When given an intravenous medication, the patient asks the nurse, “I usually take pills.
Why does this medication have to be given in the arm?” What is the nurse’s best response?

“The intravenous medication will have delayed absorption into the body’s tissues.”

“The action of the medication will begin sooner when given intravenously.”

“The medication will cause fewer adverse effects when given intravenously.”

“There is a lower chance of allergic reactions when drugs are given intravenously.”

Answer and Explanation

The Correct Answer is B

Choice A rationale:

The statement “The intravenous medication will have delayed absorption into the body’s tissues” is incorrect. Intravenous (IV) therapy is administering fluids directly into a vein. It benefits treatment by enabling water, medication, blood, or nutrients to access the body faster through the circulatory system. This bypasses the gastric system so the body can take on more fluids quickly. Therefore, the absorption of intravenous medication into the body’s tissues is not delayed but rather immediate.

Choice B rationale:

The statement “The action of the medication will begin sooner when given intravenously” is correct. Administering a medication intravenously eliminates the process of drug absorption and breakdown by directly depositing it into the blood. This results in the immediate elevation of serum levels and high concentration in vital organs, such as the heart, brain, and kidneys. Therefore, the action of the medication begins sooner when given intravenously.

Choice C rationale:

The statement “The medication will cause fewer adverse effects when given intravenously” is not necessarily true. While some medications might cause fewer adverse effects when given intravenously, this is not a general rule for all medications. The adverse effects of a medication depend on various factors including the type of medication, the dose, the patient’s health condition, and more.

Choice D rationale:

The statement “There is a lower chance of allergic reactions when drugs are given intravenously” is not necessarily true. The chance of allergic reactions depends on various factors including the type of drug, the patient’s immune response, previous exposure to the drug, and more. It’s not related to the route of administration.

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Correct Answer is C

Explanation

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.

A. Proton pump inhibitors B. Calcium channel blockers C. Loop diuretics D. Phenytoin

Correct Answer is C

Explanation

Choice A rationale:

Proton pump inhibitors (PPIs) are used extensively for the treatment of gastric acid-related disorders, often over the long term, which raises the potential for clinically significant drug interactions in patients receiving concomitant medications.

However, there is no specific mention of a significant interaction between PPIs and aminoglycosides.

Choice B rationale:

Aminoglycoside antibiotics and calcium channel blockers can interact at the neuromuscular junctions. This interaction is of clinical significance because when these agents are given concurrently during the perioperative period they may lead to respiratory depression or prolonged apnea. However, this is not directly related to the therapeutic effect of aminoglycosides, but rather a side effect of their combined use.

Choice C rationale:

The loop-diuretics (ethacrynic acid, furosemide, bumetamide) and aminoglycoside antibiotics (kanamycin, gentamicin, tobramycin, amikacin, etc.) are important drugs frequently used to treat seriously ill patients. Not uncommonly both types of drugs are given to the same patient exposing that patient to the risk of a hearing loss (ototoxicity)5. In addition, the risk of ototoxicity could be enhanced by the concomitant use of loop diuretics and aminoglycoside antibiotics.

Choice D rationale:

Phenytoin is a medication used to treat seizures. It has a complex pharmacokinetic profile and can interact with many other drugs. However, there is no specific mention of a significant interaction between phenytoin and aminoglycosides.

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When given an intravenous medication, the patient asks the nurse, “I usually take pills. Why does this medication have to be given in the arm?” What is the nurse’s best response?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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?

Correct Answer is C

Explanation

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?

Correct Answer is C

Explanation

A 6-year-old child who has chickenpox also has a fever of 102.9 F (39.4 C). The child’s mother asks the nurse if she should use aspirin to reduce the fever. What is the best response by the nurse?

When a patient is undergoing aminoglycoside therapy, which indicators should the nurse monitor for potential toxicity?

Examine the following patient data for a patient who has been prescribed vancomycin. The nurse is evaluating a patient after administering several doses of Vancomycin IV. Which of the following changes would indicate a therapeutic response to the medication? (Select all that apply)

A nurse is documenting an 8-hour intake and output (I&O) record for a patient who consumed 4 oz of juice, 6 oz of tea, a 100 mL cup of soda, an IV bolus of 150 mL, and 8 oz of broth. How many mL of intake should the nurse record on the patient’s chart?

A nurse is preparing to administer methylnaltrexone 12 mg subcutaneously to a client who has opioid-induced constipation. The available methylnaltrexone is 8 mg/0.4 mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies.

When given a scheduled morning medication, the patient states, “I haven’t seen that pill before. Are you sure it’s correct?” The nurse checks the medication administration record and verifies that it is listed. Which is the nurse’s best response?

A nurse is reinforcing teaching about insulin injections with a client who is newly diagnosed with type I diabetes mellitus. Which of the following information should the nurse include about site selection?

A nurse is reinforcing teaching with a client who has type 1 diabetes mellitus. Which statement from the client indicates that the teaching is effective?

When given an intravenous medication, the patient asks the nurse, “I usually take pills.
Why does this medication have to be given in the arm?” What is the nurse’s best response?