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 B
Explanation
A. "I will take my Furosemide whenever I notice swelling in my legs.": Furosemide should be taken regularly as prescribed, not just in response to symptoms. Intermittent use can lead to inconsistent fluid management and worsening of heart failure.
B. "I should take my Furosemide in the morning to avoid waking up frequently at night to urinate.". Furosemide is a loop diuretic that increases urine output. Taking it in the morning helps avoid nocturia, improving sleep quality while maintaining its therapeutic effects.
C. "It doesn't matter what time I take my Furosemide as long as I take it with food.": While food may reduce gastric irritation, the timing of diuretics is important due to their impact on urination. Random timing can cause sleep disturbances or inadequate symptom control.
D. "I will take my Furosemide at bedtime to prevent swelling overnight.": Taking Furosemide at bedtime increases the risk of nocturia and disrupted sleep. It does not specifically target overnight swelling and is not recommended for nighttime dosing.
Correct Answer is ["15"]
Explanation
Desired dose = 15 mg
Available concentration = 1 mg per 1 mL (or 1 mg/mL)
Volume to administer (mL) = Desired dose (mg) / Available concentration (mg/mL)
= 15 mg / 1 mg/mL
= 15 mL
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