The nurse checks the patient’s laboratory work prior to administering a dose of vancomycin and finds that the trough vancomycin level is 24 mcg/mL. What will the nurse do next?

Hold the drug, and administer 4 hours later.

Administer the vancomycin as ordered.

Hold the drug, and notify the prescriber.

Repeat the test to verify results.

Answer and Explanation

The Correct Answer is C

Choice A rationale:

Holding the drug and administering it 4 hours later is not the appropriate action. The trough vancomycin level of 24 mcg/mL is higher than the recommended range of 10-20 mcg/mL, indicating potential risk for toxicity. Administering the drug later does not address the immediate concern of a high trough level.

Choice B rationale:

Administering the vancomycin as ordered is not the correct action in this case. The trough level is above the recommended range, which could lead to vancomycin toxicity. The nurse should not administer the medication without addressing the high trough level. Choice C rationale:

This is the correct action. The nurse should hold the drug and notify the prescriber because the trough vancomycin level is higher than the recommended range. The prescriber can then make a decision based on this information, which may include adjusting the dose, extending the dosing interval, or ordering additional tests.

Choice D rationale:

While repeating the test to verify results might be done eventually, it should not be the immediate next step. The nurse has a responsibility to ensure patient safety, and with a trough level above the recommended range, the priority is to prevent potential toxicity. Therefore, the nurse should hold the drug and notify the prescriber.

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Correct Answer is A

Explanation

Choice A rationale:

Hypoglycemia, also known as low blood sugar, is a condition where blood sugar levels fall below the standard range. It is often related to diabetes treatment. When blood glucose levels are too low, individuals may experience symptoms such as shakiness, which is why the statement “I will feel shaky” indicates an understanding of the manifestations of hypoglycemia.

Choice B rationale:

The statement “My skin will be warm and moist” does not accurately represent the symptoms of hypoglycemia. While sweating can be a symptom of hypoglycemia, it does not necessarily mean that the skin will feel warm and moist. Therefore, this choice does not indicate a correct understanding of the manifestations of hypoglycemia.

Choice C rationale:

The statement “I will be more thirsty than usual” is more commonly associated with hyperglycemia, or high blood sugar, rather than hypoglycemia. Thirst is not typically a symptom of low blood sugar. Therefore, this choice does not indicate a correct understanding of the manifestations of hypoglycemia.

Choice D rationale:

The statement “My appetite will be decreased” is not a typical symptom of hypoglycemia. In fact, hunger is a common symptom of low blood sugar. Therefore, this choice does not indicate a correct understanding of the manifestations of hypoglycemia.

A. Erythromycin B. Amphotericin B C. Amoxicillin-clavulanate D. Gentamicin E. Choice D rationale:

Correct Answer is C

Explanation

Choice A rationale:

Erythromycin Erythromycin is a macrolide antibiotic that is often used as an alternative to penicillin. It is generally safe for use in patients with a penicillin allergy. It works by inhibiting bacterial protein synthesis and is effective against a wide range of bacteria.

Choice B rationale:

Amphotericin B Amphotericin B is an antifungal medication, not an antibiotic. It is used to treat serious, systemic fungal infections. It has no cross-reactivity with penicillin, so it would not be a concern for a patient with a penicillin allergy.

Choice C rationale:

Amoxicillin-clavulanate Amoxicillin-clavulanate is a type of penicillin antibiotic. Patients with a known penicillin allergy should avoid this medication, as they may have a cross-reactivity to it. This is why the nurse should verify this prescription with the provider.

Choice D rationale:

Gentamicin Gentamicin is an aminoglycoside antibiotic used to treat serious bacterial infections caused by gram-negative bacteria. It is not related to penicillin and would be safe for a patient with a penicillin allergy.

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The nurse checks the patient’s laboratory work prior to administering a dose of vancomycin and finds that the trough vancomycin level is 24 mcg/mL. What will the nurse do next?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching with a client who has diabetes mellitus about the manifestations of hypoglycemia. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is A

Explanation

A nurse is caring for a child who has a penicillin allergy. Which of the following prescriptions should the nurse verify with the provider?

Correct Answer is C

Explanation

Which of the following medications is typically prescribed for the treatment of hyperthyroidism?

The nurse is reviewing the medication orders for a patient who will be receiving aminoglycoside therapy. Which other medication or medication class, if ordered, would be a potential interaction concern?

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