The nurse is administering medications to the patient who is in renal failure resulting from end-stage renal disease.
The nurse is aware that patients with kidney failure would most likely have problems with which pharmacokinetic phase?

Metabolism.

Excretion.

Absorption.

Distribution.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Metabolism is primarily carried out by the liver, involving enzymatic biotransformation of drugs into more hydrophilic metabolites for excretion. While liver function can be impacted by systemic illness, renal failure's direct effect on drug metabolism is less significant than its impact on elimination. The liver's cytochrome P450 system typically remains functional.

Choice B rationale

Excretion is the primary elimination pathway for many drugs and their metabolites, mainly via the kidneys. In end-stage renal disease, glomerular filtration rate and tubular secretion are severely impaired, leading to accumulation of drugs and their toxic metabolites, necessitating dose adjustments or alternative elimination methods. Normal creatinine clearance is 80-120 mL/min.

Choice C rationale

Absorption refers to the movement of a drug from its administration site into the bloodstream. While renal failure can indirectly affect absorption through gastrointestinal changes (e.g., uremia-induced nausea), it is not the primary pharmacokinetic phase directly compromised by impaired kidney function. Bioavailability might be altered but not the fundamental absorption process.

Choice D rationale

Distribution involves the reversible movement of a drug from the systemic circulation into the interstitial and intracellular fluids. Renal failure can impact drug distribution due to fluid imbalances, altered protein binding (e.g., hypoalbuminemia), and changes in tissue perfusion, but it is not the most significant or direct pharmacokinetic impairment compared to excretion.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is C

Explanation

Choice A rationale

Albuterol is a selective beta-2 adrenergic agonist. Its primary action is bronchodilation by stimulating beta-2 receptors in the bronchial smooth muscle, leading to relaxation and widening of the airways. It does not directly suppress the cough reflex, which is a protective mechanism to clear airways. Cough suppression is typically achieved by antitussive medications acting on the central nervous system or peripheral cough receptors.

Choice B rationale

Albuterol is a short-acting beta-agonist (SABA), characterized by a rapid onset of action and relatively short duration (4-6 hours). Therefore, it is used for immediate relief of bronchospasm and acute symptoms of asthma, not for long-term daily maintenance. Long-term maintenance medications include inhaled corticosteroids or long-acting beta-agonists (LABAs) used consistently to control inflammation and prevent exacerbations.

Choice C rationale

Albuterol's rapid onset of action and potent bronchodilatory effects make it the ideal medication for acute relief of bronchospasm in asthma. It is used as a "rescue" inhaler to quickly open airways during an asthma attack or before exercise to prevent exercise-induced bronchospasm. This immediate effect is crucial for alleviating respiratory distress.

Choice D rationale

Post-tussive emesis, or vomiting after coughing, is often a symptom of severe coughing spells. While albuterol can alleviate coughing by reducing bronchospasm, its primary mechanism is not to prevent emesis directly. Emesis is a gastrointestinal reflex; albuterol's action is primarily on the respiratory system. Addressing the underlying cause of severe coughing would indirectly reduce emesis.

Correct Answer is ["2590/2000"]

Explanation

INTAKE:.

Step 1: Jevity (Tube feeding) 50 mL/hr × 12 hours = 600 mL.

Step 2: oz free water tube feeding flush. Convert ounces to milliliters: 6 oz × 30 mL/oz = 180 mL.

Step 3: units of PRBCs (250 mL/each) = 2 × 250 mL = 500 mL.

Step 4: Zosyn IV 50 mL.

Step 5: oz ice chips. Convert ounces to milliliters (ice chips are typically calculated as half their volume in liquid): 4 oz × 30 mL/oz = 120 mL; 120 mL ÷ 2 = 60 mL.

Step 6:.9% NS 100 mL/hr × 12 hours = 1200 mL.

Step 7: Total Intake = 600 mL + 180 mL + 500 mL + 50 mL + 60 mL + 1200 mL = 2590 mL. OUTPUT:.

Step 1: NG Suction: 50 mL.

Step 2: Urine: 1850 mL.

Step 3: Wound vac: 100 mL.

Step 4: Total Output = 50 mL + 1850 mL + 100 mL = 2000 mL. Answer: INTAKE: 2590 mL / OUTPUT: 2000 mL.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

The nurse is administering medications to the patient who is in renal failure resulting from end-stage renal disease. The nurse is aware that patients with kidney failure would most likely have problems with which pharmacokinetic phase?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with asthma is given a prescription for albuterol (a bronchodilator). The nurse should teach the client that this medication:

Correct Answer is C

Explanation

Correct Answer is ["2590/2000"]

Explanation

Which IM injection sites are preferred for the Z-track technique for the administration of medication? (SELECT 2 CORRECT ANSWERS)

After handing your client her medication, she says, "What is this blue tablet for? I have always taken a yellow pill.”. Your most appropriate action would be to:

The nurse should use which location for eliciting deep tendon reflexes?

The most critical of the following areas to assess prior to medication administration is the client's:

The nurse is aware that intramuscular injections should be given at what angle?

The patient comes to the hospital with a variety of symptoms. Which symptom will the nurse assess first?

You can be sure you have administered the intradermal injection properly if which occurs?

The nurse is assessing orientation in a 79-year-old patient. Which of these responses would lead the nurse to conclude that this patient is oriented?

The nurse is administering medications to the patient who is in renal failure resulting from end-stage renal disease.
The nurse is aware that patients with kidney failure would most likely have problems with which pharmacokinetic phase?