When teaching a client with a prescription for Vancomycin, which instruction should the nurse include?
- A. Expect red man syndrome during treatment.
- B. Take the medication with a full glass of water.
- C. Increase your intake of potassium-rich foods.
- D. Monitor for hearing loss while taking this medication.
Correct Answer: D
Rationale: The correct answer is D. Vancomycin is known to cause ototoxicity, which can result in hearing loss. Therefore, it is important for clients to monitor for any changes in their hearing while taking this medication and promptly report any issues to their healthcare provider for further evaluation and management. Choices A, B, and C are incorrect because red man syndrome is associated with rapid infusion of Vancomycin, not a common side effect during treatment; taking the medication with a full glass of water is a general instruction for many medications but not specific to Vancomycin; and increasing potassium-rich foods is not directly related to Vancomycin therapy.
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What is an expected outcome for Lithium use in patients with bipolar disorder?
- A. Reduced risk of myocardial infarction
- B. Reduced risk of GI ulcers
- C. Decrease in respiratory distress
- D. Decreased incidence of acute manic episodes
Correct Answer: D
Rationale: The correct answer is D: Decreased incidence of acute manic episodes. Lithium is commonly used to treat bipolar disorder by helping to stabilize mood and reduce the intensity and frequency of manic episodes. This leads to better overall management of the disorder. Choices A, B, and C are incorrect because lithium is not known to reduce the risk of myocardial infarction, GI ulcers, or respiratory distress in patients with bipolar disorder.
A client has a new prescription for Efavirenz, an NNRTI. Which of the following instructions should the nurse include?
- A. Take this medication at bedtime to prevent drowsiness.
- B. Take this medication with a glass of milk.
- C. Take this medication with a glass of juice.
- D. Take this medication at the same time every day.
Correct Answer: A
Rationale: The correct instruction is to take Efavirenz at bedtime to prevent drowsiness and manage central nervous system side effects like dizziness and vivid dreams. While it is important to take the medication at the same time daily for consistent blood levels, the emphasis should be on bedtime to minimize the impact of these side effects. Choices B and C suggesting taking the medication with milk or juice are incorrect and not relevant to optimizing Efavirenz therapy.
When educating a patient on taking levothyroxine, a drug used to balance thyroid activity, what should you include in their education?
- A. Don't disregard side effects and consult your healthcare professionals
- B. Take this at the same time every day
- C. Thyroid tests are necessary while taking this drug
- D. It is not recommended to take this drug if you have recently had a myocardial infarction
Correct Answer: B
Rationale: The correct answer is to take levothyroxine at the same time every day. Consistent timing helps maintain stable thyroid levels, ensuring the effectiveness of the medication. It is important to establish a routine to optimize its therapeutic benefits. Choice A is incorrect as patients should not ignore side effects but should consult healthcare professionals if they experience any. Choice C is incorrect because thyroid tests may still be necessary to monitor thyroid function while on levothyroxine. Choice D is incorrect as it is not advisable to take levothyroxine if the patient has recently had a myocardial infarction without consulting their healthcare provider.
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.
When administering Phenytoin, what should you monitor?
- A. Behavior
- B. Therapeutic blood levels
- C. For signs of Stevens-Johnson syndrome
- D. All of the above
Correct Answer: D
Rationale: When administering Phenytoin, monitoring the patient's behavior is important to assess for any changes that may indicate adverse effects. Monitoring therapeutic blood levels helps ensure the medication is within the effective range and not causing toxicity. Additionally, being vigilant for signs of Stevens-Johnson syndrome, a severe skin reaction associated with Phenytoin use, is crucial for early detection and intervention. Therefore, monitoring behavior, therapeutic blood levels, and for signs of Stevens-Johnson syndrome are all essential when administering Phenytoin.