Return to course: QBANK (In progress – I am currently making this)
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Therapeutic Monitoring and Lab Correlations
1. Mr. Raymond, 45 years old, has been receiving lithium carbonate for bipolar disorder. His most recent lab result shows a serum lithium level of 2.1 mmol/L. He reports tremors, vomiting, and confusion. What should the nurse do first?
*
Administer the next scheduled dose of lithium
Encourage oral fluids and continue monitoring
Notify the physician immediately and hold the next dose
Document the findings as expected side effects
2. A patient who has been receiving intravenous gentamicin for several days reports having had a headache for 2 days. The lab reports a high trough level.
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Administer the next dose on time
Obtain a gentamicin trough before the next dose is given
Give an analgesic to control headache discomfort.
Hold the next dose and report the result
3. A patient is on warfarin (Coumadin) therapy for atrial fibrillation. The latest INR result is 5.5 (Normal: 2-3). What should the nurse anticipate?
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Administer vitamin K as ordered
Increase the warfarin dose
Encourage green leafy vegetables
Administer protamine sulfate as ordered
4. Mr. Benoît is taking phenytoin (Dilantin) for seizure control. His serum phenytoin level is 8 mcg/mL (Normal: 1020 mcg/mL). What should the nurse anticipate?
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Signs of toxicity
The need to increase the dose
Discontinue the medication
Administer activated charcoal
5. Which parameter will the LPN assess in the patient with pneumonia who is about to receive vancomycin to ensure safe administration of the drug?
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Liver function
Cardiac function
Renal function
Neurologic function
6. A patient receiving digoxin shows a serum digoxin level of 2.8 ng/mL. The nurse notes bradycardia and visual halos. What is the most appropriate intervention?
*
Continue monitoring the heart rate
Administer digoxin as ordered
Withhold the dose and notify the physician
Encourage high-potassium foods
7. A patient is receiving theophylline for asthma. The theophylline level is 25 mcg/mL. What sign should the nurse monitor for?
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Constipation
Bradycardia
Seizures
Hypoglycemia
8. The client experiences extrapyramidal symptoms (EPS) during therapy with phenothiazines. The nurse expects which of the following drugs to be prescribed?
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Ativan
Haloperidol (Haldol)
Diazepam (Valium)
Benztropine (Cogentin)
9. Mr. Lapierre is on valproic acid for epilepsy. The nurse reviews his labs: AST and ALT are elevated. What should the nurse do?
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Document and continue the medication
Administer the next dose
Report findings to the physician
Provide extra carbohydrates
10. A patient receiving methotrexate for rheumatoid arthritis has a WBC count of 2.0 x10⁹/L (Normal: 4.5–11.0 x 10⁹/L). What is the most appropriate action?
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Administer the next dose
Place the patient in isolation and notify the physician
Encourage oral fluids
Provide extra folic acid
Therapeutic Monitoring and Lab Correlations
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