A 46-Year-Old Man Is Admitted to the Hospital Due to Right

question 641

Multiple Choice

A 46-year-old man is admitted to the hospital due to right hand cellulitis.  He has a history of intravenous drug and problematic alcohol use, hepatitis C infection, and septic arthritis of the knee.  Treatment with vancomycin is initiated.  The day after admission, the cellulitis has improved; however, the patient now reports that he sees bats flying around his room.  He says that he has never experienced visual hallucination before.  Temperature is 37.5 C (99.5 F) , blood pressure is 131/89 mm Hg, pulse is 93/min, and respirations are 18/min.  Examination shows decreased right hand swelling and redness, mild tremors bilaterally, and diaphoresis.  The patient is alert and oriented but appears frightened.  Which of the following is the most appropriate next step in management of this patient?

• A)Discontinue vancomycin
• B)Order brain MRI
• C)Prescribe haloperidol
• D)Prescribe lorazepam
• E)Prescribe methadone
• F)Prescribe olanzapine

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