Deck 35: Drug Therapy for Renal System Dysfunction

Question 1

For the client with renal impairment,appropriate drug regimen modifications might include which of the following?

A) Increasing the dose to ensure that a therapeutic serum level is obtained
B) Decreasing the dose interval to increase the serum level of the medication
C) Lengthening the interval between doses and increasing the dose
D) Decreasing the dose while maintaining the intervals between doses

Answer 1

Decreasing the dose while maintaining the intervals between doses

Question 2

The nurse monitors the drug regimen of a client with renal disease knowing that nephrotoxic drugs can lead to which of the following?

A) Renal insufficiency
B) Renal calculi
C) Acute tubular necrosis
D) Stenosis of the renal artery

Answer 2

Acute tubular necrosis

Question 3

The nurse anticipates that a client scheduled to receive a nephrotoxic drug may have fluid therapy and which diuretic ordered to reduce the risk of kidney damage?

A) Chlorothiazide (Diuril)
B) Bumetanide (Bumex)
C) Spironolactone (Aldactone)
D) Mannitol (Osmitrol)

Answer 3

Mannitol (Osmitrol)

Question 4

Special needs of the client with chronic renal failure include which of the following?

A) A dietary increase of magnesium
B) Calcium supplementation
C) Increase of sodium intake
D) Administration of phosphate

Question 5

The nurse would be diligent in monitoring which of the following priority vital signs in a client with renal failure who is receiving epoetin alfa (Epogen)?

A) Temperature
B) Pulse
C) Oxygen saturation
D) Blood pressure

Question 6

A client with renal impairment will have serum drug levels drawn as part of evaluating medication therapy.The nurse also makes it a priority to assess which of the following laboratory values that could affect drug levels?

A) Hematocrit level
B) Serum albumin
C) Bilirubin level
D) Calcium level

Question 7

The nurse encourages the client with chronic renal failure to do which of the following to reduce the risk of the most common adverse effect of calcium acetate (Phos-Lo)?

A) Drink extra fluids
B) Add more fiber to the diet
C) Avoid milk products
D) Take the tablets before bedtime

Question 8

The nurse would withhold a scheduled dose of epoetin alfa (Epogen)for a client with cancer and notify the prescriber after noting that the client's hemoglobin level is

A) 8 g/dL.
B) 9.6 g/dL.
C) 11.1 g/dL.
D) 12.5 g/dL.

Question 9

The nurse caring for a client with renal failure being treated with calcium acetate (Phos-Lo)determines that the drug regimen is effective after noting that the phosphorus level is below the goal of

A) 10 mg/dL.
B) 8 mg/dL.
C) 6 mg/dL.
D) 4 mg/dL.

Question 10

The nurse notes that a client has an order for sevelamer (Renagel).The nurse expects that review of the client's laboratory test results will reveal which of the following?

A) Increased calcium and phosphate levels
B) Decreased calcium and phosphate levels
C) Increased calcium and decreased phosphate levels
D) Decreased calcium and increased phosphate levels

Question 11

The nurse determines that which of the following is safe for a client with renal disease because it is not known to be nephrotoxic?

A) An antiinflammatory agent
B) Amphotericin B
C) Kanamycin
D) Digoxin

Question 12

The nurse withholds a dose of calcium acetate (Phos-Lo)and notifies the prescriber after noting which of the following calcium levels?

A) 8.7 mg/dL
B) 9.0 mg/dL
C) 10.3 mg/dL
D) 11.8 mg/dL

Question 13

A client with renal insufficiency requires a loading dose of a drug to achieve an immediate effect.The nurse anticipates that the size of the dose will be

A) a small fraction of the dose that would be given to a client without renal disease.
B) approximately half of the dose that would be given to a client without renal disease.
C) almost the same as the dose that would be given to a client without renal disease.
D) greater than the dose that would be given to a client without renal disease.

Question 14

A client with chronic renal failure who is receiving recombinant epoetin alfa (Epogen)is most likely diagnosed with which of the following conditions?

A) Anemia
B) Hypertension
C) Neutropenia
D) Hypercholesterolemia

Question 15

The nurse explains to a client in renal failure that epoetin alfa (Epogen)is being ordered to raise the hematocrit level into which of the following target ranges?

A) 28% to 30%
B) 30% to 33%
C) 36% to 39%
D) 39% to 42%

Question 16

One of the more common manifestations of acute renal failure is a drop in urinary output to approximately

A) 3000 mL/day.
B) 1500 mL/day.
C) 800 mL/day.
D) 400 mL/day.

Question 17

The client with mild renal disease on bed rest is receiving diuretic therapy to help maintain urine output.The nurse notes that the 24-hour fluid balance records indicate that the client's overall fluid balance for the last 24 hours was 1000 mL.The nurse calculates that the client's weight should be reduced by how many pounds?

A) 0.5
B) 1
C) 2
D) 3

Question 18

An elevation in which of the following laboratory test values would indicate poor renal clearance?

A) Blood urea nitrogen
B) Serum magnesium
C) Serum creatinine
D) Serum chloride

Question 19

The client with renal dysfunction is being taught to monitor daily weight at home to detect excess fluid volume.The nurse instructs the client to do which of the following to obtain accurate results?

A) Weigh self in the evening before supper
B) Weigh self after a shower while wrapped in a towel
C) Weigh self after the first meal of the day
D) Weigh self after voiding

Question 20

The nurse would report a sensitivity to which of the following to the physician considering prescribing epoetin alfa (Epogen)for a client with renal failure?

A) Sunlight
B) Aspirin
C) Milk products
D) Albumin

Question 21

To obtain the maximal benefit from epoetin alfa (Epogen),the nurse encourages the client with renal failure to eat foods that are high in

A) magnesium.
B) calcium.
C) iron.
D) zinc.