A 53-year-old male client who has no prior medical history and takes no medications is in a primary care provider's office for a routine physical. The client states that he has not seen a doctor in "about five years." The client's blood pressure is at the appointment is 157/92 mmHg and his fasting blood glucose is 83 mg/dL. Based on recent lab results, the provider determines that the client's glomerular filtration rate (GFR) is 54 mL/min. The provider diagnoses the client with stage 3a chronic kidney disease (CKD). Based on these findings, which medication should the clinic nurse anticipate will be prescribed for this client?
Gentamicin
Daily potassium supplement
Captopril
Metformin
The Correct Answer is C
A. Gentamicin is an aminoglycoside antibiotic used to treat bacterial infections. It is not appropriate for managing CKD directly and is generally avoided in patients with kidney impairment due to its potential nephrotoxicity.
B. Potassium supplements are typically not recommended unless there is a documented deficiency in potassium. In stage 3a CKD, managing potassium levels is crucial, but supplements are not usually needed unless potassium levels are low.
C. Captopril is an angiotensin-converting enzyme (ACE) inhibitor. ACE inhibitors are beneficial for patients with CKD as they help lower blood pressure and provide renal protective effects. They can reduce proteinuria (protein in urine), which is common in CKD, and may slow the progression of kidney disease.
D. Metformin is an oral medication used to manage type 2 diabetes by improving insulin sensitivity and lowering blood glucose levels. Although it is important to monitor blood glucose in CKD patients, this
client’s fasting blood glucose is within normal range (83 mg/dL), so Metformin is not indicated unless there was evidence of diabetes or significant glucose dysregulation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Frequent ambulation could exacerbate the edema and is not a priority in the acute management of this condition.
B. Obtaining weight weekly is an appropriate intervention to monitor for changes in fluid status and guide treatment decisions.
C. A low-protein diet is not a standard treatment for PSGN.
D. Encouraging increased fluid intake is not recommended due to the client's oliguria and risk of fluid overload
Correct Answer is C
Explanation
A. Tolvaptan does not increase the glomerular filtration rate. It actually works by blocking the action of a hormone that causes the kidneys to retain water, leading to increased urine output.
B. While Tolvaptan can slow the progression of polycystic kidney disease (PKD) and delay the need for dialysis or transplant, it does not guarantee prevention of these outcomes.
C. Tolvaptan is used to slow the growth of kidney cysts in patients with PKD.
D. Hyponatremia is a common side effect of Tolvaptan due to increased water loss through urine. However, this is not the primary role.
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