NABP NAPLEX Exam - Topic 6 Question 98 Discussion

Actual exam question for NABP's NAPLEX exam

Question #: 98
Topic #: 6

LN is 84 YOM who is in hospital for a back surgery. His height is 5 feet and 4 inches, weight 85 kg and NKDA.

His past medical history includes hypertension, diabetes mellitus, major depression, hypothyroidism and chronic back pain. Post-op day 1, LN's medication includes Dexamethasone 8mg iv q6h with taper dosing, Ondansetron 4mg iv q6h prn for N/V, Levothyroxine 0.075mg po daily, Lisinopril 10mg po daily, Citalopram 20mg po daily, Docusate sodium / Senna 1 tab po twice a day, Bisacodyl 10mg suppository daily prn for constipation, Famotidine 20mg iv q12hr, Metoclopramide 10mg iv q6h, Metformin 500mg po bid, D51/2NS with 20K at 125mls/hour and Hydromorphone PCA at 0.2mg/hour of basal rate, demand dose 0.1mg. lock-out

every 6min, one hour limit 2.2mg/hour. Pertinent morning labs includes serum creatinine 1.4mg/dl, Mg 1.5mg/ dl, K 5.0mmol/L, Na 135mmol/L.

What is LN's creatinine clearance using Cockcroft and Gault equation based on IBW?

A43 mls/min

B53 mls/min

C63 mls/min

D33 mls/min

E23 mls/min

Show Suggested Answer

Suggested Answer: C

We have 1g of potassium permanganate in 25mL We have 300mL of solution

For every 25mL of that 300mL, we have 1g of KmnO4

300mL must have 12g of potassium permanganate (300ml/25mL)

by Kathrine at Dec 04, 2024, 06:50 PM

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Belen

3 months ago

Dosing adjustments might be needed with that creatinine level.

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Jennie

3 months ago

I'm leaning towards 53 mls/min, seems reasonable!

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Benton

3 months ago

Wait, how can we be sure about the IBW calculation?

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Herminia

4 months ago

I think it's around 43 mls/min based on his weight.

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Danilo

4 months ago

LN's creatinine is 1.4, so definitely need to calculate clearance.

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Kimbery

4 months ago

I think the creatinine clearance will be lower due to his elevated serum creatinine. I’m leaning towards the lower options, but I need to calculate it out to be sure.

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Wilda

4 months ago

I feel like I’ve seen a similar question on creatinine clearance before, but I can't recall the exact steps. Was it based on total body weight or ideal body weight?

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Tiffiny

4 months ago

I think LN's weight might skew the creatinine clearance calculation since he's overweight. I need to double-check the IBW formula we used.

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Ayesha

5 months ago

I remember we practiced the Cockcroft and Gault equation in class, but I'm not entirely sure how to adjust for IBW.

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Earleen

5 months ago

Alright, let's do this! I'm ready to crunch the numbers and get the right answer.

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Marguerita

5 months ago

Right, and the question also gives us the patient's actual weight of 85 kg. I'm feeling pretty confident I can work this out.

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Trina

5 months ago

I think so. The patient's height is 5'4", so we can use that to estimate the ideal body weight and plug it into the equation.

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Hyman

5 months ago

Hmm, I'm a bit confused about how to calculate the ideal body weight. Do we have enough information in the question to determine that?

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Royal

5 months ago

Okay, let's think this through step-by-step. We need to use the Cockcroft-Gault equation to calculate the creatinine clearance based on the patient's ideal body weight.

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Elvis

10 months ago

Wow, this guy's got more meds than a walking pharmacy! I wonder if he's going to start glowing in the dark or something. *chuckles* Anyway, let's get down to business and figure out that creatinine clearance.

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Joesph

10 months ago

Alright, let's see... Creatinine of 1.4 mg/dL, Magnesium of 1.5 mg/dL, Potassium of 5.0 mmol/L, and Sodium of 135 mmol/L. Looks like this guy's got a whole pharmacy in his veins!

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India

10 months ago

Okay, so we've got the height, weight, and labs... Time to put on our thinking caps and figure out that creatinine clearance. This is going to be a piece of cake, right? *cracks knuckles* Let's do this!

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Denny

9 months ago

C) 63 mls/min

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Natalie

9 months ago

B) 53 mls/min

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Shala

10 months ago

A) 43 mls/min

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Reuben

10 months ago

Woah, this guy is really medicated! Dexamethasone, Ondansetron, Levothyroxine, Lisinopril, Citalopram, and a whole bunch of other stuff. I hope he's not growing a third arm or something!

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Julene

9 months ago

User 4: I wonder how they keep track of all the interactions between those medications.

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Denise

9 months ago

User 3: He must be feeling pretty out of it with all those drugs in his system.

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Sharen

10 months ago

User 2: I hope they're keeping a close eye on him with all those meds.

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Crissy

10 months ago

User 1: Yeah, that's a lot of medication for sure.

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Sharee

10 months ago

Hmm, let's see, 5'4\' and 85 kg... Looks like we need to use the Cockcroft-Gault equation to calculate the creatinine clearance based on the ideal body weight. Let's get calculating!

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