Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A client with an infection is being treated with vancomycin. The nurse providing care reviews the client's laboratory reports and notes that the client's blood urea nitrogen (BUN) and serum creatinine levels are newly elevated. What would be the appropriate nursing intervention?
A. Instruct the client to notify the nurse if they have any tingling in their toes.
Tingling in the toes may be indicative of peripheral neuropathy but is not specifically related to elevated BUN and serum creatinine levels.
B. Interpret the peak and trough levels.
Elevated BUN and serum creatinine levels suggest potential renal impairment, and interpreting peak and trough levels of vancomycin is essential to assess the drug's impact on renal function.
C. Assess the client's urine output.
Assessing urine output is important in evaluating renal function, but the specific action related to the elevated BUN and creatinine levels is to interpret vancomycin levels.
D. Consult the provider about the need for a less nephrotoxic medication.
Consulting the provider about the need for a less nephrotoxic medication may be a consideration, but understanding the impact of vancomycin on renal function through peak and trough levels is a crucial initial step.
This question is an excerpt from Nurse Dive's nursing test bank - Ramsussen Section 4 Module 11. Pharmocology For Professional Nursing Proctored Exam. Take the full exam now
Full Explanation
a) Tingling in the toes may be indicative of peripheral neuropathy but is not specifically related to elevated BUN and serum creatinine levels.
b) Elevated BUN and serum creatinine levels suggest potential renal impairment, and interpreting peak and trough levels of vancomycin is essential to assess the drug's impact on renal function.
c) Assessing urine output is important in evaluating renal function, but the specific action related to the elevated BUN and creatinine levels is to interpret vancomycin levels.
d) Consulting the provider about the need for a less nephrotoxic medication may be a consideration, but understanding the impact of vancomycin on renal function through peak and trough levels is a crucial initial step.
Similar Questions
When administering medications to infants, it is essential to remember which of the following? (Select all that apply.)
A. Oral medications are contraindicated in infants.
This is false because oral medications can be given to infants if they are in liquid form, have a suitable dose, and are administered with a dropper or syringe. However, oral medications should be given with caution and only when prescribed by a doctor.
B. Breastfeeding infants are more likely to develop toxicity when given lipid-soluble drugs.
This is false because lipid-soluble drugs are not easily passed into breast milk and do not affect breastfeeding infants. However, some drugs can be harmful to breastfeeding infants and should be avoided or used with caution by nursing mothers.
C. Immaturity of renal function in infancy causes infants to excrete drugs less efficiently.
Immaturity of renal function in infancy affects drug excretion, potentially leading to prolonged drug effects and increased risk of toxicity.
D. Infants are more sensitive to medications that act on the central nervous system.
Infants are more sensitive to medications that act on the central nervous system, and dose adjustments may be needed to prevent adverse effects.
E. Infants have immature livers, which slow drug metabolism.
Immature liver function in infants can slow down drug metabolism and elimination, leading to a higher risk of drug accumulation and toxicity.
Full Explanation
a) This is false because oral medications can be given to infants if they are in liquid form, have a suitable dose, and are administered with a dropper or syringe. However, oral medications should be given with caution and only when prescribed by a doctor.
b) This is false because lipid-soluble drugs are not easily passed into breast milk and do not affect breastfeeding infants. However, some drugs can be harmful to breastfeeding infants and should be avoided or used with caution by nursing mothers.
c) Immaturity of renal function in infancy affects drug excretion, potentially leading to prolonged drug effects and increased risk of toxicity.
d) Infants are more sensitive to medications that act on the central nervous system, and dose adjustments may be needed to prevent adverse effects.
e) Immature liver function in infants can slow down drug metabolism and elimination, leading to a higher risk of drug accumulation and toxicity.
A 50-year-old postmenopausal client who has had a hysterectomy has moderate to severe hot flashes and is discussing estrogen therapy with the nurse. What will the nurse tell the client regarding the side effects of estrogen therapy?
A. Transdermal preparations of estrogen therapy have reduced side effects.
Transdermal estrogen therapy may have reduced side effects compared to oral preparations.
B. An intravaginal preparation may be best.
Intravaginal preparations may be more focused on genitourinary symptoms and may not necessarily reduce side effects.
C. An estrogen-progesterone product will increase side effects.
An estrogen-progesterone combination is often used to prevent endometrial hyperplasia but may not necessarily increase side effects.
D. Side effects of estrogen therapy are uncommon among women of her age.
While side effects can occur at any age, the focus should be on the formulation of estrogen therapy, and transdermal preparations are often associated with reduced side effects.
Full Explanation
a) Transdermal estrogen therapy may have reduced side effects compared to oral preparations.
b) Intravaginal preparations may be more focused on genitourinary symptoms and may not necessarily reduce side effects.
c) An estrogen-progesterone combination is often used to prevent endometrial hyperplasia but may not necessarily increase side effects.
d) While side effects can occur at any age, the focus should be on the formulation of estrogen therapy, and transdermal preparations are often associated with reduced side effects.
A client on a morphine PCA pump is noted to be drowsy and lethargic with pinpoint pupils and the following vitals: pulse 84 beats/minute, respiratory rate 10 breaths/minute, blood pressure 90/50 mm Hg. What is the nurse's best action?
A. Discuss possible opiate dependence with the client's provider.
While discussing possible opiate dependence is important, the immediate concern is the client's respiratory depression and altered level of consciousness, which may require naloxone administration.
B. Note the effectiveness of the analgesia in the client's chart.
Noting the effectiveness of analgesia is relevant but does not address the current respiratory depression and lethargy observed in the client.
C. Encourage the client to turn over, and cough and take deep breaths.
Encouraging the client to turn over and cough may not be effective in addressing severe respiratory depression, and immediate intervention is needed.
D. Prepare to administer naloxone and provide respiratory support.
The client's symptoms, including drowsiness, lethargy, pinpoint pupils, and respiratory depression, are consistent with opioid overdose. Naloxone is the antidote for opioid toxicity and should be administered promptly.
Full Explanation
a) While discussing possible opiate dependence is important, the immediate concern is the client's respiratory depression and altered level of consciousness, which may require naloxone administration.
b) Noting the effectiveness of analgesia is relevant but does not address the current respiratory depression and lethargy observed in the client.
c) Encouraging the client to turn over and cough may not be effective in addressing severe respiratory depression, and immediate intervention is needed.
d) The client's symptoms, including drowsiness, lethargy, pinpoint pupils, and respiratory depression, are consistent with opioid overdose. Naloxone is the antidote for opioid toxicity and should be administered promptly.