Mrs. Oza, age 69, has hypertension and has one functioning kidney. She loves chocolates and enjoys an alcoholic beverage twice a week. Her hobby is gardening and she goes for long walks despite having arthritis. Which one of the following pieces of information is likely to have the greatest significance if she is prescribed vancomycin?
She only has one functioning kidney
She remains outdoors for long periods of time
She has hypertension
She enjoys an alcoholic beverage twice a week
The Correct Answer is A
A. She only has one functioning kidney:
This choice is the most significant consideration when prescribing vancomycin to Mrs. Oza. Vancomycin is primarily eliminated from the body through the kidneys. Individuals with reduced kidney function, such as Mrs. Oza with only one functioning kidney, have a higher risk of vancomycin-associated nephrotoxicity (kidney damage). Therefore, her renal status is crucial information for determining the appropriate dosage of vancomycin and monitoring for any signs of kidney impairment during treatment.
B. She remains outdoors for long periods of time:
While spending time outdoors for long periods may have implications for Mrs. Oza's overall health, it is not directly relevant to the prescription of vancomycin. This information may be important for considering sun exposure, hydration, and other factors related to her arthritis and general well-being, but it does not specifically impact the pharmacokinetics or pharmacodynamics of vancomycin.
C. She has hypertension:
Mrs. Oza's hypertension is a relevant medical condition to consider in her overall health management. However, hypertension alone does not directly affect the prescription of vancomycin. Hypertension may influence the choice of antihypertensive medications or other aspects of her medical care, but it does not have a direct impact on the renal clearance or potential nephrotoxicity of vancomycin.
D. She enjoys an alcoholic beverage twice a week:
While alcohol consumption can interact with certain medications and impact overall health, it is not the most significant consideration when prescribing vancomycin to Mrs. Oza. Moderate alcohol consumption is unlikely to directly affect the pharmacokinetics or pharmacodynamics of vancomycin. However, excessive alcohol intake may contribute to liver dysfunction, which could indirectly influence drug metabolism. Nonetheless, in Mrs. Oza's case, her reduced renal function is a more critical factor to consider when prescribing vancomycin.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Doxycycline:
Doxycycline is a tetracycline antibiotic that is effective against anthrax. It is commonly used for post-exposure prophylaxis and treatment of anthrax infections.
B. Penicillin:
Penicillin is not typically the first-line antibiotic for treating anthrax. While some strains of Bacillus anthracis may be susceptible to penicillin, other antibiotics like doxycycline or ciprofloxacin are preferred due to their broader spectrum of activity and better penetration into tissues.
C. Oxytetracycline (Terramycin):
Oxytetracycline is another tetracycline antibiotic similar to doxycycline. Like doxycycline, oxytetracycline is effective against anthrax and can be used for post-exposure prophylaxis and treatment of anthrax infections.
D. Ciprofloxacin:
Ciprofloxacin is a fluoroquinolone antibiotic that is effective against anthrax. It is commonly used as an alternative to doxycycline for post-exposure prophylaxis and treatment of anthrax infections, particularly for individuals who cannot tolerate tetracyclines.
Correct Answer is B
Explanation
A. Headaches:
Headaches are a common symptom that can occur for various reasons, including stress, tension, dehydration, or as a side effect of medications. While headaches can sometimes occur as a side effect of certain drugs, they are not specific indicators of a drug allergy. Allergic reactions to medications typically involve other symptoms such as rash, hives, itching, swelling, or respiratory symptoms.
B. Hives or shortness of breath:
Hives (urticaria) are raised, red, itchy welts on the skin that can occur as an allergic reaction to medications. They are a common manifestation of drug allergies. Shortness of breath (dyspnea) can occur as part of a severe allergic reaction known as anaphylaxis. Anaphylaxis is a life-threatening allergic reaction characterized by a rapid onset of symptoms, including difficulty breathing, swelling of the throat or tongue, rapid heart rate, and low blood pressure. Both hives and shortness of breath are significant signs of a potential drug allergy and require immediate attention.
C. Diarrhea:
Diarrhea can occur as a side effect of medications, including antibiotics. However, it is not typically a specific indicator of a drug allergy. Diarrhea is more commonly associated with gastrointestinal disturbances or as a reaction to changes in gut flora due to antibiotic use.
D. Nausea:
Nausea is a common side effect of many medications, including antibiotics. While it can be bothersome, nausea alone is not a specific indicator of a drug allergy. Allergic reactions to medications typically involve other symptoms such as rash, hives, itching, swelling, or respiratory symptoms.
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