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

Answer and Explanation

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.

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Correct Answer is C

Explanation

A. Hypomagnesemia: Magnesium levels are typically elevated in AKI due to reduced excretion.

B. Decreased creatinine level: Creatinine rises during the oliguric phase due to decreased filtration.

C. Hyperkalemia: Potassium accumulates in the blood during oliguria due to impaired excretion.

D. Increased glomerular filtration rate (GFR): GFR is decreased in AKI.

A. Hyperkalemia B. Hypernatremia C. Hypophosphatemia D. Hypercalcemia

Correct Answer is A

Explanation

A. Hyperkalemia: In AKI, the kidneys cannot excrete potassium efficiently, leading to elevated potassium levels.

B. Hypernatremia: More common in dehydration but not typically associated with prerenal AKI, where sodium may actually be low due to dilution.

C. Hypophosphatemia: Phosphate tends to increase due to impaired excretion in AKI, not decrease.

D. Hypercalcemia: Calcium levels tend to decrease in AKI due to phosphate retention and reduced vitamin D activation.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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