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 D

Explanation

Choice A reason: Telling the client to notify the nurse if the pain is not relieved is an important nursing action, but it is not the highest priority. The nurse should assess the client's pain level before and after administering the medication, and evaluate its effectiveness. If the pain is not relieved, the nurse should report it to the prescriber and consider other interventions.

Choice B reason: Advising the client that the medication should start to work in about 30 minutes is an informative nursing action, but it is not the highest priority. The nurse should educate the client about the expected onset, peak, and duration of action of the medication, and how to take it safely and effectively. However, this does not address any immediate risks or needs of the client.

Choice C reason: Administering a stool softener/laxative at the same time as the analgesic is a preventive nursing action, but it is not the highest priority. The nurse should anticipate and prevent potential side effects of the medication, such as constipation, which can be caused by codeine. However, this does not address any urgent or emergent issues of the client.

Choice D reason: Instructing the client to request assistance when ambulating to the bathroom is the highest priority nursing action, as it addresses a serious safety concern of the client. The nurse should protect the client from falls and injuries, which can be caused by codeine's sedative and drowsy effects. The nurse should also monitor the client's respiratory rate and level of consciousness, as codeine can cause respiratory depression and altered mental status.

A. Nausea and diarrhea can occur when using this supplement. B. Anxiety and headaches increase with the use of ginkgo biloba. C. Aspirin and non-steroidal anti-inflammatory drugs interact with ginkgo. D. Ginkgo biloba use should be limited and not taken during pregnancy.

Correct Answer is C

Explanation

Choice A reason: Nausea and diarrhea are possible side effects of ginkgo biloba, but they are not as serious or common as the risk of bleeding caused by the interaction with aspirin and non-steroidal anti-inflammatory drugs. Therefore, this information is not as important as choice c.

Choice B reason: Anxiety and headaches are not associated with the use of ginkgo biloba, but rather with the underlying condition of multiple sclerosis. Therefore, this information is not relevant or accurate for this client.

Choice C reason: Aspirin and non-steroidal anti-inflammatory drugs interact with ginkgo biloba, as both substances have antiplatelet effects that can increase the risk of bleeding. Therefore, this information is most important for the nurse to include in the teaching plan for this client, as the client should avoid taking these drugs while using ginkgo biloba or inform the healthcare provider if they are prescribed.

Choice D reason: Ginkgo biloba use should be limited and not taken during pregnancy, as there is insufficient evidence about its safety and efficacy for pregnant women. However, this information is not as important as choice c, as the client may not be pregnant or planning to become pregnant.

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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

Which nursing action has the highest priority when administering a dose of codeine with acetaminophen to a client?

Correct Answer is D

Explanation

A female client with multiple sclerosis reports having less fatigue and improved memory since she began using the herbal supplement, ginkgo biloba. Which information is most important for the nurse to include in the teaching plan for this client?

Correct Answer is C

Explanation

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