A client is admitted with a blood alcohol level of 180mg/dl. The nurse recognizes that the alcohol in the client's system should be fully metabolized within?

1. A

   3 hours

2. B

   5 hours

3. C

   7 hours

4. D

   9 hours

Appeared in: DHS 2018 shift 1st

Explanation

• Alcohol metabolism follows zero-order kinetics, meaning a constant amount is cleared per hour, regardless of the blood concentration.
• The average rate of alcohol clearance from the blood is approximately 15 to 20 mg/dL per hour.
• To calculate the time for complete metabolism, the total blood alcohol level is divided by the hourly rate: 180 mg/dL ÷ 20 mg/dL per hour = 9 hours.

Why Other Options Were Wrong

• Option A: In 3 hours, only about 60 mg/dL of alcohol would be metabolized (3 hours × 20 mg/dL/hr), which is insufficient to clear the total amount.
• Option B: In 5 hours, only about 100 mg/dL of alcohol would be metabolized (5 hours × 20 mg/dL/hr), leaving 80 mg/dL remaining.
• Option C: In 7 hours, only about 140 mg/dL of alcohol would be metabolized (7 hours × 20 mg/dL/hr), leaving 40 mg/dL remaining.

Related Visual

Clinical Relevance

• Nursing practice connection: Use the key finding related to Alcohol Metabolism and Clearance Time to guide bedside assessment, documentation, and the next nursing action.
• Nurses must understand alcohol clearance time to anticipate the duration of intoxication, monitor for complications like respiratory depression and hypoglycemia, and predict the potential onset of withdrawal symptoms as the blood alcohol level falls.
• This knowledge is crucial for patient education, especially regarding safe driving limits and the lingering effects of alcohol long after the last drink.
• What if the patient was a chronic alcoholic with liver disease? Severe liver cirrhosis would impair metabolism, significantly prolonging the clearance time, making the standard calculation unreliable and increasing the risk of prolonged toxicity.

How to Approach the Question

• Identify the question as a calculation problem based on a physiological rate.
• Recall the standard rate of alcohol metabolism, which follows zero-order kinetics at approximately 15-20 mg/dL per hour.
• Note the client's initial blood alcohol level (BAL) provided in the stem: 180 mg/dL.
• Set up the division: Time = Total BAL / Rate of Metabolism.
• Perform the calculation using the rate that provides a match with the options: 180 mg/dL ÷ 20 mg/dL/hr = 9 hours.
• Select the option that matches your calculated result.

Concept Tested & Keywords

• Concept Tested: Alcohol Metabolism and Clearance Time
• Stem keywords: blood alcohol level, 180mg/dl, metabolized
• Lead-in keywords: fully metabolized within
• Negative lead-in flag: false

Question ID

QnDxbO0oD4qppw7aYKePTd

Copy ID

Reference Book

E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 4209-4211