When administering medications to a group of clients, which client should the nurse closely monitor for development of acute kidney injury (AKI)?

Sucralfate.

Vancomycin.

Lorazepam.

Digoxin.

Answer and Explanation

The Correct Answer is B

Choice B reason: Vancomycin is an antibiotic that can treat serious bacterial infections that are resistant to other antibiotics. However, vancomycin can also cause nephrotoxicity, or damage to the kidneys, especially when given in high doses or for prolonged periods. Nephrotoxicity can lead to AKI, which is a sudden and severe decrease in kidney function that can cause fluid and electrolyte imbalances, acid-base disorders, uremia, and death. Therefore, the nurse should closely monitor the client who is receiving vancomycin for development of AKI by checking their serum creatinine and blood urea nitrogen (BUN) levels, urine output and specific gravity, and signs and symptoms of fluid overload or dehydration.

Choice A reason: Sucralfate is an anti-ulcer drug that forms a protective coating over the stomach lining and prevents further damage from acid or pepsin. Sucralfate does not cause nephrotoxicity or AKI and has minimal systemic absorption or side effects. Therefore, the nurse does not need to closely monitor the client who is taking sucralfate for development of AKI.

Choice C reason: Lorazepam is a benzodiazepine that can treat anxiety, insomnia, seizures, or alcohol withdrawal. Lorazepam does not cause nephrotoxicity or AKI and has low renal clearance or elimination. Therefore, the nurse does not need to closely monitor the client who is taking lorazepam for development of AKI.

Choice D reason: Digoxin is a cardiac glycoside that can treat heart failure or atrial fibrillation by increasing the force and efficiency of heart contractions and slowing down the heart rate. Digoxin does not cause nephrotoxicity

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Correct Answer is A

Explanation

Choice A reason: Risedronate is a bisphosphonate that is used to treat osteoporosis by inhibiting bone resorption. It should be taken on an empty stomach with a full glass of water at least 30 minutes before any other food, beverage, or medication. This is because food, milk, and antacids can interfere with the absorption of risedronate and reduce its effectiveness.

Choice B reason: Milk contains calcium, which can bind to risedronate and prevent its absorption. Therefore, the client should not drink milk with or within 2 hours of taking risedronate.

Choice C reason: Withholding the medication until the client's breakfast tray is available is not appropriate, as it would delay the administration of risedronate and disrupt the dosing schedule. The client should take risedronate as soon as possible after waking up and before eating anything.

Choice D reason: Consulting with a pharmacist about scheduling the dose one hour after the client eats is not necessary, as risedronate should be taken at least 30 minutes before any food or beverage. Taking risedronate one hour after eating may not ensure adequate absorption of the drug.

A. Hypertension. B. Bradycardia. C. Pupillary constriction. D. Scratchy throat.

Correct Answer is D

Explanation

Choice A reason: Hypertension is not a typical sign of an allergic reaction to piperacillin-tazobactam, which is an antibiotic. It may be caused by other factors, such as pain, anxiety, or renal impairment. The nurse should monitor the client's blood pressure and report any abnormal findings.

Choice B reason: Bradycardia is not a common or serious side effect of piperacillin-tazobactam. It may be related to other medications, such as beta-blockers, or underlying cardiac conditions. The nurse should check the client's pulse and rhythm and report any changes.

Choice C reason: Pupillary constriction is not associated with piperacillin-tazobactam or an allergic reaction. It may be caused by other drugs, such as opioids, or neurological disorders. The nurse should assess the client's level of consciousness and pupillary response.

Choice D reason: Scratchy throat is a possible sign of anaphylaxis, which is a severe and potentially fatal allergic reaction to piperacillin-tazobactam or any other drug. Other symptoms may include hives, swelling, wheezing, or hypotension. The nurse should stop the infusion immediately and call for help.

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When administering medications to a group of clients, which client should the nurse closely monitor for development of acute kidney injury (AKI)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse administers risedronate to a client with osteoporosis at 0700. The client asks for a glass of milk to drink with the medication. Which action should the nurse take?

Correct Answer is A

Explanation

The nurse initiates an infusion of piperacillin-tazobactam for a client with a urinary tract infection. Five minutes into the infusion, the client reports not feeling well. Which client manifestation should the nurse identify as a reason to stop the infusion?

Correct Answer is D

Explanation

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