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: Right patient ensures identity verification; errors here cause harm via misadministration, as drugs affect individuals differently based on physiology and condition.
Choice B reason: Right drug prevents wrong medication errors; each drug’s pharmacokinetics targets specific issues, and mistakes disrupt therapy or cause adverse reactions.
Choice C reason: Color isn’t a standard right; it’s not a reliable identifier, as formulations vary, and clinical safety relies on name, dose, and route, not appearance.
Choice D reason: Right route ensures correct delivery (e.g., IV vs. oral); wrong routes alter bioavailability and onset, risking toxicity or inefficacy per drug design.
Choice E reason: Right time optimizes efficacy; timing aligns with drug half-life and patient needs, preventing under- or overdosing from improper administration schedules.
Correct Answer is B
Explanation
Choice A reason: 60 gtts/min assumes 100 mL in 100 minutes; this underestimates the 1-hour order, delivering Levaquin too slowly, risking subtherapeutic antibiotic levels.
Choice B reason: 100 gtts/min is correct; 100 mL over 1 hour (60 min) with 60 gtts/mL equals 6000 gtts total, divided by 60 minutes matches the ordered rate.
Choice C reason: 120 gtts/min overestimates; it implies 100 mL in 50 minutes, infusing too fast, potentially causing Levaquin-related side effects like tachycardia or irritation.
Choice D reason: 200 gtts/min is excessive; 100 mL in 30 minutes doubles the rate, risking toxicity or infusion reactions, far exceeding the 1-hour prescription safely.
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