A client is receiving intravenous (IV) vancomycin and the nurse plans to draw blood for a peak and trough to determine the serum level of the drug. Which collection times provide the best determination of these levels?

Two hours after completion of the IV dose and two hours before the next administration of the medication.

One hour after completion of the IV dose and one hour before the next administration of the medication.

Thirty minutes into the administration of the IV dose and 30 minutes before the next administration of the medication.

Immediately after completion of the IV dose and 30 minutes before the next administration of the medication.

Answer and Explanation

The Correct Answer is B

choice A, Drawing the peak level two hours after the IV dose is too late to capture the drug's highest serum concentration. Similarly, drawing the trough two hours before the next dose does not reflect the lowest drug level accurately.
Choice B, Drawing the peak level one hour after completion of the IV dose ensures an accurate measurement of the highest serum concentration, as vancomycin typically peaks within this time frame. Drawing the trough one hour before the next dose ensures the lowest concentration of the drug is measured, providing precise therapeutic monitoring.

Choice C is incorrect because drawing blood 30 minutes into the IV dose would not allow the full dose to circulate and reach peak levels in the bloodstream.

Choice D. Drawing the peak level immediately after the completion of the IV dose is too early, as the drug needs time to distribute in the bloodstream and reach its highest concentration. While drawing the trough 30 minutes before the next dose is appropriate, the incorrect timing of the peak makes this option unsuitable.

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Correct Answer is D

Explanation

Choice A rationale: Probenecid does not prevent kidney stones. Its primary function is to increase the excretion of uric acid in the urine.

Choice B rationale: Probenecid does not affect the strength of the urine stream. Its action is specific to uric acid excretion.

Choice C rationale: Probenecid is not used to alleviate pain and burning during urination. Its main indication is for gout and hyperuricemia.

Choice D rationale: Probenecid is a uricosuric drug used to treat gout and hyperuricemia. It works by inhibiting the reabsorption of uric acid in the kidneys, which promotes its excretion in the urine. By increasing uric acid excretion, probenecid helps to reduce the concentration of uric acid in the blood and prevent gout attacks.

A. Low sodium antacid. B. Diphenhydramine. C. Low dose aspirin. D. Acetaminophen.

Correct Answer is A

Explanation

Choice A rationale: Heartburn when lying down after dinner can be a symptom of gastroesophageal reflux disease (GERD), which is a common concern in individuals with heart failure. Antacids are commonly used to relieve heartburn by neutralizing stomach acid. For patients with heart failure, it is essential to use low sodium antacids because excess sodium intake can worsen fluid retention and lead to increased heart failure symptoms. Low sodium antacids are specifically designed to minimize the sodium content, making them a suitable choice for individuals with heart failure.

Choice B rationale: Diphenhydramine is an antihistamine commonly used for allergy relief and as a sleep aid due to its sedative effects. However, it is not an appropriate choice for relieving heartburn. Diphenhydramine does not have any direct effect on stomach acid, and it is not indicated for GERD or heartburn relief.

Choice C rationale: Low dose aspirin is primarily used as an antiplatelet agent to reduce the risk of blood clots and is commonly prescribed for patients with certain cardiovascular conditions. However, it is not a suitable medication for relieving heartburn. In fact, aspirin can irritate the stomach lining and worsen symptoms of heartburn and gastric irritation.

Choice D rationale: Acetaminophen is a common over-the-counter pain reliever and fever reducer. While it is useful for managing pain and fever, it does not have any effect on stomach acid and is not indicated for heartburn relief. Acetaminophen is not an appropriate choice for addressing heartburn symptoms.

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A client is receiving intravenous (IV) vancomycin and the nurse plans to draw blood for a peak and trough to determine the serum level of the drug. Which collection times provide the best determination of these levels?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is providing instructions about a client's new medications. How should the nurse explain the purpose of probenecid, a uricosuric drug?

Correct Answer is D

Explanation

A male client with a history of heart failure (HF) complains of heartburn when he lies down after dinner. The home health nurse should encourage the client to talk to the healthcare provider about using which over-the-counter medication to relieve this problem?

Correct Answer is A

Explanation

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