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. This is a pre-renal cause of acute kidney injury, related to decreased blood flow to the kidneys.
B. This is a post-renal cause of acute kidney injury, as it obstructs the outflow of urine.
C. This is an intrarenal cause of acute kidney injury, directly affecting the kidney tissue.
D. This is an intrarenal cause of acute kidney injury, related to damage to the small blood vessels in the kidneys.
Correct Answer is D
Explanation
A. A prostate examination is typically performed for issues related to the prostate, such as benign prostatic hyperplasia or prostate cancer. It is not relevant to diagnosing or managing acute glomerulonephritis, which is related to kidney inflammation rather than prostate issues.
B. A blood glucose check is used to diagnose and manage diabetes. While diabetes can contribute to chronic kidney disease, it is not the primary test for diagnosing acute glomerulonephritis or identifying its most common cause.
C. Genetic testing is useful for diagnosing inherited conditions or genetic predispositions to diseases. However, acute glomerulonephritis is typically caused by an infection or an autoimmune reaction, and genetic testing is not the primary diagnostic tool for this condition.
D. Antistreptolysin-O (ASO) titers are tests used to detect antibodies produced in response to a streptococcal infection. Elevated ASO titers indicate a recent streptococcal infection, which is the most common cause of post-infectious acute glomerulonephritis.
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