The nurse is to administer a nephrotoxic medication to the patient. Which assessment finding indicates to the nurse that the patient should receive a reduced dosage of the drug?
The patient is unable to exercise due to severe osteoarthritis in both hips.
The patient follows a low-carbohydrate, low-protein, high-fat diet.
The patient has a history of hypertension and diabetic kidney disease.
The patient has a 35 pack-year history of cigarette smoking.
The Correct Answer is C
Choice A reason: Osteoarthritis limits mobility; it doesn’t affect kidney function directly, so nephrotoxic drug clearance remains unchanged, not warranting a dose reduction.
Choice B reason: Diet impacts metabolism slightly; low protein may spare kidneys, but it doesn’t indicate impaired clearance requiring adjustment of nephrotoxic medication.
Choice C reason: Diabetic kidney disease with hypertension impairs filtration; reduced glomerular rate necessitates lower nephrotoxic doses to prevent further renal damage.
Choice D reason: Smoking affects lungs primarily; while it may indirectly harm kidneys, it’s less definitive than diabetic nephropathy for needing a reduced dose.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Juice may alter absorption; liquid can dilute or degrade some drugs, and taste may deter intake, reducing effectiveness compared to soft food.
Choice B reason: Applesauce masks taste and aids swallowing; it ensures crushed medication is consumed fully, maintaining dose integrity without altering pharmacokinetics significantly.
Choice C reason: Water may not mask bitterness; some drugs dissolve poorly or lose potency, and patients may not finish it, risking incomplete dosing.
Choice D reason: Meat or vegetables may bind drugs; uneven distribution or strong flavors could reduce intake, compromising the full therapeutic dose delivery.
Correct Answer is D
Explanation
Choice A reason: Removing in the medication room risks mix-ups; tablets could be dropped or misidentified before reaching the patient, compromising the three-check safety protocol.
Choice B reason: Outside the door is premature; without the patient present, verification against the MAR is incomplete, increasing error risk before final identity confirmation.
Choice C reason: At the cart is too early; medication stays packaged until bedside to ensure the right patient, right drug match, reducing handling errors or contamination.
Choice D reason: Bedside removal allows final MAR check with patient ID; it ensures accuracy, prevents mix-ups, and aligns with safety standards for administering oral medications.
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