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.

Correct Answer is ["0.6"]

Explanation

To calculate the volume of diazepam solution needed, we can use the formula:

Volume (mL) = Total dose (mg) / Concentration (mg/mL)

Given:

Total dose = 3 mg

Concentration = 5 mg/mL

Plugging the values into the formula:

Volume (mL) = 3 mg / 5 mg/mL

Volume (mL) = 0.6 mL

The nurse should administer: 0.6 mL

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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

A nurse is preparing to administer diazepam 3 mg IM. The amount available is diazepam for injection 5 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["0.6"]

Explanation

The patient is to be started on warfarin (Coumadin) therapy. It is important for the nurse to check for the use of which herbs? (Select All that Apply)

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A nurse is caring for a client who just received a dose of IV ampicillin. Which of the following client reactions requires priority intervention by the nurse?

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Which class of antibiotic is associated with cartilage toxicity and rupture of the Achilles tendon?

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?

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?

A patient asks the nurse to define hypersensitivity reaction. The nurse begins by telling the patient that a hypersensitivity reaction is also called: