A nurse is reviewing a medication reconciliation for an 80-year-old client with renal disease. Which medication should the nurse be most concerned about?
Digoxin.
Levothyroxine.
Motrin.
Tylenol.
The Correct Answer is C

Motrin is a brand name for ibuprofen, which is a nonsteroidal anti-inflammatory drug (NSAID). NSAIDs can cause renal toxicity, especially in older adults and patients with renal disease.
Therefore, the nurse should be most concerned about this medication and its potential adverse effects on the patient’s kidney function.
Choice A is wrong because digoxin is a cardiac glycoside that is used to treat heart failure and atrial fibrillation. Digoxin has a narrow therapeutic index and can cause toxicity if the dose is too high or if the patient has hypokalemia. However, digoxin does not directly affect the kidneys and can be safely used in patients with renal disease if the dose is adjusted according to the patient’s creatinine clearance.
Choice B is wrong because levothyroxine is a synthetic thyroid hormone that is used to treat hypothyroidism. Levothyroxine does not have any major interactions with the kidneys and can be used in patients with renal disease without dose adjustment.
Choice D is wrong because Tylenol is a brand name for acetaminophen, which is an analgesic and antipyretic drug. Acetaminophen does not have any anti-inflammatory effects and does not affect the kidneys at therapeutic doses. However, acetaminophen can cause hepatotoxicity if the dose exceeds 4 g per day or if the patient has liver disease or alcohol abuse.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
This is because gelatin is a low-fat dessert that contains only 0.1 grams of fat per cup.
It is also low in calories and can be flavored with fruit juice or fresh fruits for added nutrition.
Choice A is wrong because a slice of fruit pie contains about 14 grams of fat per slice, which is high for a low-fat diet.
Fruit pies also have added sugar and refined flour that can increase the calorie intake.
Choice C is wrong because a bran muffin contains about 9 grams of fat per muffin, which is also high for a low-fat diet.
Bran muffins may have some fiber benefits, but they also have added sugar and oil that can make them less healthy.
Choice D is wrong because one plain doughnut contains about 11 grams of fat per doughnut, which is also high for a low-fat diet.
Doughnuts are deep-fried and have a lot of sugar and refined flour that can contribute to weight gain and health problems.
Some other examples of low-fat dessert choices are sorbet, fruit salad, yogurt, pudding, and angel food cake.
These desserts are lower in fat and calories than pies, muffins, and doughnuts, and can satisfy a sweet tooth without compromising the dietary instructions.
Correct Answer is ["B","C"]
Explanation
The nurse should use clarifying points made by the patient that are unclear and listening attentively while speaking slowly and clearly as communication techniques when performing a health history.
These techniques help the nurse to gather accurate and comprehensive information from the patient and to establish rapport and trust.
Choice A is wrong because avoiding silences can make the patient feel rushed or interrupted. Silences can be useful to allow the patient to think or express emotions.
Choice D is wrong because sitting approximately two feet away from the client may be too close and invade the personal space of the client. The nurse should maintain a comfortable distance of about 4 to 5 feet from the client, depending on the cultural norms and preferences of the client.
Choice E is wrong because asking the family member to complete the written form may not reflect the true health history of the client. The nurse should obtain the information directly from the client whenever possible, unless the client is unable or unwilling to provide it.
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