A client with type 2 diabetes who has been prescribed metformin. The client asks the nurse how the medication will affect their kidneys. What is the nurse’s most appropriate response?
Metformin is generally safe for the kidneys but requires monitoring in case of renal impairment
Metformin is nephrotoxic and can directly damage your kidneys over time
Metformin increases the risk of kidney stones due to changes in urine composition
Metformin has no effect on the kidneys and does not require monitoring
The Correct Answer is A
Choice A reason: Metformin is safe for kidneys in patients with normal renal function but is excreted renally, requiring monitoring in chronic kidney disease (CKD). Reduced glomerular filtration rate (GFR) can lead to metformin accumulation, increasing lactic acidosis risk. Regular renal function tests (e.g., creatinine, GFR) are needed, making this statement accurate.
Choice B reason: Metformin is not nephrotoxic; it does not directly damage kidneys. Its primary risk in renal impairment is lactic acidosis due to reduced clearance, not direct toxicity. This statement is inaccurate, as metformin is generally renal-safe when monitored appropriately in patients with adequate kidney function.
Choice C reason: Metformin does not increase kidney stone risk. It lowers blood glucose by reducing hepatic gluconeogenesis and improving insulin sensitivity, without altering urinary composition linked to stones. Kidney stones are more associated with conditions like hyperuricemia or dehydration, making this statement inaccurate for metformin’s effects.
Choice D reason: Metformin requires renal function monitoring, as it is cleared by the kidneys. In renal impairment, accumulation can cause lactic acidosis, a rare but serious complication. This statement is inaccurate, as monitoring (e.g., eGFR) is essential to ensure safe use, especially in patients with kidney disease risk.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Elevated rheumatoid factor (RF), an autoantibody, is present in 70-80% of rheumatoid arthritis (RA) patients. It contributes to immune complex formation, driving synovial inflammation and joint damage. This lab result is a key diagnostic marker, making it consistent with RA and critical for confirming the diagnosis.
Choice B reason: Decreased C-reactive protein (CRP) is inconsistent with RA, which typically shows elevated CRP due to systemic inflammation. CRP reflects acute-phase response in active RA, and low levels suggest inactive disease or another condition, making this result inaccurate for supporting an RA diagnosis.
Choice C reason: Normal erythrocyte sedimentation rate (ESR) is not typical in active RA, where ESR is elevated due to inflammation-driven increases in plasma proteins. Normal ESR may occur in remission but does not support an active RA diagnosis, making this result inconsistent with the condition.
Choice D reason: Low antinuclear antibody (ANA) levels are not specific to RA and are more associated with systemic lupus erythematosus. While some RA patients may have low ANA, it is not a diagnostic marker for RA, making this result irrelevant and inconsistent with confirming rheumatoid arthritis.
Correct Answer is B
Explanation
Choice A reason: Melena, dark tarry stools from digested blood, indicates upper gastrointestinal bleeding, not typically GERD. GERD involves acid reflux causing esophageal irritation, not bleeding severe enough for melena. This statement is inaccurate, as melena is more associated with ulcers or varices, not reflux disease.
Choice B reason: Heartburn, a burning sensation in the chest, is a hallmark of GERD, caused by stomach acid refluxing into the esophagus, irritating the mucosa. It results from lower esophageal sphincter dysfunction, allowing acid backflow. This statement is accurate, as heartburn is a primary diagnostic symptom of GERD.
Choice C reason: Hematemesis, vomiting blood, is not a common GERD symptom but indicates severe conditions like esophageal varices or ulcers. While chronic GERD may lead to esophagitis, bleeding is rare. This statement is inaccurate, as hematemesis is not a characteristic feature of typical GERD presentations.
Choice D reason: Dysphagia, difficulty swallowing, can occur in severe GERD due to esophageal strictures or motility issues but is not a primary characteristic. Heartburn is more common and diagnostic. This statement is less accurate, as dysphagia is a complication, not a defining feature of GERD.
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.