The nurse checks the patient’s laboratory work prior to administering a dose of vancomycin and finds that the trough vancomycin level is 24 mcg/mL. What will the nurse do next?

Hold the drug, and administer 4 hours later.

Administer the vancomycin as ordered.

Hold the drug, and notify the prescriber.

Repeat the test to verify results.

Answer and Explanation

The Correct Answer is C

Choice A rationale:

Holding the drug and administering it 4 hours later is not the appropriate action. The trough vancomycin level of 24 mcg/mL is higher than the recommended range of 10-20 mcg/mL, indicating potential risk for toxicity. Administering the drug later does not address the immediate concern of a high trough level.

Choice B rationale:

Administering the vancomycin as ordered is not the correct action in this case. The trough level is above the recommended range, which could lead to vancomycin toxicity. The nurse should not administer the medication without addressing the high trough level. Choice C rationale:

This is the correct action. The nurse should hold the drug and notify the prescriber because the trough vancomycin level is higher than the recommended range. The prescriber can then make a decision based on this information, which may include adjusting the dose, extending the dosing interval, or ordering additional tests.

Choice D rationale:

While repeating the test to verify results might be done eventually, it should not be the immediate next step. The nurse has a responsibility to ensure patient safety, and with a trough level above the recommended range, the priority is to prevent potential toxicity. Therefore, the nurse should hold the drug and notify the prescriber.

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Correct Answer is C

Explanation

Choice A rationale:

Fluconazole Fluconazole is an antifungal medication used to treat and prevent fungal infections. It works by stopping the growth of certain types of fungus. However, it is not effective against bacterial infections such as anthrax.

Choice B rationale:

Tobramycin Tobramycin is an aminoglycoside antibiotic used to treat various types of bacterial infections, particularly Gramnegative infections. It works by stopping the growth of bacteria. However, it is not typically used to treat anthrax.

Choice C rationale:

Ciprofloxacin Ciprofloxacin is a fluoroquinolone antibiotic used for the treatment of a number of bacterial infections. This includes bone and joint infections, intra-abdominal infections, certain type of infectious diarrhea, respiratory tract infections, skin infections, typhoid fever, and urinary tract infections, among others. For the treatment of anthrax, ciprofloxacin is one of the antibiotics that could be used. It works by killing the anthrax or by stopping the anthrax from growing. When the anthrax can’t grow anymore, it dies.

Choice D rationale:

Vancomycin Vancomycin is an antibiotic used to treat a number of bacterial infections. It is recommended intravenously as a treatment for complicated skin infections, bloodstream infections, endocarditis, bone and joint infections, and meningitis caused by methicillin-resistant Staphylococcus aureus. However, it is not typically used to treat anthrax.

Correct Answer is ["2"]

Explanation

Let’s solve the medication math problem step by step:

Step 1: Identify the total daily dose of amoxicillin. The total daily dose is 2 gm/day.

Step 2: Convert the total daily dose from grams to milligrams, as the available medication is in milligrams. We know that 1 gm = 1000 mg, so 2 gm = 2000 mg.

Step 3: The total daily dose is divided into two doses. So, each dose will be 2000 mg ÷ 2 = 1000 mg.

Step 4: Determine the number of tablets for each dose. Each tablet contains 500 mg of amoxicillin. So, the number of tablets for each dose is 1000 mg ÷ 500 mg/tablet = 2 tablets.

So, the nurse should administer 2 tablets of amoxicillin with each dose.

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The nurse checks the patient’s laboratory work prior to administering a dose of vancomycin and finds that the trough vancomycin level is 24 mcg/mL. What will the nurse do next?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who was exposed to anthrax. Which of the following antibiotics should the nurse plan to administer?

Correct Answer is C

Explanation

A nurse is preparing to administer amoxicillin 2 gm/day PO divided into two doses. The amount available is amoxicillin 500 mg tablets. How many tablets should the nurse administer with each dose?

Correct Answer is ["2"]

Explanation

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