Patient Data

Exhibits

The nurse is preparing the client's plan of care (POC).

Select 4 findings that would indicate to the nurse that the administration of the vancomycin antibiotic would be safe to administer.

No known allergies

Used for prophylaxis

Potassium 4.4 mEq/L (4.4 mmol/L)

Dosage in safe range

Peripheral IV (PIV) in large vein

Blood urea nitrogen 17 mg/dL (6.07 mmol/L)

Answer and Explanation

Correct Answer : A,D,E,F

A. No known allergies: Confirming the client has no allergies to vancomycin or related substances is critical for safe administration. Administering an antibiotic to a client with a known allergy could result in life-threatening anaphylaxis.

B. Used for prophylaxis: Although vancomycin is often used prophylactically before procedures to prevent infection, the indication alone does not ensure that it is safe to administer. Safety focuses more on client-specific factors like allergies and organ function.

C. Potassium 4.4 mEq/L (4.4 mmol/L): This is a normal potassium level and reflects good electrolyte balance but does not directly relate to the safety of administering vancomycin, which is more concerning for kidney function and allergic reactions.

D. Dosage in safe range: Verifying that the vancomycin dose is within the recommended therapeutic range is essential to prevent toxicity, particularly nephrotoxicity and ototoxicity, which are risks with improper dosing.

E. Peripheral IV (PIV) in large vein: Administering vancomycin through a large-bore IV in a large vein reduces the risk of phlebitis and tissue irritation. Proper venous access is an important safety consideration when giving this medication.

F. Blood urea nitrogen 17 mg/dL (6.07 mmol/L): A normal BUN level suggests that renal function is adequate. Since vancomycin is primarily excreted by the kidneys, good renal function supports safe medication clearance and reduces toxicity risk.

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Correct Answer is A

Explanation

A. Hemoglobin level increased to 12 g/dL (7.45 mmol/L): Epoetin alfa stimulates red blood cell production, and an increase in hemoglobin is the primary indicator of the drug’s effectiveness. A hemoglobin of 12 g/dL reflects a significant therapeutic improvement in anemia management for a client with CKD.

B. Reports of increased energy levels and decreased fatigue: Although feeling more energetic is a positive clinical sign, it is subjective and does not provide objective evidence of improved red blood cell production. Lab values are preferred for evaluating medication effectiveness.

C. Food diary shows increased consumption of iron-rich foods: Dietary improvements support erythropoiesis but are not the direct measure of epoetin alfa’s effect. The medication’s success is best gauged by the actual rise in hemoglobin, not dietary habits alone.

D. Takes concurrent iron therapy without adverse effects: Iron supplementation is often needed to maximize epoetin alfa’s effect, but merely tolerating iron therapy does not confirm that epoetin alfa is working to correct the anemia. The focus remains on hemoglobin response.

A. Use relaxation techniques to reduce excessive anxiety. B. Avoid alcohol and other sedatives while taking the medication. C. Move slowly from a sitting position to a standing position. D. Stop taking the medication if intended effect is not immediate.

Correct Answer is D

Explanation

A. Use relaxation techniques to reduce excessive anxiety: Incorporating non-pharmacological strategies such as relaxation exercises complements lorazepam therapy and can improve anxiety management. This statement reflects appropriate understanding and safe self-care practices.

B. Avoid alcohol and other sedatives while taking the medication: Lorazepam is a central nervous system depressant, and combining it with alcohol or other sedatives can lead to respiratory depression, increased sedation, and potentially life-threatening effects. This is an important and accurate precaution.

C. Move slowly from a sitting position to a standing position: Orthostatic hypotension and dizziness are common side effects of benzodiazepines like lorazepam. Changing positions slowly helps minimize the risk of falls, especially in older adults or those sensitive to the medication.

D. Stop taking the medication if intended effect is not immediate: Lorazepam has a relatively quick onset, but stopping it abruptly without consulting a healthcare provider is unsafe and may lead to withdrawal symptoms including increased anxiety, insomnia, tremors, and even seizures. Clients must understand that medication adjustments require medical guidance.

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Patient Data Exhibits The nurse is preparing the client's plan of care (POC). Select 4 findings that would indicate to the nurse that the administration of the vancomycin antibiotic would be safe to administer.

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Naxlex Comprehensive Predictor Exams

A client with anemia secondary to chronic kidney disease (CKD) started a prescription for epoetin alfa two months ago. Which client finding best indicates that the medication is effective?Reference Range:Hemoglobin (Hgb) [14 to 18 g/dL (8.7 to 11.2 mmol/L)]

Correct Answer is A

Explanation

A client with generalized anxiety disorder (GAD) receives a new prescription for lorazepam. Which statement provided by the client requires additional instruction by the nurse?

Correct Answer is D

Explanation

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Patient Data

Exhibits

The nurse is preparing the client's plan of care (POC).

Select 4 findings that would indicate to the nurse that the administration of the vancomycin antibiotic would be safe to administer.