A patient is receiving gentamicin every 12 hours IVPB for an infection.

The nurse has administered the 0900 dose, which is prescribed to run over 1 hour. The physician prescribed peak and trough levels to be drawn.

When should the nurse expect to draw the peak level?

0930

1000

2030

2100

Answer and Explanation

The Correct Answer is B

Choice A rationale

Drawing the peak level at 0930, which is 30 minutes after the start of the infusion, would be too early. The medication would not have had enough time to reach its peak level in the blood.

Choice B rationale

The peak level of gentamicin is typically evaluated 30 minutes after the completion of the infusion. Since the infusion is administered over 1 hour, the peak level would be expected to be drawn at 10001.

Choice C rationale

Drawing the peak level at 2030, which is 12 hours after the start of the infusion, would not provide an accurate representation of the peak level of gentamicin. This is because the medication would have been metabolized and excreted over this period.

Choice D rationale

Drawing the peak level at 2100, which is 12.5 hours after the start of the infusion, would not provide an accurate representation of the peak level of gentamicin. This is because the medication would have been metabolized and excreted over this period.

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Correct Answer is B

Explanation

Choice A rationale

Administering the PRN antianxiety medication is not the most appropriate next step. The client’s symptoms—shortness of breath, anxiety, restlessness, tachycardia, tachypnea, hypotension, and decreased oxygen saturation—are indicative of a potential pulmonary embolism, a life-threatening complication of deep vein thrombosis. While anxiety can be a symptom of a pulmonary embolism, treating it without addressing the underlying cause could delay necessary medical intervention.

Choice B rationale

Calling the rapid response team is the most appropriate next step. The client’s symptoms suggest a potential pulmonary embolism, a serious and life-threatening condition that requires immediate medical intervention. The rapid response team can provide the necessary urgent care.

Choice C rationale

Increasing the intravenous infusion rate is not the most appropriate next step. While hydration is important, it would not address the immediate life-threatening situation. The client’s symptoms suggest a potential pulmonary embolism, which requires immediate medical intervention.

Choice D rationale

Preparing for mechanical ventilation is not the most appropriate next step. While the client’s decreased oxygen saturation and increased respiratory rate suggest respiratory distress, the priority should be to address the potential pulmonary embolism. Mechanical ventilation may be necessary later depending on the client’s response to treatment.

A. Limit intake to non-caloric containing liquids until the glucose is within normal limits. B. Decrease intake of carbohydrates until blood glucose level is less than 100 mg/dL. C. Monitor blood glucose levels every 4 hours and notify the doctor if it continues to rise. D. Only administer the morning prescribed dose of insulin.

Correct Answer is C

Explanation

Choice A rationale

Limiting intake to non-caloric containing liquids until the glucose is within normal limits is not the best advice for a patient with Type 1 diabetes reporting a blood glucose level of 210 mg/dL and symptoms of a sore throat, cough, and fever. While it’s important to stay hydrated, especially when sick, it’s also crucial to maintain a balanced diet to provide the body with necessary nutrients for recovery.

Choice B rationale

Decreasing intake of carbohydrates until blood glucose level is less than 100 mg/dL is not recommended. Carbohydrates are a primary source of energy, and reducing their intake could lead to low blood sugar or hypoglycemia, which can be dangerous.

Choice C rationale

Monitoring blood glucose levels every 4 hours and notifying the doctor if it continues to rise is the best advice. When a patient with diabetes is sick, their blood glucose levels can rise due to the stress the body is under. Regular monitoring allows for timely adjustments in insulin dosage and helps prevent diabetic ketoacidosis, a serious complication.

Choice D rationale

Administering only the morning prescribed dose of insulin is not advisable. Insulin requirements can increase when a person with diabetes is sick. Therefore, sticking to the regular insulin regimen without adjustments could lead to high blood sugar or hyperglycemia.

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A patient is receiving gentamicin every 12 hours IVPB for an infection. The nurse has administered the 0900 dose, which is prescribed to run over 1 hour. The physician prescribed peak and trough levels to be drawn. When should the nurse expect to draw the peak level?

Choice B rationale

Choice C rationale

Choice D rationale

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Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

Choice A rationale

Choice B rationale

Choice C rationale

Choice D rationale

A patient diagnosed with Type 1 diabetes reports a blood glucose level of 210 mg/dL and symptoms of a sore throat, cough, and fever. What advice should the nurse give to the patient?

Correct Answer is C

Explanation

Choice A rationale

Choice B rationale

Choice C rationale

Choice D rationale

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A patient is receiving gentamicin every 12 hours IVPB for an infection.

The nurse has administered the 0900 dose, which is prescribed to run over 1 hour. The physician prescribed peak and trough levels to be drawn.

When should the nurse expect to draw the peak level?