The health care provider orders a trough level of an antibiotic administered every twenty four hours.
When should the nurse plan for a trough level to be drawn?

Every morning at 08:00AM (0800).

Halfway between next scheduled dose.

Just prior to next scheduled dose.

Two hours after a scheduled dose.

Answer and Explanation

The Correct Answer is C

Just prior to the next scheduled dose. A trough level is the lowest concentration of a drug in the blood, and it is measured just before the next dose is due to be administered.

This helps to ensure that the drug level does not fall below the therapeutic range or rise above the toxic range.

Choice A is wrong because every morning at 08:00 AM (0800) is not a consistent time interval for a drug that is administered every twenty-four hours.

The trough level should be measured at the same time before each dose.

Choice B is wrong because halfway between next scheduled dose is not a trough level, but a midpoint level.

This does not reflect the lowest concentration of the drug in the blood.

Choice D is wrong because two hours after a scheduled dose is not a trough level, but a peak level. This is the highest concentration of the drug in the blood, and it is measured after the drug has been absorbed and distributed. Peak levels are no longer routinely recommended for vancomycin.

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Correct Answer is A

Explanation

Notify the health care provider to report and anticipate new orders.

This is because an oral temperature of 100.8° F (38.2° C) indicates a fever, which could be a sign of infection or inflammation in an elderly client.

A fever of this magnitude could also cause dehydration, confusion, or seizures in older adults.

Therefore, the nurse should notify the health care provider as soon as possible to determine the cause and treatment of the fever.

Choice B is wrong because covering the client with an additional blanket could increase the body temperature and worsen the fever.

The UAP should not recheck the temperature in two hours, but rather monitor it more frequently and report any changes to the nurse.

Choice C is wrong because charting the temperature on the vital signs sheet and reporting to the new shift coming on is not enough to address the urgency of the situation.

The nurse has a responsibility to act on abnormal findings and communicate them to the health care provider.

Choice D is wrong because assessing the client’s temperature rectally and comparing the results is not necessary and could cause discomfort or injury to the client.

Rectal temperatures are usually higher than oral temperatures by about 0.5° F (0.3° C), so this would not change the interpretation of the fever.

The normal range for oral temperature in adults is 97.6° F to 99.6° F (36.4° C to 37.6° C).

A. I should have my hemoglobin A1C checked monthly. B. I should always have my breakfast ready to eat before injecting my morning insulin. C. If I feel hungry I can eat early and take a little extra insulin next time it is due. D. On sick days I don’t have to check my blood sugar or eat, just get plenty of fluids.

Correct Answer is B

Explanation

I should always have my breakfast ready to eat before injecting my morning insulin. This statement confirms that the client understands the importance of matching insulin administration with food intake to prevent hypoglycemia.

Choice A is wrong because hemoglobin A1C should be checked every 3 months, not monthly, to monitor long-term glycemic control.

Choice C is wrong because eating early and taking extra insulin later can cause fluctuations in blood glucose levels and increase the risk of complications.

Choice D is wrong because on sick days, the client should check blood sugar more

often and eat small amounts of carbohydrates to prevent hyperglycemia and ketoacidosis.

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The health care provider orders a trough level of an antibiotic administered every twenty four hours. When should the nurse plan for a trough level to be drawn?

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Naxlex Comprehensive Predictor Exams

A 75-year-old client has a baseline oral temperature of 96.8° F (36° C). Two hours later the client’s oral temperature is 100.8° F (38.2° C). Which action should a nurse take next?

Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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The health care provider orders a trough level of an antibiotic administered every twenty four hours.
When should the nurse plan for a trough level to be drawn?