Which of the following patients is most at risk for liver damage after taking acetaminophen regularly for arthritis pain?

Patient with a history of alcohol abuse and hepatitis C

Patient with COPD and a 20 pack-year history of smoking

Patient with type 2 diabetes and end-stage renal disease

Patient with prostate enlargement and urinary frequency

Answer and Explanation

The Correct Answer is A

Choice A reason: Alcohol and hepatitis C impair liver function; acetaminophen’s metabolite NAPQI accumulates, causing hepatotoxicity in an already compromised organ.

Choice B reason: COPD and smoking affect lungs, not liver; acetaminophen metabolism is minimally impacted, posing lower hepatic risk compared to liver disease states.

Choice C reason: Renal disease affects drug excretion, not liver metabolism; acetaminophen’s hepatic load is unchanged, making liver damage less likely here.

Choice D reason: Prostate issues involve urinary tract; liver metabolism of acetaminophen remains intact, with no heightened risk of hepatotoxicity from this condition.

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Correct Answer is C

Explanation

Choice A reason: Osteoarthritis limits mobility; it doesn’t affect kidney function directly, so nephrotoxic drug clearance remains unchanged, not warranting a dose reduction.

Choice B reason: Diet impacts metabolism slightly; low protein may spare kidneys, but it doesn’t indicate impaired clearance requiring adjustment of nephrotoxic medication.

Choice C reason: Diabetic kidney disease with hypertension impairs filtration; reduced glomerular rate necessitates lower nephrotoxic doses to prevent further renal damage.

Choice D reason: Smoking affects lungs primarily; while it may indirectly harm kidneys, it’s less definitive than diabetic nephropathy for needing a reduced dose.

A. Place the tablet in the patient's mouth next to the cheek. B. Have the patient swallow the tablet with a sip of water. C. Crush the tablet and dissolve it in a teaspoon of water. D. Place the tablet under the patient's tongue.

Correct Answer is D

Explanation

Choice A reason: Positioning the tablet next to the cheek alters absorption and delays onset. Sublingual placement ensures rapid effect.

Choice B reason: Swallowing bypasses sublingual absorption, reducing efficacy. The route is critical for desired therapeutic outcomes.

Choice C reason: Crushing and dissolving disrupts integrity, compromising rapid sublingual absorption. Proper administration maintains efficacy.

Choice D reason: Sublingual placement allows rapid dissolution and absorption via mucous membranes, ensuring swift therapeutic action.

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Which of the following patients is most at risk for liver damage after taking acetaminophen regularly for arthritis pain?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is to administer a nephrotoxic medication to the patient. Which assessment finding indicates to the nurse that the patient should receive a reduced dosage of the drug?

Correct Answer is C

Explanation

How will the nurse administer a nitroglycerin sublingual tablet to the patient?

Correct Answer is D

Explanation

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