Saunders Comprehensive Review for the NCLEX-RN Examination Silvestri 5th Edition Test Bank


TOP: Content Area: Nursing Sciences MSC: Integrated Process: Nursing Process—Evaluation


23. The client with chronic obstructive pulmonary disease (COPD) has had a sample for a serum theophylline level drawn as part of routine follow-up care. Which of the following results would lead the nurse to conclude that the client has most likely been compliant with medication therapy? 1. 3 mcg/mL 2. 7 mcg/mL 3. 14 mcg/mL 4. 24 mcg/mL


ANS: 3


Rationale: The therapeutic range for serum theophylline (or aminophylline) level is 10 to 20 mcg/mL. If the level is within the therapeutic range, the client is most likely compliant with medication therapy. If the level is below the therapeutic range, the client may not be compliant with medication therapy and is at risk for more frequent exacerbations of the disease. Clients who are noncompliant require special follow-up to minimize the frequency of complications.


Test-Taking Strategy: Note that the strategic word in the question is “compliant.” This tells you that the correct option will be a value that is within the therapeutic range. Knowledge of the therapeutic level of theophylline is then needed to select the correct option. Remember that this therapeutic range is 10 to 20 mcg/mL. Review this therapeutic range if you had difficulty with this question.


PTS: 1 DIF: Level of Cognitive Ability: Understanding REF: Hodgson, B., & Kizior, R. (2010). Saunders nursing drug handbook 2010. St. Louis: Saunders. OBJ: Client Needs: Physiological Integrity TOP: Content Area: Nursing Sciences MSC: Integrated Process: Nursing Process—Evaluation


24. A long-term care nurse about to give a daily dose of digoxin (Lanoxin) is told that a serum digoxin level drawn earlier in the day measured 2.7 ng/mL. The nurse should take which of the following actions first? 1. Administer the daily dose of the medication. 2. Report the finding to the health care provider. 3. Record the normal value on the intershift report sheet. 4. Gather data from the client related to signs of toxicity.


ANS: 4


Rationale: The normal therapeutic range for digoxin is 0.5 to 2.0 ng/mL. A value of 2.7 ng/mL exceeds the therapeutic range and could be toxic to the client. The nurse should gather data about signs of digoxin toxicity and then notify the health care provider.


Saunders Comprehensive Review for the NCLEX-RN Examination Silvestri 5th Edition Test Bank


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