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.

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Correct Answer is C

Explanation

Azithromycin is a macrolide antibiotic that can cause a rare but serious side effect calledQT prolongation, which affects the electrical activity of the heart and can lead toirregular heartbeats, chest pain, and sudden cardiac death. The patient should report any signs of chest pain or palpitations to the doctor immediately.

Choice A is wrong because diarrhea is a common side effect of azithromycin that usually does not require medical attention unless it is severe or bloody.

Choice B is wrong because headache is also a common side effect of azithromycin that usually does not require medical attention unless it is severe or persistent.

Choice D is wrong because nausea is another common side effect of azithromycin that usually does not require medical attention unless it is severe or accompanied by vomiting.

A. Jaundice B. Vision changes C. Hearing loss D. Orange-colored urine E. Numbness in the hands or feet.

Correct Answer is ["A","B","E"]

Explanation

Jaundice, vision changes and numbness in the hands or feet are possible adverse effects of the drugs used to treat tuberculosis.The nurse should instruct the client to report these signs or symptoms as they may indicate liver damage, optic neuritis or peripheral neuropathy respectively.

Choice C is wrong because hearing loss is not a common side effect of these drugs.Hearing loss may be caused by other drugs such as aminoglycosides.

Choice D is wrong because orange-colored urine is a harmless side effect of rifampin and does not need to be reported.

The nurse should inform the client about this expected change and reassure them that it is not harmful.

The normal ranges for liver function tests are:

• AST: 10-40 U/L

• ALT: 7-56 U/L

• ALP: 45-115 U/L

• Bilirubin: 0.1-1.2 mg/dL

The normal range for visual acuity is 20/20.

The normal range for sensation is intact and symmetrical in all extremities.

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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 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?

Correct Answer is C

Explanation

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.)

Correct Answer is ["A","B","E"]

Explanation

A nurse is caring for a client who has tuberculosis and is prescribed rifampin, an antitubercular drug. The nurse should instruct the client about which potential side effect of rifampin?

A nurse is teaching a client who has been prescribed tetracycline, a tetracycline antibiotic, for acne vulgaris. Which of these instructions should the nurse include in the teaching? (Select all that apply.)

A nurse is preparing to administer ivermectin to a client who has onchocerciasis (river blindness). Which of the following adverse effects should the nurse monitor for in this client?

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.).

A nurse is administering penicillin to a client who has streptococcal pharyngitis. The nurse should monitor for which adverse effect of penicillin therapy?

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?

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

A nurse is educating a client who has a respiratory infection and a new prescription for azithromycin (Zithromax). Which of the following instructions should the nurse include? (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?