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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Pseudoephedrine, a decongestant, relieves nasal congestion by vasoconstriction but doesn’t address inflammation or histamine-mediated symptoms like sneezing or itching in rhinitis. It’s less effective than intranasal corticosteroids, which target the underlying allergic response, making this choice less optimal for comprehensive rhinitis treatment.
Choice B reason: Intranasal cromolyn sodium stabilizes mast cells, reducing histamine release, but it’s less effective than corticosteroids for rhinitis. Atrovent (ipratropium) is incorrectly referenced here, as it treats rhinorrhea, not inflammation. Corticosteroids like fluticasone are preferred, making this choice incorrect for optimal treatment.
Choice C reason: Propranolol, a beta-blocker, treats hypertension and cardiac conditions, not rhinitis. It has no effect on allergic inflammation, histamine, or nasal congestion. Its use in rhinitis could worsen symptoms by causing bronchoconstriction in asthmatics, making this choice inappropriate and incorrect.
Choice D reason: Fluticasone propionate, an intranasal corticosteroid, reduces inflammation, edema, and histamine effects in seasonal and perennial rhinitis. It targets the allergic cascade, decreasing nasal congestion, sneezing, and itching, making it the most effective and guideline-recommended treatment, thus the correct choice for rhinitis management.
Correct Answer is ["A","C","D"]
Explanation
Choice A reason: Benzonatate suppresses cough by anesthetizing stretch receptors in the respiratory tract, reducing the cough reflex. It acts locally on nerve endings in the lungs and pleura, effectively decreasing cough frequency without systemic opioid effects, making it an appropriate choice for cough suppression.
Choice B reason: Guaifenesin is an expectorant, promoting mucus clearance by thinning secretions, not suppressing the cough reflex. It facilitates productive coughing rather than inhibiting it, making it ineffective for cough suppression and an incorrect choice for this indication in managing cough symptoms.
Choice C reason: Dextromethorphan suppresses cough by acting on the medulla’s cough center, reducing the urge to cough. As a non-opioid antitussive, it effectively controls non-productive cough without significant respiratory depression, making it a suitable and correct choice for cough suppression in various conditions.
Choice D reason: Codeine, an opioid, suppresses cough by acting on the central nervous system’s cough center, reducing reflex activity. It’s effective for non-productive cough but carries risks of sedation and dependency, making it a correct but cautiously used choice for cough suppression.
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