Lorazepam can be safely used as a preanesthetic medication in a patient undergoing liver transplantation without fear of excessive CNS depression because the drug is

Correct Answer: C

Rationale: Lorazepam is a benzodiazepine commonly used as a preanesthetic medication due to its anxiolytic and sedative properties. In patients undergoing liver transplantation, where hepatic function is compromised, drugs that rely on liver metabolism could accumulate and cause excessive central nervous system depression. Lorazepam's key advantage lies in its pharmacokinetic profile: it undergoes glucuronidation, a conjugation process that occurs outside the liver, primarily in the kidneys. This extrahepatic metabolism ensures that its clearance is less affected by liver dysfunction, reducing the risk of prolonged or excessive sedation. Unlike other benzodiazepines that depend heavily on hepatic cytochrome P450 enzymes, lorazepam's metabolism is more predictable in such patients, making it a safer choice. Excretion in unchanged form or secretion into the GI tract does not apply, and while it is anxiolytic, it does have CNS depressant effects, ruling out other options. Naloxone reverses opioids, not benzodiazepines.

Correct Answer: D

Rationale: Antilipemic therapy is used to lower cholesterol levels in the blood. This type of therapy often places a strain on the liver as it metabolizes and processes the cholesterol-lowering medications. Therefore, patients receiving antilipemic therapy are at an increased risk of developing liver dysfunction. The nurse should monitor the patient closely for signs and symptoms of liver dysfunction, such as jaundice, abdominal pain, nausea, vomiting, and changes in liver function tests. Early detection and intervention can help prevent serious complications associated with liver dysfunction.

Correct Answer: A

Rationale: When a client receives total parenteral nutrition (TPN), monitoring blood glucose levels is critical due to the high glucose content in TPN solutions, which can lead to hyperglycemia. This condition arises because TPN delivers concentrated nutrients directly into the bloodstream, bypassing the digestive system, and the body may struggle to regulate sugar levels effectively without proper insulin response. Potassium levels, while important in overall electrolyte balance, are less immediately impacted by TPN compared to glucose, as potassium imbalances typically develop over time rather than acutely from TPN initiation. Mental status assessments are valuable for neurological conditions but lack direct relevance to TPN's metabolic effects. Similarly, blood pressure monitoring is essential for cardiovascular health but isn't the primary concern with TPN, as it doesn't directly influence hypertension or hypotension in the same way glucose dysregulation does. The focus on glucose stems from its rapid impact on the client's metabolic state, making it the priority assessment to prevent complications like hyperglycemia, which can escalate to severe outcomes if unaddressed. Regular monitoring ensures timely intervention, aligning with TPN's nutritional goals.

Correct Answer: C

Rationale: Flumazenil is the specific antidote for Alprazolam, which is a benzodiazepine sedative-hypnotic drug. Flumazenil works by competitively inhibiting the actions of benzodiazepines at the benzodiazepine receptor site on the gamma-aminobutyric acid (GABA) receptor complex. It effectively reverses the sedative effects of benzodiazepines like Alprazolam, making it the appropriate antidote in cases of benzodiazepine overdose or toxicity. The other options provided (Physostigmine, Protamine sulfate, and Acetylcysteine) are unrelated to Alprazolam and are not indicated as antidotes for this specific drug.

Correct Answer: C

Rationale: Lorazepam is a benzodiazepine commonly used as a preanesthetic medication due to its anxiolytic and sedative properties. In patients undergoing liver transplantation, where hepatic function is compromised, drugs that rely on liver metabolism could accumulate and cause excessive central nervous system depression. Lorazepam's key advantage lies in its pharmacokinetic profile: it undergoes glucuronidation, a conjugation process that occurs outside the liver, primarily in the kidneys. This extrahepatic metabolism ensures that its clearance is less affected by liver dysfunction, reducing the risk of prolonged or excessive sedation. Unlike other benzodiazepines that depend heavily on hepatic cytochrome P450 enzymes, lorazepam's metabolism is more predictable in such patients, making it a safer choice. Excretion in unchanged form or secretion into the GI tract does not apply, and while it is anxiolytic, it does have CNS depressant effects, ruling out other options. Naloxone reverses opioids, not benzodiazepines.