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?
Atorvastatin
Losartan
Vancomycin
Aspirin
The Correct Answer is C
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. "Vomiting blood or material that looks like coffee grounds is a serious sign that I need to go to the emergency room." This is a correct understanding. Vomiting blood or coffee-ground material is a sign of gastrointestinal bleeding and requires immediate medical attention.
B. "If I experience severe abdominal pain, I should take an over-the-counter antacid and rest."
Taking an over-the-counter antacid without contacting a healthcare provider for severe pain could mask serious complications, such as recurrent bleeding or perforation, that need immediate medical attention. This statement indicates a need for further teaching.
C. "I should avoid taking NSAIDs like ibuprofen as they can increase my risk of bleeding." This is a correct understanding, as NSAIDs can cause or worsen gastric ulcers and increase the risk of bleeding.
D. "I should immediately report any black, tarry stools to my healthcare provider."This is a correct understanding. Black, tarry stools (melena) indicate upper gastrointestinal bleeding.
Correct Answer is C
Explanation
A. Hypervolemia: This is unlikely during the diuretic phase, as the patient is typically losing large volumes of fluid.
B. Hyperkalemia: Hyperkalemia is more common in the oliguric phase of ATN, not the diuretic phase, when potassium levels usually decrease due to fluid loss.
C. Hypernatremia: During the diuretic phase of ATN, the kidneys start to recover but may not be able to concentrate urine effectively, leading to large volumes of dilute urine. This can result in fluid and electrolyte imbalances, particularly hypernatremia (high sodium levels) due to excessive fluid loss.
D. Hypertension: Hypotension is more likely due to excessive fluid loss during the diuretic phase, not hypertension.
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