A nurse is caring for a client diagnosed with chronic renal disease. The nurse should recognize that which of the following medications is contraindicated for clients with chronic renal disease?

Docusate Sodium (Colace)

Acetaminophen (Tylenol)

Meperidine (Demerol)

Atorvastatin (Lipitor)

Answer and Explanation

The Correct Answer is C

A.   Docusate Sodium (Colace) is a stool softener and is not contraindicated in chronic renal disease.
B.   Acetaminophen (Tylenol) is generally safe for use in chronic renal disease, but dosing adjustments may be necessary based on renal function.
C.   Meperidine (Demerol) is contraindicated in clients with chronic renal disease because its metabolites can accumulate in renal impairment, leading to neurotoxicity and seizures. It is often replaced with alternative opioid analgesics like morphine or fentanyl in these patients.
D.   Atorvastatin (Lipitor) is a statin medication used to lower cholesterol levels and is generally safe in chronic renal disease, although dosing adjustments may be needed depending on the severity of renal impairment.

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Correct Answer is ["A","D","E"]

Explanation

A. Confusion and restlessness: Confusion and restlessness can indicate changes in cerebral perfusion as the body begins to shut down. These signs may occur as death approaches.

B. Increased appetite and thirst: Increased appetite and thirst are less likely as death approaches.

In fact, clients often have decreased appetite and thirst as the body's systems slow down.

C. Increase in urinary and bowel output: As death approaches, urinary and bowel output typically decrease as the body's metabolic processes slow down.

D. Increased fatigue and sleep: Increased fatigue and sleepiness are common as death approaches. The body's energy levels decrease, leading to increased periods of sleep and rest.

E. Excess secretions in the throat and decrease swallow reflex: Excess secretions in the throat and a decrease in the swallow reflex can occur as the body's ability to manage secretions diminishes. This can lead to a gurgling sound in the throat known as the death rattle.

A. Recovery phase. B. Diuretic phase. C. Initiation phase. D. Oliguric phase. E. End phase.

Correct Answer is ["A","B","C","D"]

Explanation

A. Recovery phase: The recovery phase occurs after the oliguric phase and is characterized by the gradual improvement of renal function. During this phase, diuresis may occur as the kidneys begin to excrete waste and excess fluid more effectively.

B. Diuretic phase: The diuretic phase follows the oliguric phase and is characterized by increased urine output as the kidneys start to recover and regain their ability to concentrate urine. This phase can lead to electrolyte imbalances and dehydration if not managed properly.

C. Initiation phase: The initiation phase marks the onset of acute renal failure and is characterized by the initial insult or injury to the kidneys. This phase may be triggered by various factors such as hypotension, nephrotoxic medications, or sepsis.

D. Oliguric phase: The oliguric phase is the initial phase of acute renal failure and is characterized by decreased urine output (<400 mL/day). During this phase, waste products and electrolytes may accumulate in the body, leading to metabolic acidosis and fluid overload.

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A nurse is caring for a client diagnosed with chronic renal disease. The nurse should recognize that which of the following medications is contraindicated for clients with chronic renal disease?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is receiving hospice care in the home. The family asks, "how will we know when death is near?" The nurse should inform the family that which of the following signs indicates that death is approaching? (Select all that apply.)

Correct Answer is ["A","D","E"]

Explanation

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Explanation

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