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. Increased appetite: Not typical in AKI; anorexia is more common.
B. Elevated serum creatinine levels: A hallmark of AKI, indicating reduced kidney filtration capacity.
C. Hyperglycemia: Not a direct indicator of AKI, though may occur in diabetics.
D. Increased urine output: AKI is typically oliguric (low urine output) or anuric in early phases.
Correct Answer is B
Explanation
A. Evaluating the patient's level of pain after medication administration: This is important but comes after the medication is given.
B. Ensuring a bag valve mask (BVM) is at the bedside: Opioids and sedatives depress respiratory drive. Emergency resuscitation equipment (like a BVM) must be ready in case of respiratory compromise.
C. Verification of allergies to medications: Important, but verifying allergies should already be done before administering any meds; not the priority here.
D. Documenting the level of pain before medication administration: Also important, but secondary to safety preparation.
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