The health care provider orders a trough level of an antibiotic administered every twenty four hours.
When should the nurse plan for a trough level to be drawn?

Every morning at 08:00AM (0800).

Halfway between next scheduled dose.

Just prior to next scheduled dose.

Two hours after a scheduled dose.

Answer and Explanation

The Correct Answer is C

Just prior to the next scheduled dose. A trough level is the lowest concentration of a drug in the blood, and it is measured just before the next dose is due to be administered.

This helps to ensure that the drug level does not fall below the therapeutic range or rise above the toxic range.

Choice A is wrong because every morning at 08:00 AM (0800) is not a consistent time interval for a drug that is administered every twenty-four hours.

The trough level should be measured at the same time before each dose.

Choice B is wrong because halfway between next scheduled dose is not a trough level, but a midpoint level.

This does not reflect the lowest concentration of the drug in the blood.

Choice D is wrong because two hours after a scheduled dose is not a trough level, but a peak level. This is the highest concentration of the drug in the blood, and it is measured after the drug has been absorbed and distributed. Peak levels are no longer routinely recommended for vancomycin.

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

Explanation

Clubbing in upper digits and tripod positioning are signs of chronic obstructive pulmonary disease (COPD), a respiratory disorder that has components of chronic bronchitis and emphysema. Clubbing is a thickening and widening of the fingertips and nails due to chronic low oxygen levels in the blood. Tripod positioning is when the person leans forward and supports their arms on a table or chair to facilitate breathing.

Choice A is wrong because a BMI greater than 30% indicates obesity, which is not a specific sign of COPD, although it can worsen the condition.

Choice C is wrong because AP chest diameter of 1:1 means that the chest is as wide as it is deep, which is also known as barrel chest. This is a sign of emphysema, one of the components of COPD, but not of COPD itself.

Choice E is wrong because high amounts of energy are not associated with COPD. On the contrary, people with COPD often experience fatigue, weakness, and reduced exercise tolerance due to impaired gas exchange and respiratory muscle function.

A. Isolate the client when there are observable physiologic symptoms of anxiety. B. Ignore the client’s behavior as obvious attempts to gain attention. C. Reduce all stress whenever the client seems anxious. D. Assist the client to identify triggers for the episodes.

Correct Answer is D

Explanation

This is because helping the client to recognize and avoid situations that cause anxiety can reduce the frequency and severity of acute anxiety episodes. According to , a nurse should encourage the client to verbalize feelings and provide a calm and supportive environment.

Choice A is wrong because isolating the client when there are observable physiologic symptoms of anxiety can increase the client’s sense of fear and loneliness.

The nurse should stay with the client and offer reassurance and comfort.

Choice B is wrong because ignoring the client’s behavior as obvious attempts to gain attention can make the client feel rejected and misunderstood.

The nurse should acknowledge the client’s feelings and provide empathy and support.

Choice C is wrong because reducing all stress whenever the client seems anxious can prevent the client from learning coping skills and developing resilience.

The nurse should help the client to identify healthy ways of managing stress and anxiety.

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The health care provider orders a trough level of an antibiotic administered every twenty four hours. When should the nurse plan for a trough level to be drawn?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is admitting a client with an exacerbation of chronic obstructive pulmonary disease. What signs would the nurse expect to observe with this client? Select all that apply.

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

Explanation

Which action should a nurse plan for a client who has episodes of acute anxiety?

Correct Answer is D

Explanation

A nurse takes actions to avoid liability when caring for a client with a psychiatric disorder. Which action is not appropriate in the prevention of liability?

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The health care provider orders a trough level of an antibiotic administered every twenty four hours.
When should the nurse plan for a trough level to be drawn?