Which range is the targeted therapeutic adult dosage range of theophylline?

1 to 5 mcg/mL

30 to 40 mcg/mL

50 to 60 mcg/mL

10 to 20 mcg/mL

Answer and Explanation

The Correct Answer is D

Choice A reason: The 1 to 5 mcg/mL range is too low for theophylline’s therapeutic effect. Theophylline, a methylxanthine, requires 10-20 mcg/mL to achieve bronchodilation by inhibiting phosphodiesterase and increasing cyclic AMP. Levels below this range are ineffective for asthma or COPD management, risking suboptimal control.

Choice B reason: The 30 to 40 mcg/mL range is toxic for theophylline. Levels above 20 mcg/mL can cause serious side effects like seizures, arrhythmias, or nausea due to its narrow therapeutic index. Therapeutic monitoring ensures levels stay within 10-20 mcg/mL for safe and effective bronchodilation.

Choice C reason: The 50 to 60 mcg/mL range is far above theophylline’s therapeutic range, leading to severe toxicity, including life-threatening arrhythmias or convulsions. Theophylline’s efficacy for airway relaxation occurs at 10-20 mcg/mL, and such high levels are dangerous, requiring immediate intervention to reduce toxicity risks.

Choice D reason: The 10 to 20 mcg/mL range is the targeted therapeutic range for theophylline in adults. Within this range, theophylline inhibits phosphodiesterase, increasing cyclic AMP, promoting bronchodilation, and relieving asthma or COPD symptoms. Monitoring ensures efficacy while minimizing toxicity risks like tachycardia or seizures.

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Correct Answer is C

Explanation

Choice A reason: Amoxicillin, a penicillin antibiotic, inhibits bacterial cell wall synthesis and is commonly used for infections like otitis media. It is not associated with tendon rupture, as it lacks the mechanism affecting collagen or connective tissue. Its side effects include gastrointestinal upset and allergic reactions, not musculoskeletal issues.

Choice B reason: Clarithromycin, a macrolide antibiotic, inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit. It is used for respiratory infections but is not linked to tendon rupture. Its side effects include gastrointestinal disturbances and QT prolongation, with no known impact on tendon integrity or collagen metabolism.

Choice C reason: Ciprofloxacin, a fluoroquinolone, is associated with tendon rupture, particularly in the Achilles tendon. It may disrupt collagen synthesis and extracellular matrix integrity, increasing tendon vulnerability, especially in older adults or those on corticosteroids. This rare but serious side effect requires monitoring during therapy.

Choice D reason: Doxycycline, a tetracycline antibiotic, inhibits protein synthesis and is used for infections like acne or Lyme disease. While it can cause photosensitivity or gastrointestinal issues, it is not associated with tendon rupture. Its mechanism does not involve collagen disruption, unlike fluoroquinolones such as ciprofloxacin.

A. Vitamin K B. Vitamin E C. Protamine sulfate D. Potassium chloride

Correct Answer is A

Explanation

Choice A reason: Warfarin overdose causes excessive anticoagulation, increasing bleeding risk by inhibiting vitamin K-dependent clotting factors (II, VII, IX, X). Vitamin K reverses this by restoring clotting factor synthesis, correcting INR and stopping gastrointestinal bleeding, making it the standard treatment for warfarin toxicity.

Choice B reason: Vitamin E has no role in reversing warfarin toxicity. It is an antioxidant with no effect on clotting factor synthesis or warfarin’s mechanism. Its use may be associated with bleeding risk in high doses, making it inappropriate for managing warfarin-induced gastrointestinal bleeding.

Choice C reason: Protamine sulfate reverses heparin, not warfarin. Heparin enhances antithrombin activity, and protamine neutralizes it. Warfarin’s effect on vitamin K-dependent factors is unrelated, and protamine has no impact on warfarin toxicity or gastrointestinal bleeding, making it an incorrect choice.

Choice D reason: Potassium chloride treats hypokalemia, not warfarin toxicity. Warfarin’s bleeding complications result from inhibited clotting factor synthesis, not electrolyte imbalances. Potassium chloride is irrelevant to reversing anticoagulation or managing gastrointestinal bleeding caused by excessive warfarin, making this an inappropriate treatment.

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Which range is the targeted therapeutic adult dosage range of theophylline?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following antibiotics is associated with a risk of tendon rupture?

Correct Answer is C

Explanation

A patient who has been anticoagulated with warfarin has been admitted for gastrointestinal bleeding. The history and physical examination indicate that the patient may have taken too much warfarin. The nurse anticipates that the patient will receive what treatment?

Correct Answer is A

Explanation

A nurse is caring for a patient who has been prescribed metronidazole. The patient has elevated alanine transaminase (ALT) and aspartate transaminase (AST). What action should the nurse take concerning the administration of metronidazole to this patient?

A patient has prescriptions for two inhalers. One inhaler is albuterol, and the other is fluticasone. Which instruction regarding these inhalers will the nurse give to the patient?

When reviewing the allergy history of a patient, the nurse notes that the patient is allergic to penicillin. Based on this finding, the nurse would question an order for which class of antibiotics?

A patient who is diagnosed with genital herpes is using topical acyclovir, and the nurse is providing instructions about adverse effects. What topic will the nurse include?

Which of the following is a short-acting beta agonist (SABA) commonly used to relieve acute bronchospasm in asthma?

The nurse is caring for a client receiving an intravenous heparin infusion. The client has a new prescription for warfarin and asks the nurse why he has to be on two medications. What response by the nurse is appropriate?

The nurse is administering an amphotericin B infusion. Which actions by the nurse are appropriate? (Select all that apply)