A nurse is preparing to administer vancomycin, a glycopeptide antibiotic, to a client with a severe infection caused by Clostridium difficile.
The nurse should select all that apply:

Monitor the client’s serum creatinine level

Monitor the client’s serum vancomycin level

Infuse the drug over at least 60 minutes

Observe the client

Answer and Explanation

Correct Answer : A,B,C

Here is why:

• Choice A: Monitor the client’s serum creatinine level.

This is correct because vancomycin can cause nephrotoxicity (damage to the kidneys) and serum creatinine is a marker of kidney function. A high serum creatinine level indicates impaired kidney function and may require dose adjustment or discontinuation of vancomycin.

• Choice B: Monitor the client’s serum vancomycin level.

This is correct because vancomycin has a narrow therapeutic range, meaning that there is a small difference between the effective dose and the toxic dose. Monitoring the serum vancomycin level can help to ensure that the drug is within the therapeutic range and avoid toxicity or suboptimal efficacy.

• Choice C: Infuse the drug over at least 60 minutes.

This is correct because vancomycin can cause a hypersensitivity reaction called “red man syndrome” or “red neck syndrome”, which is characterized by flushing, itching, rash, hypotension and tachycardia.

This reaction is not an allergy but a result of histamine release due to rapid infusion of vancomycin. Infusing the drug over at least 60 minutes can reduce the risk of this reaction.

• Choice D: Observe the client for signs of ototoxicity.

This is incorrect because vancomycin is not known to cause ototoxicity (damage to the ears) in humans. Ototoxicity has been reported in animal studies and in vitro studies, but not in clinical trials or case reports involving humans.

Therefore, there is no need to monitor for signs of ototoxicity such as hearing loss, tinnitus or vertigo.

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Correct Answer is ["A","B","E"]

Explanation

Jaundice, vision changes and numbness in the hands or feet are possible adverse effects of the drugs used to treat tuberculosis.The nurse should instruct the client to report these signs or symptoms as they may indicate liver damage, optic neuritis or peripheral neuropathy respectively.

Choice C is wrong because hearing loss is not a common side effect of these drugs.Hearing loss may be caused by other drugs such as aminoglycosides.

Choice D is wrong because orange-colored urine is a harmless side effect of rifampin and does not need to be reported.

The nurse should inform the client about this expected change and reassure them that it is not harmful.

The normal ranges for liver function tests are:

• AST: 10-40 U/L

• ALT: 7-56 U/L

• ALP: 45-115 U/L

• Bilirubin: 0.1-1.2 mg/dL

The normal range for visual acuity is 20/20.

The normal range for sensation is intact and symmetrical in all extremities.

A. Development of medication resistance in the host B. Over-riding of the minimum bactericidal concentration C. Incorrect dosing, which contributes to ribosome mutations D. Transfer of DNA coding to other bacteria E. Spontaneous mutation in the microbial genome.

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

Explanation

A microbe acquires antibiotic resistance by transferring DNA coding to other bacteria or by spontaneous mutation in the microbial genome.

These genetic changes allow the microbe to survive the effects of the antibiotic and pass on the resistance to its offspring.

ChoiceAis wrong because the host does not develop medication resistance, but the microbe does.

ChoiceBis wrong because the minimum bactericidal concentration (MBC) is the lowest concentration of an antibiotic needed to kill 99.9% of bacteria, not a mechanism of resistance.

ChoiceCis wrong because incorrect dosing does not cause ribosome mutations, but may promote the emergence of drug-resistant microbes by exposing them to suboptimal levels of the antibiotic.

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A nurse is preparing to administer vancomycin, a glycopeptide antibiotic, to a client with a severe infection caused by Clostridium difficile. The nurse should select all that apply:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has tuberculosis about the prescribed drug regimen, which includes isoniazid, rifampin, pyrazinamide, and ethambutol. The nurse should instruct the client to report which signs or symptoms as possible adverse effects of these drugs? (Select all that apply.)

Correct Answer is ["A","B","E"]

Explanation

(Select all that apply) A microbe acquires antibiotic resistance by which means?

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

Explanation

The development of a new infection as a result of the elimination of normal flora by an antibiotic is referred to as what?

A patient is receiving cefazolin, a first-generation cephalosporin, for a surgical prophylaxis. The nurse should assess the patient for which of the following possible allergic reactions? (Select all that apply.)

A nurse is administering penicillin to a client who has streptococcal pharyngitis. The nurse should monitor for which adverse effect of penicillin therapy?

Which term is used to describe an agent that inhibits bacterial growth but does not kill bacteria?

Which statement is true regarding antimicrobial stewardship?

A nurse is caring for a client who is receiving gentamicin, an aminoglycoside antibiotic, for a severe infection. The nurse should monitor the client for which adverse effects of this drug? (Select all that apply.)

Which of the following antiviral medications inhibits neuraminidase enzyme?

A nurse is preparing to administer vancomycin, a glycopeptide antibiotic, to a client with a severe infection caused by Clostridium difficile. The nurse should select all that apply:

A nurse is preparing to administer vancomycin, a glycopeptide antibiotic, to a client with a severe infection caused by Clostridium difficile.
The nurse should select all that apply: