Which of the following best describes how grapefruit juice typically interacts with medications?

It increases the metabolism of drugs in the liver

It decreases the absorption of medications

It only affects medications taken in the morning

It blocks the action of enzymes, leading to increased drug levels in the blood

Answer and Explanation

The Correct Answer is D

A. It increases the metabolism of drugs in the liver: Grapefruit juice actually inhibits, rather than increases, the activity of liver enzymes particularly CYP3A4 resulting in slower drug metabolism and higher plasma concentrations of certain medications.
B. It decreases the absorption of medications: Grapefruit juice does not generally reduce drug absorption. In fact, by inhibiting intestinal enzymes, it can increase the absorption and bioavailability of some drugs, potentially raising them to toxic levels.
C. It only affects medications taken in the morning: The interaction is not time-specific. Grapefruit juice can affect drug metabolism even when consumed hours apart from the medication, as enzyme inhibition can persist for up to 24–72 hours.
D. It blocks the action of enzymes, leading to increased drug levels in the blood: Grapefruit juice inhibits cytochrome P450 enzymes especially CYP3A4 in the intestinal wall. This results in decreased drug breakdown and higher systemic concentrations, increasing the risk of adverse effects and toxicity.

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Correct Answer is B

Explanation

A. Apply the drops directly onto the patient's cornea: Eye drops should be instilled into the conjunctival sac, not directly onto the cornea. The cornea is highly sensitive, and direct application can cause discomfort, injury, and decreased patient adherence.
B. Perform punctal occlusion after instilling the drops: Punctal occlusion (gentle pressure on the inner corner of the eye) for 1–2 minutes reduces systemic absorption of the drug via the nasolacrimal duct. This is especially important with beta-blockers like Timolol, which can cause systemic effects such as bradycardia and hypotension.
C. Administer the medication immediately after meals: The timing of Timolol eye drops is not dependent on meals. Food intake has no impact on the efficacy or absorption of ophthalmic medications.
D. Instruct the patient to blink rapidly after instillation: Blinking rapidly can cause the medication to be expelled from the eye, reducing its effectiveness. Patients should be instructed to gently close the eye for a minute or two to enhance absorption.

A. "Barbiturates carry a higher risk of dependence and overdose compared to other sedative-hypnotics." B. "Barbiturates are more expensive than newer medications like benzodiazepines, which limits their use." C. "Barbiturates have been replaced because they are less effective than over-the-counter sleep aids." D. "Barbiturates are safer for long-term use compared to other sedatives, but they have limited availability."

Correct Answer is A

Explanation

A. "Barbiturates carry a higher risk of dependence and overdose compared to other sedative-hypnotics.": Barbiturates have a narrow therapeutic index, and overdose can lead to fatal respiratory depression. Their high abuse potential and severe withdrawal symptoms make them less favorable than safer alternatives like benzodiazepines.
B. "Barbiturates are more expensive than newer medications like benzodiazepines, which limits their use.": Cost is not the primary reason for their reduced use. In fact, many barbiturates are inexpensive. Their safety profile and high risk of fatal overdose are the major concerns.
C. "Barbiturates have been replaced because they are less effective than over-the-counter sleep aids.": Barbiturates are actually very potent sedative-hypnotics. However, their risks outweigh their benefits. OTC sleep aids are less effective but considered safer for short-term use.
D. "Barbiturates are safer for long-term use compared to other sedatives, but they have limited availability.": Barbiturates are not safer for long-term use. They are associated with tolerance, dependence, cognitive impairment, and severe withdrawal, which is why their use has been largely replaced.

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Which of the following best describes how grapefruit juice typically interacts with medications?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer Timolol eye drops to a patient with glaucoma. Which of the following actions should the nurse prioritize when administering this medication?

Correct Answer is B

Explanation

A preceptor is educating a new graduate nurse about barbiturates. The preceptor states, "Barbiturates were once widely used but are now rarely prescribed." Which follow-up statement by the preceptor best explains why barbiturates are not as commonly used today?

Correct Answer is A

Explanation

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