A nurse is reviewing the BUN and creatinine levels of an older adult patient with chronic kidney disease. The nurse should anticipate which of the following findings?
BUN 8 mg/dL and creatinine 0.7 mg/dL
BUN 45 mg/dL and creatinine 8 mg/dL
BUN 23 mg/dL and creatinine 1.0 mg/dL
BUN 10 mg/dL and creatinine 0.3 mg/dL
The Correct Answer is B
Choice A reason:
A BUN level of 8 mg/dL and a creatinine level of 0.7 mg/dL are within normal ranges for a healthy individual without kidney disease. In chronic kidney disease (CKD), we would expect these values to be elevated due to the kidneys' reduced ability to filter waste products from the blood.
Choice B reason:
A BUN level of 45 mg/dL and a creatinine level of 8 mg/dL are significantly higher than the normal range, which is consistent with impaired kidney function seen in CKD. These elevated levels indicate that the kidneys are not effectively filtering urea and creatinine from the blood, leading to their accumulation.
Choice C reason:
A BUN level of 23 mg/dL and a creatinine level of 1.0 mg/dL could be seen in the early stages of CKD. While the creatinine level is within the normal range, the BUN level is slightly elevated, which may suggest a decline in kidney function.
Choice D reason:
A BUN level of 10 mg/dL and a creatinine level of 0.3 mg/dL are both below the normal range. This is an unlikely finding for a patient with CKD, as kidney impairment typically leads to increased levels of these substances in the blood.
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Correct Answer is D
Explanation
Choice A reason:
Reducing the dosage of methotrexate during pregnancy is not a safe option because methotrexate is contraindicated during pregnancy due to its potential to cause birth defects and other adverse pregnancy outcomes.
Choice B reason:
While dietary modifications may be necessary during pregnancy, this is not specifically related to the use of methotrexate. The primary concern with methotrexate and pregnancy is the risk it poses to the developing fetus, not dietary interactions.
Choice C reason:
Breastfeeding while taking methotrexate is not recommended. Methotrexate can be excreted in breast milk and may harm a nursing infant.
Choice D reason:
Methotrexate should indeed be discontinued at least 3 months prior to a planned pregnancy. This is to ensure that the drug is completely cleared from the body, as it can cause serious birth defects and other pregnancy-related complications.
Correct Answer is B
Explanation
Choice A reason:
Urinary retention is not commonly reported as an adverse effect of tamoxifen. While urinary symptoms can occur, they are not as prevalent as other side effects such as hot flashes or mood changes.
Choice B reason:
Hot flashes are a well-documented adverse effect of tamoxifen. They occur due to the antiestrogenic effects of the medication, which can mimic menopausal symptoms, including hot flashes. Tamoxifen is a medication used to treat breast cancer and is known to cause several adverse effects. Based on the information provided by reliable health sources, hot flashes are a common side effect experienced by patients taking tamoxifen
Choice C reason:
Constipation is not typically listed as a common adverse effect of tamoxifen. Gastrointestinal symptoms may occur, but they are more often related to nausea or vomiting rather than constipation.
Choice D reason:
Tinnitus, or ringing in the ears, is not a recognized common adverse effect of tamoxifen. While patients may experience a range of side effects, tinnitus is not frequently associated with the use of tamoxifen.