A nurse is reviewing provider prescriptions for a client who has reduced kidney function. Which of the following prescribed diagnostics should the nurse question?

CT scan with contrast

Magnetic resonance imaging (MRI) of the abdomen

Kidney ureter, bladder (KUB) radiograph

Renal ultrasound

Answer and Explanation

The Correct Answer is A

A. A CT scan with contrast uses iodinated contrast dye, which can be nephrotoxic and worsen kidney function. This prescription should be questioned or done with caution in clients with reduced kidney function.
B. MRI of the abdomen typically uses gadolinium-based contrast, which is generally safer but still used cautiously; however, MRI without contrast is often safe.
C. A KUB radiograph is an X-ray without contrast and is safe for clients with kidney impairment.
D. A renal ultrasound is a non-invasive, contrast-free diagnostic tool and is safe for clients with reduced kidney function.

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Correct Answer is B

Explanation

A. Oxygen via nasal cannula at 10 L/min is too high for COPD clients and may suppress their respiratory drive; oxygen should be administered cautiously, usually starting at low flow (1–3 L/min) and titrated to maintain target saturation (usually 88-92%).
B. Administering a bronchodilator is appropriate to relieve bronchospasm and improve airflow during a COPD exacerbation.
C. Loop diuretics are not first-line treatment for COPD exacerbations unless there is concurrent fluid overload or heart failure.
D. The lateral recumbent position is not standard for COPD exacerbations; clients typically benefit from sitting upright or semi-Fowler’s position to ease breathing.

A. Ibuprofen B. Captopril C. Phenytoin D. Digoxin

Correct Answer is A

Explanation

A. Ibuprofen, like naproxen, is a nonsteroidal anti-inflammatory drug (NSAID). Taking two NSAIDs together increases the risk of gastrointestinal bleeding.
B. Captopril is an ACE inhibitor and does not directly increase the risk for bleeding when combined with naproxen.
C. Phenytoin is an anticonvulsant and does not interact with naproxen to increase bleeding risk.
D. Digoxin is a cardiac glycoside and also does not increase bleeding risk with naproxen.

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A nurse is reviewing provider prescriptions for a client who has reduced kidney function. Which of the following prescribed diagnostics should the nurse question?

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