Nursing Elites

1. The healthcare professional is reviewing a patient’s chart prior to administering gentamicin (Garamycin) and notes that the last serum peak drug level was 9 mcg/mL and the last trough level was 2 mcg/mL. What action will the healthcare professional take?

• A. Administer the next dose as prescribed.
• B. Obtain repeat peak and trough levels before administering the next dose.
• C. Report potential drug toxicity to the patient’s healthcare provider.
• D. Notify the patient’s healthcare provider of decreased drug therapeutic level.

Correct answer: C

Rationale: Gentamicin peak levels should ideally be between 5 to 8 mcg/mL, and trough levels should be within the range of 0.5 to 2 mcg/mL to ensure therapeutic efficacy while minimizing toxicity risk. In this case, the patient's peak level is above the recommended range, and the trough level is at the higher end, indicating potential drug toxicity. Therefore, the correct action for the healthcare professional is to report the possibility of drug toxicity to the patient’s healthcare provider. Administering the next dose as prescribed (Choice A) would exacerbate the toxicity risk. Obtaining repeat peak and trough levels (Choice B) may confirm the current levels but does not address the immediate concern of potential toxicity. Reporting a decreased drug therapeutic level (Choice D) is not the priority in this scenario, as the focus should be on addressing the potential toxicity issue.

2. When performing a health history on a patient who is to begin receiving a thiazide diuretic to treat heart failure, the nurse will be concerned about a history of which condition?

• A. Asthma
• B. Glaucoma
• C. Gout
• D. Hypertension

Correct answer: C

Rationale: Thiazide diuretics block uric acid secretion, leading to elevated levels that can contribute to gout. Therefore, patients with a history of gout should take thiazide diuretics with caution. Asthma (Choice A), Glaucoma (Choice B), and Hypertension (Choice D) are not directly contraindicated with thiazide diuretics, making choices A, B, and D incorrect.

3. Which of the following is a common sign of meningitis?

• A. Joint pain.
• B. Severe headache.
• C. Stiff neck.
• D. Coughing up blood.

Correct answer: C

Rationale: A stiff neck is a common sign of meningitis due to inflammation of the meninges. Meningitis typically presents with symptoms such as fever, severe headache, nausea, vomiting, sensitivity to light, and a stiff neck. Joint pain (Choice A) is not a typical symptom of meningitis and is more commonly associated with other conditions. While severe headache (Choice B) can be a symptom of meningitis, it is not as specific as a stiff neck. Coughing up blood (Choice D) is not a typical sign of meningitis and may indicate other respiratory or cardiovascular issues.

4. The healthcare provider is caring for a patient who is receiving an intravenous antibiotic. The patient has a serum drug trough of 1.5 mcg/mL. The normal trough for this drug is 1.7 mcg/mL to 2.2 mcg/mL. What will the healthcare provider expect the patient to experience?

• A. Inadequate drug effects
• B. Increased risk of superinfection
• C. Minimal adverse effects
• D. Slowed onset of action

Correct answer: A

Rationale: A serum drug trough level below the normal range (1.7 mcg/mL to 2.2 mcg/mL) indicates that the medication concentration is insufficient to provide therapeutic effects, leading to inadequate drug effects. A low trough level does not directly correlate with an increased risk of superinfection, minimal adverse effects, or a slowed onset of action, as these are more related to the drug's concentration within the therapeutic range.

5. A client who has had two episodes of bacterial cystitis in the last 6 months is being assessed by a nurse. Which questions should the nurse ask? (Select all that apply.)

• A. How much water do you drink every day?
• B. Do you take estrogen replacement therapy?
• C. Does anyone in your family have a history of cystitis?
• D. All of the Above

Correct answer: D

Rationale: The correct answers are all of the above (D). Asking about fluid intake (choice A) is important as it can affect the risk of cystitis. Estrogen levels (choice B) can also impact the likelihood of recurrent cystitis. Family history (choice C) is relevant as certain genetic factors can predispose individuals to cystitis. Cranberry juice, not grapefruit or orange juice, has been found to reduce the risk of bacterial cystitis by increasing the acidic pH. Therefore, choices A, B, and C are all pertinent questions to ask during the assessment of a client with recurrent bacterial cystitis.

Similar Questions