury.
Dose adjustments may be necessary for renal or hepatic impairment, but these conditions are not absolute contraindications.
Always monitor for signs of respiratory depression and CNS changes in high-risk patients.

A. 1 g/day B. 2 g/day C. 4 g/day D. 6 g/day

Correct Answer is C

Explanation

Acetaminophen is widely used for pain and fever, but overdose can cause severe hepatotoxicity. Safe dosing limits are critical to prevent liver damage, especially in patients taking multiple acetaminophen-containing products.

Rationale for correct answer:

C. 4 g/day:
The maximum recommended adult dose of acetaminophen is 4 grams per day when taken in divided doses. Exceeding this amount increases the risk of liver injury or acute liver failure, particularly in patients who consume alcohol or have preexisting liver disease.

Rationale for incorrect answers:

A. 1 g/day:
This is well below the therapeutic maximum. While safe, it may not provide adequate analgesia or antipyresis for adults.

B. 2 g/day:
This is below the recommended upper limit for healthy adults and may be unnecessarily restrictive for short-term use.

D. 6 g/day:
This exceeds the safe limit and significantly increases the risk of hepatotoxicity, even with short-term use.

Take-home points:

Do not exceed 4 g/day of acetaminophen for adults.
Assess all sources of acetaminophen, including combination OTC and prescription products.
Monitor for signs of liver injury such as jaundice, dark urine, or abdominal pain in patients using high or chronic doses.

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For the patient who is taking acetaminophen (Tylenol), what should the nurse do? Select all that apply

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

An opioid analgesic is prescribed for a patient. The nurse checks the patient's medical history knowing this medication is contraindicated in which disorder? Select all that apply

Correct Answer is ["B","C","D"]

Explanation

A patient states during a medical history that he takes several acetaminophen tablets throughout the day. The nurse teaches the patient that the dosage should not exceed which amount?

Correct Answer is C

Explanation

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