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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Free Nursing Study Resources

Correct Answer is A

Explanation

Maraviroc is aCCR5 coreceptor antagonistthat blocks the receptor site the HIV virus needs to interact with in order to enter the cell.It prevents viral fusion with host cell membrane by binding to the CCR5 receptor on CD4+ T cells and macrophages.

Choice B is wrong becauseAbacavir is wrong because it is anucleoside reverse transcriptase inhibitor (NRTI)that inhibits the enzyme reverse transcriptase, which converts viral RNA into DNA.

It does not prevent viral fusion with host cell membrane.

Choice C is wrong becauseDarunavir is wrong because it is aprotease inhibitor (PI)that inhibits the enzyme protease, which cleaves viral proteins into functional units.

It does not prevent viral fusion with host cell membrane.

Choice D is wrong becauseFosamprenavir is wrong because it is also aprotease inhibitor (PI)that inhibits the enzyme protease.

It does not prevent viral fusion with host cell membrane.

A. Photosensitivity B. Tooth discoloration C. Hepatic impairment D. Superinfection E. Bone marrow suppression.

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

Explanation

Tetracycline can causephotosensitivity, which means increased sensitivity to sunlight and risk of sunburn.It can also causesuperinfection, which means overgrowth of resistant bacteria or fungi in the mouth, intestines, or vagina.

Choice B is wrong because tetracycline can causetooth discolorationin children under 8 years old, not in adults.

Choice C is wrong because tetracycline can causehepatic impairmentonly in patients with preexisting liver disease or who take high doses for a long time.

Choice E is wrong because tetracycline can causebone marrow suppressiononly in patients with preexisting blood disorders or who take high doses for a long time.

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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

Which of the following antiviral medications prevents viral fusion with host cell membrane?

Correct Answer is A

Explanation

A nurse is administering tetracycline, a broad-spectrum antibiotic, to a patient who has acne vulgaris. The nurse should monitor the patient for which of the following adverse effects of this medication? (Select all that apply.)

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

Explanation

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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: