The nurse is to administer a nephrotoxic medication to the patient. Which assessment finding indicates to the nurse that the patient should receive a reduced dosage of the drug?

Choice A reason: Osteoarthritis limits mobility; it doesn’t affect kidney function directly, so nephrotoxic drug clearance remains unchanged, not warranting a dose reduction. Choice B reason: Diet impacts metabolism slightly; low protein may spare kidneys, but it doesn’t indicate impaired clearance requiring adjustment of nephrotoxic medication. Choice C reason: Diabetic kidney disease with hypertension impairs filtration; reduced glomerular rate necessitates lower nephrotoxic doses to prevent further renal damage. Choice D reason: Smoking affects lungs primarily; while it may indirectly harm kidneys, it’s less definitive than diabetic nephropathy for needing a reduced dose.