A 55-year-old patient admitted with an abrupt onset of jaundice and nausea has abnormal liver function studies but serologic testing is negative for viral causes of hepatitis. Which question by the nurse is most appropriate?
a. "Is there any history of IV drug use?"
b. "Do you use any over-the-counter drugs?"
c. "Are you taking corticosteroids for any reason?"
d. "Have you recently traveled to a foreign country?"
b. "Do you use any over-the-counter drugs?"
The patient's symptoms, lack of antibodies for hepatitis, and the abrupt onset of symptoms suggest toxic hepatitis, which can be caused by commonly used over-the-counter drugs such as acetaminophen (Tylenol). Travel to a foreign country and a history of IV drug use are risk factors for viral hepatitis. Corticosteroid use does not cause the symptoms listed.
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