The nurse is caring for a patient receiving vancomycin (Vancocin) for treatment of an infection caused by methicillin-resistant Staphylococcus aureus (MRSA).
Which assessment finding would indicate a potentially serious adverse reaction to this drug?

Redness and itching at the infusion site

Flushing, rash, and pruritus on the face and upper torso

Nausea, vomiting, and abdominal cramps

Tinnitus, vertigo, and hearing loss.

Report any signs of oral thrush to the provider.

Answer and Explanation

The Correct Answer is D

These are signs of ototoxicity, a potentially serious adverse reaction to vancomycin (Vancocin) and other aminoglycosides. Ototoxicity can damage the inner ear and cause permanent hearing loss or balance problems.

Choice A is wrong because redness and itching at the infusion site are not specific to vancomycin (Vancocin) and could indicate a local irritation or an allergic reaction to any drug.

Choice B is wrong because flushing, rash, and pruritus on the face and upper torso are symptoms of red man syndrome, a common but not serious side effect of vancomycin (Vancocin) that occurs due to rapid infusion and histamine release. Red man syndrome can be prevented by infusing the drug over at least 1 hour.

Choice C is wrong because nausea, vomiting, and abdominal cramps are not specific to vancomycin (Vancocin) and could be caused by many factors, such as infection, food poisoning, or other drugs.

Normal ranges for vancomycin (Vancocin) trough levels are 10 to 20 mcg/mL for most infections and 15 to 20 mcg/mL for serious infections such as osteomyelitis, endocarditis, or meningitis. Levels above 20 mcg/mL increase the risk of ototoxicity and nephrotoxicity.

Therefore, the nurse should monitor the patient’s trough levels regularly and report any abnormal findings to the prescriber.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is D

Explanation

They are effective against a few types of organisms.Narrow spectrum antibiotics are antibiotics that work against a limited range of bacteria, usually either gram-positive or gram-negative.They are more specific and less likely to cause resistance or disrupt the normal flora.

Choice A) They are effective against gram-positive bacteria only.This is not true because some narrow spectrum antibiotics can also target gram-negative bacteria, such as aminoglycosides.

Choice B) They are effective against gram-negative bacteria only.This is not true because some narrow spectrum antibiotics can also target gram-positive bacteria, such as vancomycin.

Choice C) They are effective against one type of organism.This is too restrictive because narrow spectrum antibiotics can work against more than one type of organism, such as penicillins that target both streptococci and staphylococci.

A. Age B. Competent immune function C. Genetic heritage D. Previous medication reactions.

Correct Answer is B

Explanation

This is because antibiotics act synergistically with the immune system to subdue infection, and it is critical for success that the host defenses are adequate.

Choice A is wrong becauseAge is wrong because age is a general factor that must be considered when choosing any medication, not just antimicrobials.

Choice C is wrong becauseGenetic heritage is wrong because genetic heritage is also a general factor that may affect the metabolism and excretion of medications, not the selection of antimicrobials.

Choice D is wrong becausePrevious medication reactions is wrong because previous medication reactions are also a general factor that may indicate allergies or intolerances to certain medications, not the selection of antimicrobials.

Normal ranges for immune function vary depending on the type and level of immunity measured, such as innate, adaptive, humoral or cellular immunity.Some common tests for immune function include complete blood count (CBC), immunoglobulin levels, complement levels, antibody titers and skin tests.

Normal ranges for these tests depend on the laboratory and the method used, but some examples are:

• CBC: white blood cell count 4.5-11 x 10^9/L; neutrophils 40-75%; lymphocytes 20-50%; monocytes 2-10%; eosinophils 1-6%; basophils 0-2%.

• Immunoglobulin levels: IgG 7-16 g/L; IgA 0.7-4 g/L; IgM 0.4-2.3 g/L; IgE 0-0.4 g/L.

• Complement levels: C3 0.9-1.8 g

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

The nurse is caring for a patient receiving vancomycin (Vancocin) for treatment of an infection caused by methicillin-resistant Staphylococcus aureus (MRSA). Which assessment finding would indicate a potentially serious adverse reaction to this drug?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which statement is true regarding narrow spectrum antibiotics?

Correct Answer is D

Explanation

The nurse identifies which host factor as the most important when choosing an antimicrobial drug?

Correct Answer is B

Explanation

The nurse is providing discharge teaching for a patient who will be taking oral linezolid (Zyvox) to treat a complicated skin infection caused by vancomycin-resistant enterococci (VRE). Which statement by the patient indicates a need for further teaching?

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.)

The nurse is caring for a patient receiving vancomycin (Vancocin) for treatment of an infection caused by methicillin-resistant Staphylococcus aureus (MRSA). Which assessment finding would indicate a potentially serious adverse reaction to this drug?

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.)

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

A nurse is caring for a client who has a severe infection and is receiving vancomycin (Vancocin). The nurse should monitor the client for which of the following manifestations of ototoxicity?

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.)

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

The nurse is caring for a patient receiving vancomycin (Vancocin) for treatment of an infection caused by methicillin-resistant Staphylococcus aureus (MRSA).
Which assessment finding would indicate a potentially serious adverse reaction to this drug?