A patient with renal impairment is prescribed a medication that is primarily excreted by the kidneys. What adjustment should the nurse anticipate?

Administering the medication with meals only

No dose adjustment is required

Increasing the dose to ensure therapeutic effect

Decreasing the dose to prevent toxicity

Answer and Explanation

The Correct Answer is D

Choice A reason: Administering the medication with meals only is not a valid adjustment for a medication that is primarily excreted by the kidneys. The food intake does not affect the renal clearance of the drug, unless it alters the pH of the urine or the blood flow to the kidneys. The nurse should follow the instructions on the medication label or the prescriber's order regarding the timing of the administration.

Choice B reason: No dose adjustment is required is an incorrect statement for a medication that is primarily excreted by the kidneys. The renal impairment can reduce the elimination of the drug and increase its concentration in the blood. This can cause adverse effects and toxicity. The nurse should consult with the prescriber or the pharmacist about the appropriate dose reduction or frequency change for the patient's level of renal function.

Choice C reason: Increasing the dose to ensure therapeutic effect is a dangerous and inappropriate adjustment for a medication that is primarily excreted by the kidneys. The renal impairment can reduce the elimination of the drug and increase its concentration in the blood. This can cause adverse effects and toxicity. The nurse should not increase the dose without the prescriber's order and should monitor the patient for signs of overdose or toxicity.

Choice D reason: Decreasing the dose to prevent toxicity is the correct and rational adjustment for a medication that is primarily excreted by the kidneys. The renal impairment can reduce the elimination of the drug and increase its concentration in the blood. This can cause adverse effects and toxicity. The nurse should consult with the prescriber or the pharmacist about the appropriate dose reduction or frequency change for the patient's level of renal function. The nurse should also monitor the patient for the therapeutic response and the adverse effects of the drug.

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Correct Answer is D

Explanation

Choice A reason: Distribution is not the correct term to describe the movement of a drug from its site of administration to the bloodstream. Distribution is the process by which a drug moves from the bloodstream to the tissues and organs of the body. Distribution depends on factors such as blood flow, tissue permeability, plasma protein binding, and tissue binding. Distribution occurs after the drug has been absorbed into the bloodstream, and it determines how much drug reaches the site of action.

Choice B reason: Metabolism is not the correct term to describe the movement of a drug from its site of administration to the bloodstream. Metabolism is the process by which a drug is chemically transformed in the body, usually by enzymes in the liver or other tissues. Metabolism can affect the activity, duration, and elimination of a drug. Metabolism occurs after the drug has been absorbed into the bloodstream, and it can occur before or after the drug reaches the site of action.

Choice C reason: Excretion is not the correct term to describe the movement of a drug from its site of administration to the bloodstream. Excretion is the process by which a drug or its metabolites are eliminated from the body. Excretion can occur through various routes, such as urine, feces, sweat, or breath. Excretion occurs after the drug has been absorbed into the bloodstream, and it can occur before or after the drug reaches the site of action.

Choice D reason: Absorption is the correct term to describe the movement of a drug from its site of administration to the bloodstream. Absorption is the process by which a drug enters the bloodstream from the site of administration. Absorption depends on factors such as the route of administration, the dose, the formulation, and the bioavailability of the drug. Absorption is the first step of pharmacokinetics, and it determines how much and how fast a drug reaches the bloodstream and the site of action.

A. Taking antacids will allow me to eat as much spicy food as I want. B. Taking antacids will prevent my stomach from digesting carbohydrates. C. Taking antacids will prevent my stomach from making too much acid. D. Taking antacids will help neutralize the acid that is already in my stomach.

Correct Answer is D

Explanation

Choice A reason: This is incorrect. Taking antacids does not protect the stomach from the irritation caused by spicy foods. Antacids only reduce the acidity of the stomach contents, but they do not heal the ulcer or prevent further damage.

Choice B reason: This is incorrect. Taking antacids does not affect the digestion of carbohydrates or any other nutrients. Antacids only act on stomach acid, not on the enzymes that break down food.

Choice C reason: This is incorrect. Taking antacids does not stop the stomach from producing acid. Antacids only react with the acid that is already present in the stomach, but they do not inhibit the secretion of acid by the stomach cells.

Choice D reason: This is correct. Taking antacids will help neutralize the acid that is already in the stomach, which can relieve the pain and discomfort caused by the ulcer. Antacids can also form a protective coating over the ulcer, which can help it heal faster.

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A patient with renal impairment is prescribed a medication that is primarily excreted by the kidneys. What adjustment should the nurse anticipate?

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Naxlex Comprehensive Predictor Exams

Which phase of pharmacokinetics involves the movement of a drug from its site of administration to the bloodstream?

Correct Answer is D

Explanation

The nurse is teaching a patient who has been diagnosed with a gastric ulcer and has been prescribed an antacid. The patient demonstrates understanding when they state:

Correct Answer is D

Explanation

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