The nurse is teaching a client about their medications for a psychological disorder. Which statement should not be included in the client education?
Renal disease may impact drug choice and dose in some clients
These medications have the risk for cytochrome P450 interactions that impact the action of the medication
Psychopharmacological medications have similar dosing across all age groups
Hepatic disease can impact dose
The Correct Answer is C
Choice A reason: Renal disease affects drug clearance, particularly for psychopharmacological medications like lithium, which is renally excreted. Impaired renal function can lead to toxicity, necessitating dose adjustments or alternative drugs. This statement is accurate, as renal function is critical in tailoring psychotropic therapy to ensure safety and efficacy.
Choice B reason: Many psychopharmacological drugs, like SSRIs, are metabolized by cytochrome P450 enzymes, leading to potential drug interactions. Inhibitors or inducers of these enzymes can alter medication levels, affecting efficacy or toxicity. This statement is accurate, as P450 interactions are a key consideration in psychotropic prescribing.
Choice C reason: Psychopharmacological dosing varies significantly across age groups. Elderly patients often require lower doses due to slower metabolism and higher sensitivity, while children’s doses are weight-based. This statement is inaccurate, as age-specific dosing adjustments are essential to prevent adverse effects and ensure therapeutic efficacy.
Choice D reason: Hepatic disease impacts drug metabolism, particularly for psychotropics like antipsychotics or SSRIs, which are hepatically cleared. Liver dysfunction can increase drug levels, risking toxicity, requiring dose adjustments. This statement is accurate, as hepatic function is a critical factor in psychopharmacological dosing and safety.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Excessive bile acid absorption, often due to ileal dysfunction, reduces bile acid availability in the gallbladder, promoting cholesterol supersaturation and gallstone formation. This contributes to cholelithiasis, particularly cholesterol gallstones, by altering bile composition, making this condition a significant risk factor, not the least likely.
Choice B reason: Elevated serum calcium (hypercalcemia) is not directly linked to cholelithiasis. While hypercalcemia can cause kidney stones, gallstone formation is driven by bile composition changes, like cholesterol or bile acid imbalances, not serum calcium levels. This makes it the least likely contributor to gallstone development.
Choice C reason: Elevated dietary cholesterol increases hepatic cholesterol secretion into bile, leading to supersaturation and cholesterol gallstone formation. This is a well-established risk factor for cholelithiasis, as excess cholesterol overwhelms bile acid and phospholipid solubilization, promoting crystal formation, making it a significant contributor, not the least likely.
Choice D reason: Inflammation of epithelial tissue, such as in chronic cholecystitis, promotes gallstone formation by altering gallbladder motility and bile stasis. Inflammatory changes disrupt bile acid metabolism and increase mucin production, facilitating stone nucleation. This condition is a known risk factor for cholelithiasis, not the least likely contributor.
Correct Answer is A
Explanation
Choice A reason: Obesity significantly increases the risk of type 2 diabetes mellitus by promoting insulin resistance. Excess adipose tissue, particularly visceral fat, releases free fatty acids and cytokines, impairing glucose uptake in cells. This leads to hyperglycemia and beta-cell dysfunction, with obese individuals having a 5-10 times higher risk of developing this condition.
Choice B reason: Hypothyroidism is less directly linked to obesity than type 2 diabetes. While it can cause weight gain due to slowed metabolism, obesity is not a primary risk factor for hypothyroidism. Thyroid dysfunction arises more from autoimmune or iodine-related causes, making it a less likely complication compared to diabetes.
Choice C reason: Osteoporosis risk is not strongly associated with obesity. Excess body weight may increase bone density due to mechanical loading, but it does not directly cause bone loss. Obesity-related inflammation may have minor effects, but type 2 diabetes poses a far greater risk due to metabolic changes.
Choice D reason: Migraine headaches are not a primary complication of obesity. While obesity may exacerbate migraines through inflammatory pathways or comorbidities like sleep apnea, the association is weaker than with type 2 diabetes. Metabolic and insulin-related effects of obesity make diabetes the most significant and direct risk.
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