A 70-year-old man with a history of osteoarthritis has been taking Ibuprofen 600 mg three times daily for chronic knee pain. During a routine check-up, his blood pressure is found to be elevated at 160/95 mmHg, up from his usual 135/85 mmHg. Laboratory tests reveal an elevation in his kidney function tests and serum potassium level. Which of the following adverse effects of NSAIDS best explains these findings?
Cardiotoxicity
Nephrotoxicity
Neurotoxicity
Hepatotoxicity
The Correct Answer is B
A. Cardiotoxicity: While NSAIDs can contribute to cardiovascular risks such as hypertension and fluid retention, nephrotoxicity is the more direct explanation for the elevated kidney function tests and potassium level. Cardiotoxicity typically presents with symptoms like heart failure or arrhythmias rather than kidney-related lab abnormalities.
B. Nephrotoxicity: NSAIDs inhibit prostaglandin synthesis, which plays a key role in maintaining renal blood flow, especially in older adults or those with preexisting renal impairment. Chronic NSAID use can reduce glomerular filtration, leading to elevated creatinine, hyperkalemia, and worsening blood pressure control, all of which are evident in this patient.
C. Neurotoxicity: Neurotoxic effects are not commonly associated with NSAID use. Symptoms of neurotoxicity include confusion or seizures, which are not relevant to the clinical findings in this scenario.
D. Hepatotoxicity: NSAID-induced liver injury is rare and would typically present with elevated liver enzymes (AST, ALT), not elevated creatinine or potassium. The current lab findings and blood pressure changes are more consistent with kidney involvement.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["12.5"]
Explanation
Desired dose = 25 mg
Available concentration = 10 mg per 5 mL
- Calculate the concentration in mg/mL:
Concentration (mg/mL) = Available dose / Available volume
= 10 mg / 5 mL
= 2 mg/mL
Volume to administer = Desired dose / Available concentration
= 25 mg / 2 mg/mL
= 12.5 mL
Correct Answer is B
Explanation
A. To decrease the cost of medication for the patient: While cost may be a consideration in long-term therapy, it is not the primary reason for tapering corticosteroids. The tapering process is necessary to protect the patient’s physiological balance, not driven by cost concerns.
B. To prevent the risk of acute adrenal insufficiency: Long-term prednisone use suppresses the hypothalamic-pituitary-adrenal (HPA) axis. Abrupt discontinuation can lead to adrenal insufficiency, a potentially life-threatening condition characterized by hypotension, fatigue, and electrolyte imbalances. Gradual tapering allows the adrenal glands to resume natural cortisol production.
C. To minimize the potential for drug interactions: Tapering does not reduce drug interactions. Such risks are managed through medication reconciliation and monitoring, not by adjusting steroid taper schedules.
D. To reduce the likelihood of rheumatoid arthritis flare-up: While tapering may reduce flare risk, the primary concern is adrenal suppression. Flare prevention is managed with other disease-modifying agents rather than the tapering schedule alone.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.