The nurse is providing medications to an adult patient with a history of advanced kidney disease. Which laboratory finding indicates that the dosages of medications may need to be decreased?

Hemoglobin 12 mg/dL

Glucose 100 mg/dL

Creatinine 8 mg/dL

Potassium 4.0 mEq/L

Answer and Explanation

The Correct Answer is C

A. Hemoglobin 12 mg/dL: Hemoglobin levels reflect the oxygen-carrying capacity of the blood and are not directly related to kidney function or medication dosage adjustments. This value is within the normal range and does not suggest a need for medication dosage changes.

B. Glucose 100 mg/dL: Blood glucose levels are not directly related to kidney function and do not indicate the need to adjust medication dosages. This value is within normal limits.

C. Creatinine 8 mg/dL: Creatinine levels are a key indicator of kidney function. A creatinine level of 8 mg/dL is significantly elevated, suggesting severe renal impairment. Medications that are excreted by the kidneys may need to be dosed lower or avoided altogether to prevent toxicity.

D. Potassium 4.0 mEq/L: This is a normal potassium level and does not indicate the need for medication dosage adjustments. While potassium levels are important in kidney disease, this specific value does not suggest a dosage change is necessary.

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Correct Answer is A

Explanation

A. Therapeutic level: This is the correct answer. It refers to the concentration of a drug in the bloodstream at which it achieves the desired effect without causing toxicity.

B. Therapeutic index: This is a ratio that compares the toxic dose to the therapeutic dose of a drug. It does not refer to the point of optimal effect.

C. Toxic level: This refers to the concentration of a drug at which it becomes harmful or toxic. It is not associated with the desired effect.

D. Therapeutic range: This refers to the range between the minimum effective concentration and the toxic concentration of a drug. It does not pinpoint the optimal effect but indicates the safe range.

A. Call the health-care provider to see if intravenous fluids are needed. B. Increase fluid intake prior to midnight to make sure the patient remains hydrated. C. Remove the patient's water pitcher at the bedside shortly before midnight. D. This is an example of a STAT order and should be documented in the patient's chart.

Correct Answer is C

Explanation

A. Call the health-care provider to see if intravenous fluids are needed: This is not usually necessary unless the patient has a condition that requires it. It's more important to ensure NPO status is maintained.

B. Increase fluid intake prior to midnight to make sure the patient remains hydrated: This could be done, but it is less important than ensuring the patient follows the NPO instructions.

C. Remove the patient's water pitcher at the bedside shortly before midnight: This is the correct answer. Removing the pitcher helps prevent the patient from accidentally drinking water and violating NPO status.

D. This is an example of a STAT order and should be documented in the patient's chart: NPO orders are not STAT orders; they are routine orders related to the preparation for a procedure.

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The nurse is providing medications to an adult patient with a history of advanced kidney disease. Which laboratory finding indicates that the dosages of medications may need to be decreased?

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Naxlex Comprehensive Predictor Exams

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