A patient with chronic kidney disease (CKD) is being evaluated for medication management. Which of the following medications should be avoided due to its potential nephrotoxic effects?

Atorvastatin

Losartan

Vancomycin

Aspirin

Answer and Explanation

The Correct Answer is C

A. Atorvastatin: Atorvastatin is a statin used to manage cholesterol levels. It is generally safe for use in patients with CKD.

B. Losartan: Losartan is an angiotensin II receptor blocker (ARB) used to manage hypertension and protect the kidneys in diabetic nephropathy. It can be beneficial in CKD patients.

C. Vancomycin: Vancomycin is an antibiotic known to be nephrotoxic, especially in patients with compromised kidney function. It should be used with caution or avoided in patients with CKD.

D. Aspirin: While aspirin can have adverse effects on the kidneys at high doses, its nephrotoxic potential is lower than that of vancomycin. In low doses, aspirin is commonly used for cardiovascular protection, even in patients with CKD.

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Correct Answer is ["A","B","C","D"]

Explanation

A. Administer IV fluids: The patient is hypotensive (blood pressure 88/54 mmHg) and tachycardic (heart rate 115 bpm), indicating possible hypovolemic shock due to blood loss. Administering IV fluids will help to stabilize blood pressure.

B. Prepare for possible blood transfusion: The patient's hemoglobin level is critically low (6.5 g/dL), indicating significant blood loss and severe anemia. Preparing for a blood transfusion is crucial to correct the anemia.

C. Monitor hemoglobin and hematocrit levels: Continuous monitoring of hemoglobin and hematocrit levels is vital to assess the severity of the patient's anemia and response to treatment, guiding further interventions.

D. Administer a proton pump inhibitor (PPI): PPIs can help reduce gastric acid secretion, which may help control bleeding from peptic ulcers, a common cause of upper GI bleeding.

E. Administer oral iron supplements to address anemia: Oral iron supplements are typically used for long-term management of iron deficiency anemia but are not effective for immediate correction of severe anemia, particularly in an acute setting with ongoing blood loss.

A. Low back pain B. Confusion C. Urinary retention D. Incontinence

Correct Answer is B

Explanation

A. Low back pain: While this can be a symptom of a UTI, it is not unique to older adults and can be seen in various age groups.

B. Confusion: In older adults, UTIs often present with atypical symptoms, such as confusion or delirium, rather than the classic symptoms like dysuria or frequency. This can be a sign of infection in this population.

C. Urinary retention: This is not specific to UTIs in older adults and can occur for other reasons, such as benign prostatic hyperplasia (BPH).

D. Incontinence: Although older adults may experience incontinence, it is not a unique sign of UTI and could be related to other conditions like weakened pelvic muscles.

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A patient with chronic kidney disease (CKD) is being evaluated for medication management. Which of the following medications should be avoided due to its potential nephrotoxic effects?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["A","B","C","D"]

Explanation

A nurse is assessing an older adult client who has a urinary tract infection (UTI). Which of the following findings should the nurse identify as unique for this age group?

Correct Answer is B

Explanation

A nurse is reinforcing teaching with a client who has end-stage liver disease and a recent diagnosis of thrombocytopenia. Which of the following statements provides the best recommendation to prevent complications of bleeding?

A nurse is reinforcing teaching about renal transplant with a newly licensed nurse. Which of the following clients should the nurse identify as having a contraindication for this procedure?

A nurse is caring for a client who is experiencing an acute exacerbation of ulcerative colitis. The nurse should recognize that which of the following actions is the priority?

During the process of collecting a comprehensive medical history from a client who has been admitted with pyelonephritis, which of the following symptoms or historical details would the nurse most likely expect the client to report?

A female presents to the clinic with complaints of dysuria and increased urinary frequency. Which of the following findings on physical examination would most likely support a diagnosis of cystitis?

A female patient presents with epigastric pain and is being evaluated for peptic ulcer disease (PUD). Upon reviewing her history, which of the following risk factors would be most indicative of increasing his likelihood of developing PUD?

When caring for older adult clients at a long-term care facility, which of the following assessments should the nurse prioritize when evaluating for the risk and presence of urinary retention? (Select all that apply.)