A patient is to have peak and trough levels drawn for a particular drug. The nurse explains to the patient that these drug blood levels are important to:

determine the amount of protein binding of the drug.

determine if the blood concentration is at a level to produce beneficial effects.

measure the distribution of the drug throughout the body.

measure the first pass effect.

Answer and Explanation

The Correct Answer is B

A. determine the amount of protein binding of the drug: Protein binding affects the drug’s activity and distribution, but peak and trough levels specifically measure blood concentration, not protein binding.

B. determine if the blood concentration is at a level to produce beneficial effects: Peak and trough levels are used to ensure the drug concentration stays within a therapeutic range—high enough to be effective but low enough to avoid toxicity. This monitoring is crucial for drugs with narrow therapeutic windows.

C. measure the distribution of the drug throughout the body: Drug distribution refers to how a drug spreads to tissues and organs, which is not directly assessed by peak and trough blood levels.

D. measure the first pass effect: The first pass effect relates to drug metabolism by the liver before reaching systemic circulation, which is not evaluated by peak and trough drug level measurements.

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Correct Answer is ["B","C","D"]

Explanation

A. 33-year-old client with chronic pain: While chronic pain requires ongoing medication management, this client is not inherently at increased risk for toxic effects without additional factors such as organ dysfunction or polypharmacy.

B. 43-year-old client with end stage renal (kidney) disease: Renal impairment reduces the body’s ability to excrete drugs, increasing the risk of drug accumulation and toxicity. Dosage adjustments and close monitoring are essential to prevent adverse effects.

C. 36-year-old client with chronic liver disease: Liver disease impairs drug metabolism, leading to prolonged drug action and higher risk of toxic effects. Careful selection and dosing of medications are necessary to avoid toxicity.

D. 84-year-old client with congestive heart failure: Older adults and those with heart failure often have altered pharmacokinetics and pharmacodynamics, making them more susceptible to drug toxicity. Age-related changes and reduced cardiac output can affect drug metabolism, distribution and elimination.

A. Pedal Pulses B. Skin Integrity C. Intake and Output D. Temperature

Correct Answer is C

Explanation

A. Pedal Pulses: While assessing pedal pulses can provide information about circulation, they are not a direct indicator of hydration status. Pulse quality may be affected by other factors such as vascular disease or cardiac output, making this a less reliable measure.

B. Skin Integrity: Skin integrity assesses for potential breakdown or wounds. Although dehydration can affect skin turgor, this alone is insufficient to evaluate fluid balance comprehensively, especially in older adults where elasticity changes naturally with age.

C. Intake and Output: Monitoring fluid intake and urine output provides the most accurate and immediate data on fluid balance. It helps determine if the patient is retaining, losing, or maintaining fluids, making it a primary tool for assessing hydration.

D. Temperature: Elevated temperature may indicate infection or inflammation, which can contribute to fluid loss, but temperature changes alone are not a reliable measure of overall fluid status. It is an indirect and nonspecific indicator.

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A patient is to have peak and trough levels drawn for a particular drug. The nurse explains to the patient that these drug blood levels are important to:

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Naxlex Comprehensive Predictor Exams

When administering a medication, the nurse would identify which of the following clients at risk for toxic effects? (SELECT ALL THAT APPLY)

Correct Answer is ["B","C","D"]

Explanation

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Correct Answer is C

Explanation

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