A 53-year-old male client who has no prior medical history and takes no medications is in a primary care provider's office for a routine physical. The client states that he has not seen a doctor in "about five years." The client's blood pressure is at the appointment is 157/92 mmHg and his fasting blood glucose is 83 mg/dL. Based on recent lab results, the provider determines that the client's glomerular filtration rate (GFR) is 54 mL/min. The provider diagnoses the client with stage 3a chronic kidney disease (CKD). Based on these findings, which medication should the clinic nurse anticipate will be prescribed for this client?
Gentamicin
Daily potassium supplement
Captopril
Metformin
The Correct Answer is C
A. Gentamicin is an aminoglycoside antibiotic used to treat bacterial infections. It is not appropriate for managing CKD directly and is generally avoided in patients with kidney impairment due to its potential nephrotoxicity.
B. Potassium supplements are typically not recommended unless there is a documented deficiency in potassium. In stage 3a CKD, managing potassium levels is crucial, but supplements are not usually needed unless potassium levels are low.
C. Captopril is an angiotensin-converting enzyme (ACE) inhibitor. ACE inhibitors are beneficial for patients with CKD as they help lower blood pressure and provide renal protective effects. They can reduce proteinuria (protein in urine), which is common in CKD, and may slow the progression of kidney disease.
D. Metformin is an oral medication used to manage type 2 diabetes by improving insulin sensitivity and lowering blood glucose levels. Although it is important to monitor blood glucose in CKD patients, this
client’s fasting blood glucose is within normal range (83 mg/dL), so Metformin is not indicated unless there was evidence of diabetes or significant glucose dysregulation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Calcium gluconate is used to treat or prevent calcium deficiencies and to manage conditions related to calcium imbalances, such as hypocalcemia. It is not typically used to prevent struvite stones.
B. Antibiotics are the most appropriate choice for preventing the recurrence of struvite stones. Since struvite stones are associated with urinary tract infections caused by urease-producing bacteria, antibiotic therapy is aimed at eliminating these infections. By treating or preventing UTIs, the conditions that lead to struvite stone formation are addressed, reducing the likelihood of recurrence.
C. Tamsulosin is an alpha-blocker used to relax the muscles in the prostate and bladder neck to improve urine flow in conditions like benign prostatic hyperplasia (BPH). It is not specifically used for preventing struvite stones.
D. Phosphate binders are used to reduce phosphate levels in the blood, which is important in managing conditions such as chronic kidney disease (CKD) where phosphate levels can be elevated.
Correct Answer is C
Explanation
A. Tolvaptan does not increase the glomerular filtration rate. It actually works by blocking the action of a hormone that causes the kidneys to retain water, leading to increased urine output.
B. While Tolvaptan can slow the progression of polycystic kidney disease (PKD) and delay the need for dialysis or transplant, it does not guarantee prevention of these outcomes.
C. Tolvaptan is used to slow the growth of kidney cysts in patients with PKD.
D. Hyponatremia is a common side effect of Tolvaptan due to increased water loss through urine. However, this is not the primary role.
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