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 B
Explanation
Choice A reason: Crushing pills can alter drug efficacy and safety, especially for medications with controlled-release properties, making this inappropriate without specific provider instructions.
Choice B reason: Requesting a liquid form accommodates the patient’s physical limitations, maintaining therapeutic integrity and ensuring safe and effective medication administration.
Choice C reason: Introducing pills directly into the patient’s mouth risks aspiration and violates safe administration practices, emphasizing the need for alternative methods.
Choice D reason: If the patient struggles to hold the cup, self-administration becomes impractical. Assistance through appropriate alternative forms ensures compliance and safety.
Correct Answer is B
Explanation
Choice A reason: One 5-mg tablet delivers 5 mg; this underdoses the 10 mg ordered, reducing salivation stimulation needed for dry eye relief.
Choice B reason: Two 5-mg tablets equal 10 mg; this matches the order, ensuring therapeutic cholinergic effect to increase tear production effectively.
Choice C reason: Three tablets (15 mg) overdose; excess pilocarpine risks side effects (e.g., sweating, bradycardia) without added benefit for dry eyes.
Choice D reason: Four tablets (20 mg) far exceed the dose; this could cause severe cholinergic toxicity, including respiratory distress, outweighing therapeutic intent.
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