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Exam NAPLEX topic 1 question 38 discussion

Actual exam question from Test Prep's NAPLEX
Question #: 38
Topic #: 1
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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?

  • A. 43 mls/min
  • B. 53 mls/min
  • C. 63 mls/min
  • D. 33 mls/min
  • E. 23 mls/min
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Suggested Answer: D 🗳️
ABW = 85 kg IBW = 50 kg + 2.3 kg (4) = 59.2 kg 85/59.2 = 1.44 AdjBW = 59.2 kg + 0.4(85 kg-59.2 kg) = 69.52 kg CrCl (IBW) = [(140-84) 59.2]/(72 × 1.4) = 32.8
CrCl (AdjBW) = [(140-84) 69.52]/(72 × 1.4) = 38.6

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Paco1
1 month ago
Selected Answer: B
My calculations gave me 46.96, which is approximately 47. I don't seem to understand the calculations that resulted in 33mg/dL. The steps are not clear and are confusing to comprehend. It's just cumbersome to follow the steps presented. Thank you.
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