A nurse is reviewing the medication record for a client diagnosed with chronic kidney disease (CKD). Which of the following medications should the nurse identify as having the potential to cause nephrotoxicity?
Omeprazole
Ondansetron
Vancomycin
Diphenhydramine
The Correct Answer is C
A. Omeprazole: Not directly nephrotoxic, but long-term use has been associated with interstitial nephritis, although rarely.
B. Ondansetron: Generally safe in renal disease and not known to cause nephrotoxicity.
C. Vancomycin: Known nephrotoxic agent, especially with high trough levels or when used with other nephrotoxins; requires dose adjustment in CKD.
D. Diphenhydramine: Not nephrotoxic; primarily affects the CNS and anticholinergic systems.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Bradycardia: Peritonitis is usually associated with tachycardia, not bradycardia.
B. Nausea and vomiting: These are common early signs of peritonitis, often accompanied by abdominal pain and fever.
C. Increased urinary output: Clients with peritoneal dialysis often have reduced kidney function, so urine output is generally decreased, not increased.
D. Hyperactive bowel sounds: Bowel sounds are usually diminished or hypoactive in peritonitis due to inflammation.
Correct Answer is D
Explanation
A. Urinary output 25 mL/hr: This is below normal, but not an immediate airway threat.
B. Heart rate 122/min: Elevated HR is common in burns due to fluid shifts and stress.
C. Pain of 6 on a scale of 0 to 10: Pain is expected but not life-threatening.
D. Difficulty swallowing secretions: Indicates possible airway edema or inhalation injury, which can progress to airway obstruction. This is a medical emergency.
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