Nokea
A client has an infection and a prescription for gentamicin intermittent IV bolus every 8 hr. A peak and trough is required with the next dose. Which of the following actions should be taken to obtain an accurate gentamicin serum level?
- A. Draw a trough level immediately prior to administering the medication and a peak level 30 min after the dose.
- B. Draw a peak level 90 min prior to administering the medication and a trough level 90 min after the dose.
- C. Draw a trough level immediately prior to administering the medication and a peak level 30 min after the dose.
- D. Draw a peak level at 0900 and a trough level at 2100.
Correct Answer: C
Rationale: To obtain an accurate gentamicin serum level, the trough should be drawn immediately before administering the medication, and the peak level should be drawn 30 minutes after the dose. This timing allows for the assessment of the lowest and highest drug concentrations in the bloodstream, ensuring therapeutic levels are achieved while minimizing the risk of toxicity. Choice A is correct as it follows this timing protocol. Choices B and D have incorrect timing for peak and trough levels, which would not provide an accurate representation of the drug's concentration in the bloodstream.
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A client with active pulmonary tuberculosis (TB) is to be started on intravenous rifampin therapy. The client should be informed by the nurse that this medication can cause which of the following adverse effects?
- A. Constipation
- B. Black-colored stools
- C. Staining of teeth
- D. Body secretions turning a red-orange color
Correct Answer: D
Rationale: The correct answer is D: Body secretions turning a red-orange color. Rifampin is known to cause body secretions, such as urine, sweat, tears, and sputum, to turn a harmless red-orange color. This is a common and expected side effect of rifampin therapy. Choices A, B, and C are incorrect. Constipation is not a common adverse effect of rifampin. Black-colored stools and staining of teeth are not associated with rifampin therapy. It is important for the nurse to educate the client about the harmless red-orange discoloration that may occur with this medication.
A client has a fungal infection and a new prescription for amphotericin B. Which of the following laboratory values should the nurse report to the provider before initiating the medication?
- A. Sodium 140 mEq/L
- B. Potassium 4.5 mEq/L
- C. BUN 55 mg/dL
- D. Glucose 120 mg/dL
Correct Answer: C
Rationale: An elevated BUN level of 55 mg/dL should be reported before starting amphotericin B due to its nephrotoxic effects. Amphotericin B can cause kidney damage, and an elevated BUN indicates impaired kidney function, increasing the risk of further renal damage with this medication. Sodium, potassium, and glucose levels are not directly associated with the nephrotoxic effects of amphotericin B, making choices A, B, and D incorrect.
While caring for a client receiving IV heparin, which of the following findings should the nurse identify as an adverse effect of this medication?
- A. Hypertension
- B. Hyperglycemia
- C. Thrombocytopenia
- D. Leukopenia
Correct Answer: C
Rationale: Thrombocytopenia, a decrease in platelet count, is a known adverse effect associated with heparin therapy. It can lead to an increased risk of bleeding and should be closely monitored during treatment. Choices A, B, and D are incorrect. Hypertension is not typically associated with heparin use; hyperglycemia is not a common adverse effect of heparin; leukopenia is not a primary side effect of heparin therapy.
A client receives a new prescription for NRTIs for HIV treatment. Which statement should the nurse include during teaching about these medications?
- A. These medications work by inhibiting enzymes to prevent HIV replication.
- B. These medications work by preventing protein synthesis within the HIV cell.
- C. These medications work by weakening the cell wall of the HIV virus.
- D. These medications work by blocking HIV entry into cells.
Correct Answer: A
Rationale: NRTIs inhibit the enzyme reverse transcriptase, essential for HIV replication. By preventing this process, viral replication is hindered, ultimately reducing the viral load in the body. Option A correctly explains the mechanism of action of NRTIs in treating HIV infection. Choices B, C, and D describe mechanisms of action that do not align with how NRTIs work in HIV treatment. B is incorrect because NRTIs do not target protein synthesis within the HIV cell. C is incorrect as NRTIs do not affect the cell wall of the HIV virus. D is incorrect because NRTIs do not block HIV entry into cells.
A client is starting a new prescription for levothyroxine. Which of the following instructions should the nurse include?
- A. Take the medication at bedtime.
- B. Take the medication with food.
- C. Take the medication first thing in the morning on an empty stomach.
- D. Take the medication with a full glass of milk.
Correct Answer: C
Rationale: The correct instruction for taking levothyroxine is to take the medication first thing in the morning on an empty stomach. This timing is important for optimal absorption of the medication. Taking levothyroxine with food or at bedtime can interfere with its absorption. Milk and other foods, as well as certain medications, can reduce the effectiveness of levothyroxine by interfering with its absorption, so it should be taken separately from these items. Therefore, the correct choice is to take the medication first thing in the morning on an empty stomach.