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 A
Explanation
Choice A reason: Deltoid and vastus lateralis are large muscles with good vascularity; they safely absorb IM injections, minimizing nerve damage or tissue irritation risks.
Choice B reason: Chest and abdomen lack sufficient muscle mass for IM; these are subcutaneous or IV sites, risking poor absorption or injury if used intramuscularly.
Choice C reason: Forearm and scapula are too thin or bony; IM injections here risk nerve or bone damage, lacking the muscle bulk needed for safe drug delivery.
Choice D reason: Lower leg (e.g., calf) has small muscles and major vessels; IM use risks vascular injury or slow absorption, making it an unsafe injection site.
Correct Answer is C
Explanation
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.
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