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

Answer and Explanation

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.

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Correct Answer is D

Explanation

A. Apply a heating pad to the abdomen: This is incorrect and potentially harmful, as applying heat to the abdomen can increase blood flow and worsen inflammation or risk rupture of the appendix.

B. Administer a cleansing enema: Enemas should not be administered for suspected appendicitis as they may cause irritation and increase the risk of perforation.

C. Administer oral analgesics as needed: Oral analgesics are contraindicated since the patient should be NPO, and strong pain relief might mask the symptoms of a ruptured appendix.

D. Place the patient on NPO status: The highest priority preoperative intervention is to place the patient on NPO (nothing by mouth) status to prevent aspiration during anesthesia, a standard preoperative practice, especially for abdominal surgeries.

A. "You will need to avoid high-fiber foods to prevent blockages. B. The output from your stoma will be mostly liquid." C. "You will need to change your colostomy bag every 24 hours." D. “Your stoma will be located on the left side of your abdomen."

Correct Answer is D

Explanation

A. "You will need to avoid high-fiber foods to prevent blockages": While caution with high-fiber foods may be needed initially, long-term, a balanced diet including fiber can help regulate bowel movements and prevent constipation. This statement could cause unnecessary concern.

B. "The output from your stoma will be mostly liquid": This statement is incorrect for a sigmoid colostomy, where the stool tends to be more formed since it is further along the digestive tract. Liquid output is more common with ileostomies or colostomies higher in the colon.

C. "You will need to change your colostomy bag every 24 hours":
Rationale: Colostomy bag changes depend on several factors, including the type of appliance and personal preferences. Bags are not changed on a strict 24-hour schedule but are emptied as needed and changed every few days or when required.

D. "Your stoma will be located on the left side of your abdomen." A sigmoid colostomy is typically located on the left lower quadrant of the abdomen, as this is the anatomical location of the sigmoid colon.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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

Correct Answer is D

Explanation

A nurse is assisting with teaching a client who is preoperative for a sigmoid colostomy. Which of the following statements should the nurse include?

Correct Answer is D

Explanation

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