Mr. Carter has been recently started on an antibiotic, and has developed a rash and pruritis. You suspect an allergic reaction and immediately assess him for other more serious symptoms. What question would be most important to ask Mr. Carter?

"Are you having any difficulty breathing?"

"Have you noticed any blood in your stool?"

"Are you having difficulty with your hearing?"

"Do you have a headache?”

Answer and Explanation

The Correct Answer is A

A. "Are you having any difficulty breathing?":

Difficulty breathing is a critical symptom that may indicate a severe allergic reaction, such as anaphylaxis, which can be life-threatening. It is essential to assess for difficulty breathing immediately as it requires urgent intervention to ensure the patient's airway is clear and to administer appropriate treatment.

B. "Have you noticed any blood in your stool?":

While blood in the stool could indicate gastrointestinal bleeding, it is not typically associated with allergic reactions to antibiotics. This symptom is more commonly associated with other conditions such as gastrointestinal ulcers, infections, or inflammatory bowel disease. While important to assess, it is not as immediately concerning as difficulty breathing in the context of a suspected allergic reaction.

C. "Are you having difficulty with your hearing?":

Difficulty with hearing is not a common symptom of allergic reactions to antibiotics. It may be associated with other conditions such as ear infections or ototoxicity from certain medications. While it is important to assess any changes in hearing, it is not typically an immediate concern in the context of a suspected allergic reaction.

D. "Do you have a headache?":

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 typically associated with severe allergic reactions such as anaphylaxis. Therefore, while it is important to assess for headaches, it is not as immediately concerning as difficulty breathing in the context of a suspected allergic reaction.

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Correct Answer is B

Explanation

A. Kanamycin (Kantrex):

Kanamycin is an aminoglycoside antibiotic, but it is not commonly used as a first-line treatment for MRSA infections. Aminoglycosides are not typically preferred for treating MRSA because they are not as effective against these resistant bacteria compared to other agents like vancomycin.

B. Vancomycin:

Vancomycin is a glycopeptide antibiotic and is considered the drug of choice for the treatment of MRSA infections, including serious bloodstream infections, pneumonia, and skin and soft tissue infections. It works by inhibiting cell wall synthesis in bacteria, including MRSA.

C. Streptomycin:

Streptomycin is another aminoglycoside antibiotic, similar to kanamycin. Like kanamycin, streptomycin is not typically used as a first-line treatment for MRSA infections because it is less effective against resistant strains compared to other agents like vancomycin.

D. Penicillin:

Penicillin and other beta-lactam antibiotics are ineffective against MRSA because MRSA is resistant to these antibiotics, including methicillin. Therefore, penicillin would not be an appropriate choice for treating MRSA infections.

A. By assessing the temperature every 4 hours B. By repeating a culture and sensitivity test on day 3 C. By obtaining drug peak and trough levels D. By assessing for breathlessness

Correct Answer is C

Explanation

A. By assessing the temperature every 4 hours:

Monitoring temperature every 4 hours is a common practice in hospitalized patients to detect fever, which could indicate an infection or an inflammatory response. However, this method does not directly assess the therapeutic blood levels of vancomycin. Fever alone does not provide specific information about the effectiveness or concentration of the antibiotic in the bloodstream.

B. By repeating a culture and sensitivity test on day 3:

Culture and sensitivity tests involve taking a sample from the patient (such as blood, urine, or sputum) and growing the microorganisms in a laboratory to identify the causative organism and determine its susceptibility to antibiotics. While this test is essential for identifying the appropriate antibiotic therapy initially, repeating it on day 3 does not directly monitor therapeutic blood levels of vancomycin. It also doesn't provide real-time information about the concentration of vancomycin in the bloodstream.

C. By obtaining drug peak and trough levels:

This choice involves measuring the highest (peak) and lowest (trough) concentrations of vancomycin in the bloodstream. Peak levels are typically measured about 1 hour after the completion of a vancomycin infusion, while trough levels are measured just before the next dose is administered. These measurements allow healthcare providers to ensure that the drug concentration remains within the therapeutic range to effectively treat the infection while minimizing the risk of toxicity.

D. By assessing for breathlessness:

Assessing for breathlessness is important for monitoring respiratory status, particularly in patients receiving vancomycin, as rare side effects like red-man syndrome or anaphylaxis can cause respiratory distress. However, this method does not directly monitor therapeutic blood levels of vancomycin.

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Mr. Carter has been recently started on an antibiotic, and has developed a rash and pruritis. You suspect an allergic reaction and immediately assess him for other more serious symptoms. What question would be most important to ask Mr. Carter?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is admitting a client to the acute care floor with methicillin-resistant S. aureus. The nurse would expect the physician to order which of the following medications for the client?

Correct Answer is B

Explanation

What is the best method of monitoring therapeutic blood levels of vancomycin during therapy?

Correct Answer is C

Explanation

Which of the following complaints by a man taking gentamycin would be most indicative that he is experiencing ototoxicity?

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