The nurse is to administer a nephrotoxic medication to the patient. Which assessment finding indicates to the nurse that the patient should receive a reduced dosage of the drug?
The patient is unable to exercise due to severe osteoarthritis in both hips.
The patient follows a low-carbohydrate, low-protein, high-fat diet.
The patient has a history of hypertension and diabetic kidney disease.
The patient has a 35 pack-year history of cigarette smoking.
The Correct Answer is C
Choice A reason: Osteoarthritis limits mobility; it doesn’t affect kidney function directly, so nephrotoxic drug clearance remains unchanged, not warranting a dose reduction.
Choice B reason: Diet impacts metabolism slightly; low protein may spare kidneys, but it doesn’t indicate impaired clearance requiring adjustment of nephrotoxic medication.
Choice C reason: Diabetic kidney disease with hypertension impairs filtration; reduced glomerular rate necessitates lower nephrotoxic doses to prevent further renal damage.
Choice D reason: Smoking affects lungs primarily; while it may indirectly harm kidneys, it’s less definitive than diabetic nephropathy for needing a reduced dose.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Toxic effects involve overdose symptoms like coma; staying awake isn’t toxicity, as Nembutal’s sedative intent is reversed, not exaggerated, in this reaction.
Choice B reason: Drug allergy causes immune responses (e.g., rash); insomnia isn’t allergic, but a paradoxical effect, differing from hypersensitivity reactions entirely.
Choice C reason: Idiosyncrasy is an unexpected reaction; Nembutal, a barbiturate, should sedate, but wakefulness is an abnormal, individual response, fitting this category precisely.
Choice D reason: Tolerance reduces efficacy over time; this acute, opposite reaction to a sedative isn’t tolerance, but an immediate, unpredictable drug response.
Correct Answer is C
Explanation
Choice A reason: Promising instant relief is misleading; most drugs take time, and false expectations may erode trust, reducing cooperation in a toddler’s care.
Choice B reason: Calling it candy is unethical; it risks future candy confusion with drugs, potentially leading to accidental ingestion, unsafe for a 3-year-old.
Choice C reason: Confident explanation suits a toddler’s understanding; it builds trust, reduces fear, and ensures cooperation by clearly stating purpose and process age-appropriately.
Choice D reason: Firm insistence may scare a toddler; without explanation, it lacks reassurance, potentially increasing resistance and distress during medication administration.
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