Which of the following medications would you anticipate being prescribed for the renal failure patient who has hyperphosphatemia?
Calcium carbonate
Sensipar (Cinacicet)
Levothyroxine
Vitamin D (Calcitrol)
The Correct Answer is A
A. Calcium carbonate: This is commonly used as a phosphate binder in patients with renal failure and hyperphosphatemia. It works by binding dietary phosphate in the gut, reducing its absorption, and thereby helping to lower serum phosphate levels.
B. Sensipar (Cinacalcet): Cinacalcet is used to treat secondary hyperparathyroidism in chronic kidney disease. It works by increasing the sensitivity of calcium-sensing receptors in the parathyroid gland to lower PTH levels.
C. Levothyroxine: This is a synthetic thyroid hormone used in the treatment of hypothyroidism. It does not have any role in managing phosphate levels in renal failure patients.
D. Vitamin D (Calcitriol): Calcitriol helps manage hypocalcemia and suppresses parathyroid hormone secretion in CKD. However, it may increase phosphate absorption from the gut, potentially worsening hyperphosphatemia if not carefully monitored.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Three: Up to three bowel movements per day is generally considered the upper limit of normal for stool frequency in adults. This range accommodates individual variation while distinguishing normal from diarrhea.
B. Five: Five stools per day exceed the typical upper limit and may indicate diarrhea or an underlying gastrointestinal disorder if persistent, rather than normal bowel habits.
C. Two: Two stools per day fall well within the normal range but do not represent the upper limit. Normal stool frequency can range from three times per day to three times per week.
D. Seven: Seven stools per day indicate frequent bowel movements consistent with diarrhea, which is above normal frequency and warrants further assessment for underlying causes.
Correct Answer is C
Explanation
A. Imaging tests are likely to reveal scarring and deformation of the renal calices and pelvis: These findings are more typical of chronic pyelonephritis, which results from repeated or persistent kidney infections. Acute pyelonephritis usually presents with more subtle imaging changes.
B. Most cases of acute pyelonephritis are attributable to poorly controlled hypertension: While hypertension can complicate kidney disease, it is not a common cause of acute pyelonephritis. Most cases are due to ascending urinary tract infections, particularly from organisms like E. coli.
C. Flank pain, dysuria and nausea and vomiting are likely assessment findings: These are hallmark symptoms of acute pyelonephritis. Flank pain results from inflammation of the renal capsule, while dysuria and systemic symptoms like nausea, vomiting, and fever indicate infection.
D. The infection in the kidney is most likely a manifestation of a systemic infection: Acute pyelonephritis is typically caused by local ascending infections from the lower urinary tract, not systemic bacteremia. Though it can lead to systemic illness if not treated, its origin is usually localized.
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