A male presents to the emergency department with confusion, lethargy, and a decreased level of consciousness. His friends report that he ingested a large quantity of unknown pills in a suicide attempt. Laboratory results reveal severe metabolic acidosis, high anion gap, and elevated serum creatinine. Which of the following is the most urgent indication for initiating dialysis in this patient?

Overdose

Chronic Kidney Disease

Hypertension

Dehydration

Answer and Explanation

The Correct Answer is A

A. Overdose: The patient has ingested a large quantity of unknown pills, leading to severe metabolic acidosis, high anion gap, and possible toxic accumulation. Dialysis is often indicated to clear toxins in the case of overdose, especially if renal function is impaired (as indicated by elevated creatinine).

B. Chronic Kidney Disease: While chronic kidney disease may eventually require dialysis, the acute overdose and metabolic acidosis are the more immediate concerns requiring urgent dialysis.

C. Hypertension: Hypertension may require management, but it is not the primary reason to initiate urgent dialysis in this scenario. The overdose and metabolic acidosis take precedence.

D. Dehydration: Dehydration alone does not necessitate dialysis. However, the overdose, metabolic acidosis, and renal impairment are the critical reasons for initiating dialysis.

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Correct Answer is C

Explanation

A. Atorvastatin: Atorvastatin is a statin used to manage cholesterol levels. It is generally safe for use in patients with CKD.

B. Losartan: Losartan is an angiotensin II receptor blocker (ARB) used to manage hypertension and protect the kidneys in diabetic nephropathy. It can be beneficial in CKD patients.

C. Vancomycin: Vancomycin is an antibiotic known to be nephrotoxic, especially in patients with compromised kidney function. It should be used with caution or avoided in patients with CKD.

D. Aspirin: While aspirin can have adverse effects on the kidneys at high doses, its nephrotoxic potential is lower than that of vancomycin. In low doses, aspirin is commonly used for cardiovascular protection, even in patients with CKD.

A. Dehydration B. Hyperkalemia C. Iron-deficiency anemia D. Electrolyte imbalance

Correct Answer is C

Explanation

A. Dehydration: While dehydration is a possible complication in ulcerative colitis, it does not explain the symptoms of fatigue and pallor.

B. Hyperkalemia: Hyperkalemia is not typically associated with chronic blood loss and would present with symptoms like muscle weakness or arrhythmias.

C. Iron-deficiency anemia: Chronic blood loss from frequent diarrhea and ulceration of the colon in ulcerative colitis can lead to iron-deficiency anemia, causing symptoms like fatigue, dizziness, and pallor.

D. Electrolyte imbalance: While electrolyte imbalances may occur with ulcerative colitis, they do not directly cause fatigue, dizziness, and pallor related to chronic blood loss.

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Naxlex Comprehensive Predictor Exams

A patient with chronic kidney disease (CKD) is being evaluated for medication management. Which of the following medications should be avoided due to its potential nephrotoxic effects?

Correct Answer is C

Explanation

A patient with a history of ulcerative colitis presents to the clinic with complaints of fatigue, dizziness, and pallor. Upon further assessment, you suspect chronic blood loss. Which potential complication is most likely contributing to these symptoms?

Correct Answer is C

Explanation

A patient with suspected appendicitis is being prepared for surgery. Which of the following preoperative interventions should the nurse prioritize?

A nurse is caring for a client admitted for renal calculus. Which of the following assessment findings should the nurse associate with renal calculi? (Select All that Apply.)

A male patient presents with complaints of chronic stomach pain and is diagnosed with a Helicobacter pylori infection. The physician decides to initiate triple therapy. Which combination of medications is most appropriate for this treatment?

A nurse practicing population health works for a local hospital's weight-loss program for bariatric patients. After assisting to implement various health-style changes in their care plans, which of the following findings would indicate to the nurse that the interventions are working?

A patient with ascites has been admitted to your unit. Which of the following safety precautions should you reinforce to prevent complications?

During the process of collecting a comprehensive medical history from a client who has been admitted with pyelonephritis, which of the following symptoms or historical details would the nurse most likely expect the client to report?

A patient with a history of ulcerative colitis presents to the emergency department with severe abdominal pain, frequent bloody diarrhea, and signs of dehydration. Which medication should the nurse anticipate administering during this exacerbation of ulcerative colitis?

A nurse is assessing an older adult client who has a urinary tract infection (UTI). Which of the following findings should the nurse identify as unique for this age group?