Mrs. Oza, age 69, has hypertension and has one functioning kidney. She loves chocolates and enjoys an alcoholic beverage twice a week. Her hobby is gardening and she goes for long walks despite having arthritis. Which one of the following pieces of information is likely to have the greatest significance if she is prescribed vancomycin?

She only has one functioning kidney

She remains outdoors for long periods of time

She has hypertension

She enjoys an alcoholic beverage twice a week

Answer and Explanation

The Correct Answer is A

A. She only has one functioning kidney:

This choice is the most significant consideration when prescribing vancomycin to Mrs. Oza. Vancomycin is primarily eliminated from the body through the kidneys. Individuals with reduced kidney function, such as Mrs. Oza with only one functioning kidney, have a higher risk of vancomycin-associated nephrotoxicity (kidney damage). Therefore, her renal status is crucial information for determining the appropriate dosage of vancomycin and monitoring for any signs of kidney impairment during treatment.

B. She remains outdoors for long periods of time:

While spending time outdoors for long periods may have implications for Mrs. Oza's overall health, it is not directly relevant to the prescription of vancomycin. This information may be important for considering sun exposure, hydration, and other factors related to her arthritis and general well-being, but it does not specifically impact the pharmacokinetics or pharmacodynamics of vancomycin.

C. She has hypertension:

Mrs. Oza's hypertension is a relevant medical condition to consider in her overall health management. However, hypertension alone does not directly affect the prescription of vancomycin. Hypertension may influence the choice of antihypertensive medications or other aspects of her medical care, but it does not have a direct impact on the renal clearance or potential nephrotoxicity of vancomycin.

D. She enjoys an alcoholic beverage twice a week:

While alcohol consumption can interact with certain medications and impact overall health, it is not the most significant consideration when prescribing vancomycin to Mrs. Oza. Moderate alcohol consumption is unlikely to directly affect the pharmacokinetics or pharmacodynamics of vancomycin. However, excessive alcohol intake may contribute to liver dysfunction, which could indirectly influence drug metabolism. Nonetheless, in Mrs. Oza's case, her reduced renal function is a more critical factor to consider when prescribing vancomycin.

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Correct Answer is D

Explanation

A. Echinacea:

Echinacea is an herbal supplement commonly used to support the immune system and reduce the severity and duration of cold symptoms. However, there is limited evidence to support its efficacy in preventing urinary tract infections (UTIs). While it may have some immune-boosting properties, it is not typically recommended specifically for UTI prevention.

B. Saw palmetto:

Saw palmetto is an herbal supplement often used for prostate health and to alleviate symptoms of benign prostatic hyperplasia (BPH) in men. It is not typically used for preventing urinary tract infections in either men or women.

C. Black cohosh:

Black cohosh is an herbal supplement commonly used by women to alleviate symptoms of menopause, such as hot flashes and mood swings. It is not typically used for preventing urinary tract infections.

D. Cranberry juice:

Cranberry juice and cranberry supplements have long been studied for their potential role in preventing urinary tract infections, particularly in women. Cranberry contains compounds that may prevent bacteria, such as Escherichia coli (E. coli), from adhering to the walls of the urinary tract, reducing the risk of infection. While the evidence supporting cranberry's effectiveness in preventing UTIs is mixed, some studies suggest that it may be beneficial, especially in individuals prone to recurrent UTIs.

A. Keep the serum drug level within the therapeutic margin B. increase the therapeutic effect of the drug by gradually decreasing the drug dose C. Provide maximum physical comfort to the patient D. Treat the main disorder with no psychological distress to the patient

Correct Answer is A

Explanation

A. Keep the serum drug level within the therapeutic margin:

This is the correct goal of monitoring peak and trough levels during antibacterial therapy. The therapeutic margin refers to the range of drug concentrations in the bloodstream that achieves optimal therapeutic effects while avoiding toxicity. By monitoring peak and trough levels, healthcare providers can adjust the dosing regimen to maintain drug levels within this therapeutic margin.

B. Increase the therapeutic effect of the drug by gradually decreasing the drug dose:

This statement is incorrect. Monitoring peak and trough levels is not about increasing the therapeutic effect of the drug by gradually decreasing the drug dose. Instead, it's about ensuring that the drug levels are maintained within the appropriate therapeutic range to achieve optimal efficacy without causing adverse effects.

C. Provide maximum physical comfort to the patient:

Monitoring peak and trough levels is not primarily aimed at providing physical comfort to the patient. While optimizing drug therapy can contribute to improved clinical outcomes and patient well-being, the goal of monitoring these levels is specifically related to achieving therapeutic drug concentrations.

D. Treat the main disorder with no psychological distress to the patient:

This statement is unrelated to the goal of monitoring peak and trough levels during antibacterial therapy. While psychological distress may be a consideration in patient care, the primary goal of monitoring drug levels is to ensure therapeutic efficacy and safety.

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Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching with a client who has frequent urinary tract infections (UTIs). The nurse should identify that the client can use which of the following herbal supplements to help prevent UTIs?

Correct Answer is D

Explanation

Which of the following is the goal of monitoring peak and trough levels during antibacterial therapy?

Correct Answer is A

Explanation

Which of the following differentiates a bacteriostatic drug from a bactericidal drug?

A nurse is preparing a presentation for coworkers about the various herbal remedies clients might report using. Which of the following should she include as an herbal supplement clients might use to treat menopause-related hot flashes?

Which of the following would reduce the absorption of ciprofloxacin?

The nurse is caring for a client receiving gentamycin IV. Which of the following adverse effects would the nurse report to the physician immediately?

A client has been diagnosed with tuberculosis. How long does the nurse anticipate this client will require treatment?

A nurse is reinforcing teaching about vancomycin with a client who has an infection. Which of the following information should the nurse include in the teaching?

Which of the following common habit of patients may cause microbes to re-populate and re-establish an infection?

A client has been prescribed isoniazid (INI) for tuberculosis. Which foods should the client avoid while taking this medication, as they are high in tyramine? (Select All that Apply.)