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

Vancomycin is an antibiotic that can cause ototoxicity, which is damage to the inner ear due to exposure to certain drugs.Ototoxicity can manifest as tinnitus (ringing in the ears), vertigo (dizziness), and hearing loss.Vancomycin ototoxicity is usually related to high serum levels of the drug and is more likely to occur in patients with renal impairment.Vancomycin can also potentiate the ototoxicity of other drugs, such as aminoglycosides.

Choice A is wrong because tinnitus is a possible manifestation of ototoxicity.

Choice B is wrong because vertigo is a possible manifestation of ototoxicity.

Choice C is wrong because hearing loss is a possible manifestation of ototoxicity.

A. Antibiotic guidelines in critical care reduce the hospital length of stay. B. Inappropriate antibiotic use leads to the emergence of resistance. C. Antibiotic dosing has little effect on antimicrobial resistance. D. An antibiotic stewardship programme leads to an increase in antimicrobial resistance.

Correct Answer is B

Explanation

Inappropriate antibiotic use leads to the emergence of resistance.This is a well-established fact that is supported by the CDC and other organizations.Resistance can occur when antibiotics are used unnecessarily, excessively, or incorrectly, and can lead to infections that are harder to treat and more costly.

Choice A is wrong because antibiotic guidelines in critical care do not necessarily reduce the hospital length of stay.Although some studies have suggested that adherence to pneumonia guidelines may improve outcomes in severe pneumonia, other studies have found no significant effect of antibiotic stewardship on hospital length of stay or mortality in critically ill patients.

Therefore, this statement is not universally true.

Choice C is wrong because antibiotic dosing has a significant effect on antimicrobial resistance.Optimal dosing of antibiotics can help eradicate infections, prevent relapse, and minimize the selection of resistant bacteria.Conversely, suboptimal dosing can lead to treatment failure, prolonged infection, and increased resistance.

Therefore, antibiotic dosing should be carefully adjusted according to the pharmacokinetic and pharmacodynamic properties of the drug and the patient.

Choice D is wrong because an antibiotic stewardship programme leads to a decrease in antimicrobial resistance, not an increase.An antibiotic stewardship programme is a coordinated effort to improve and measure the appropriate use of antibiotics by promoting the selection of the optimal drug regimen, dose, duration, and route of administration.Such programmes have been shown to reduce antibiotic consumption, resistance rates, adverse events, and costs in various settings.

Therefore, this statement is false.

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

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?

Correct Answer is D

Explanation

Which statement is true regarding antimicrobial stewardship?

Correct Answer is B

Explanation

A nurse is educating a group of travelers who are going to a region where malaria is endemic. Which of the following antimalarial drugs should the nurse recommend for prophylaxis? (Select all that apply.).

Which antibiotics are classified as concentration-dependent antimicrobials?

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.)

A patient has been prescribed azithromycin, a macrolide antibiotic, for a respiratory infection. The nurse should instruct the patient to report which of the following signs or symptoms of a potential adverse effect?

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

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 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:

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

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?