The nurse is caring for a patient who has jaundice, dark urine, malaise, light-colored stools, nausea, and vomiting. What is this patient most likely experiencing?

An allergic reaction

An idiosyncratic drug effect on the bone marrow

Iatrogenic disease of the skin

Drug toxicity of the liver

Answer and Explanation

The Correct Answer is D

Choice A reason: Allergic reactions typically present with symptoms like rash, itching, or anaphylaxis, not jaundice, dark urine, or light stools. These symptoms indicate hepatobiliary dysfunction, not an immune-mediated response. Allergic reactions don’t typically affect liver function or bile excretion, making this choice inconsistent with the patient’s clinical presentation.

Choice B reason: Idiosyncratic drug effects on bone marrow cause hematologic issues like anemia or leukopenia, not jaundice or light stools. These symptoms suggest liver dysfunction, as bile pigment changes cause dark urine and pale stools. Bone marrow effects don’t explain the hepatobiliary symptoms, making this choice incorrect.

Choice C reason: Iatrogenic skin disease might involve rashes or lesions, but jaundice, dark urine, and light stools point to liver or bile duct issues. These symptoms result from impaired bilirubin metabolism, not cutaneous pathology. This choice doesn’t align with the systemic hepatobiliary symptoms described, making it incorrect.

Choice D reason: Drug-induced liver toxicity, such as from acetaminophen or statins, impairs bilirubin metabolism, causing jaundice, dark urine (bilirubinuria), and light stools (reduced bile). Malaise, nausea, and vomiting reflect systemic effects of liver dysfunction. This matches the patient’s symptoms, making it the most likely diagnosis and correct choice.

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Correct Answer is D

Explanation

Choice A reason: Low drug interactions are desirable but unrelated to ease of administration. Adherence is directly tied to administration simplicity, so this is incorrect.

Choice B reason: Low production cost is a manufacturing benefit, not administration ease. Patient adherence is the outcome of easy administration, so this is incorrect.

Choice C reason: Storage stability aids logistics, not administration. Easy administration improves compliance, like taking oral pills, so this is incorrect for the outcome.

Choice D reason: Easy administration, like simple dosing or oral routes, enhances patient adherence by reducing barriers. This is the desired outcome, making it correct.

A. Metoprolol [Lopressor] and furosemide [Lasix] B. Furosemide [Lasix] and enalapril [Vasotec] C. Captopril [Capoten] and spironolactone [Aldactone] D. Amlodipine [Norvasc] and propranolol [Inderal]

Correct Answer is C

Explanation

Choice A reason: Metoprolol (beta-blocker) and furosemide (loop diuretic) are commonly used in heart failure. Furosemide may lower potassium, counteracting hyperkalemia (5.5 mEq/L), and metoprolol doesn’t significantly affect potassium. This combination poses less risk for hyperkalemia exacerbation, making it less concerning than potassium-sparing combinations.

Choice B reason: Furosemide promotes potassium excretion, potentially reducing hyperkalemia (5.5 mEq/L), while enalapril (ACE inhibitor) may increase potassium. However, furosemide’s effect often offsets enalapril’s, making this combination less likely to worsen hyperkalemia significantly compared to two potassium-sparing drugs, so this choice is less critical.

Choice C reason: Captopril (ACE inhibitor) and spironolactone (potassium-sparing diuretic) both increase potassium levels by reducing aldosterone activity, exacerbating hyperkalemia (5.5 mEq/L). In heart failure, this combination risks severe hyperkalemia, causing arrhythmias, making it the most concerning interaction requiring close monitoring or adjustment.

Choice D reason: Amlodipine (calcium channel blocker) and propranolol (beta-blocker) primarily affect blood pressure and heart rate, not potassium levels. Their interaction may cause bradycardia or hypotension but doesn’t worsen hyperkalemia (5.5 mEq/L), making this combination less concerning for the patient’s current electrolyte status.

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The nurse is caring for a patient who has jaundice, dark urine, malaise, light-colored stools, nausea, and vomiting. What is this patient most likely experiencing?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What is a desired outcome when a drug is described as easy to administer?

Correct Answer is D

Explanation

A nurse is reviewing a patient’s medications before administration. Which drug-to-drug interactions will most concern the nurse in a patient with a history of heart failure and a potassium level of 5.5 mEq/L?

Correct Answer is C

Explanation

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