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A healthcare professional is caring for a client receiving gentamicin therapy. Which of the following client assessments is a priority for the healthcare professional to monitor for an adverse effect of this medication?
- A. Urinary output
- B. Serum glucose
- C. Respiratory rate
- D. Hearing acuity
Correct Answer: D
Rationale: The correct answer is D: Hearing acuity. Gentamicin is known to be ototoxic, which means it can cause damage to the auditory system leading to hearing loss. Monitoring hearing acuity is crucial to detect early signs of hearing impairment. Monitoring urinary output (choice A) is important for assessing kidney function but is not directly related to gentamicin's adverse effects. Monitoring serum glucose (choice B) and respiratory rate (choice C) are not specifically associated with gentamicin therapy.
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A nurse is caring for a client prescribed digoxin. Which of the following should alert the nurse to possible digitalis toxicity?
- A. Anorexia and weakness
- B. Hyperactivity and hunger
- C. Tachycardia and increased urination
- D. Polyphagia and polydipsia
Correct Answer: A
Rationale: The correct answer is A: Anorexia and weakness. These symptoms are early indicators of potential digitalis toxicity. Anorexia refers to a loss of appetite, which can be a sign of toxicity, and weakness can indicate an issue with digoxin. Choices B, C, and D are incorrect. Hyperactivity and hunger, tachycardia and increased urination, as well as polyphagia and polydipsia are not typically associated with digitalis toxicity.
A nurse is caring for a client receiving IV vancomycin. The nurse notes flushing of the client's neck and chest. Which of the following actions should the nurse take?
- A. Stop the infusion
- B. Document the findings as a harmless reaction
- C. Slow the infusion rate
- D. Administer diphenhydramine
Correct Answer: C
Rationale: The correct action for the nurse to take when a client receiving IV vancomycin shows flushing of the neck and chest is to slow the infusion rate. Flushing is a common sign of Red Man Syndrome, which is associated with rapid infusions of vancomycin. Slowing down the infusion rate can help prevent further flushing and the development of Red Man Syndrome. Stopping the infusion (Choice A) may be too drastic if the symptoms are mild and can be managed by slowing the rate. Documenting the findings as a harmless reaction (Choice B) is incorrect because flushing should be addressed promptly to prevent complications. Administering diphenhydramine (Choice D) is not the initial or best intervention for flushing associated with vancomycin; slowing the infusion rate is the priority.
A nurse is caring for a client receiving patient-controlled analgesia (PCA). Which of the following interventions should the nurse take while caring for this client?
- A. Advise the client to use the pump sparingly to prevent addiction
- B. Encourage the client to use the PCA before dressing changes
- C. Encourage the client's family to administer PCA while the client is sleeping
- D. Increase the client's 4-hour limit as needed
Correct Answer: B
Rationale: The correct answer is B because encouraging the client to use the PCA before dressing changes helps in managing pain proactively. Choice A is incorrect as PCA is a safe method of pain control when used appropriately, and the nurse should not suggest using it sparingly. Choice C is incorrect as only the client should operate the PCA to ensure they are in control of their pain management. Choice D is incorrect as changing the PCA limit without proper assessment and orders from the healthcare provider can lead to adverse effects.
A nurse is preparing to administer furosemide to a client. Which of the following findings indicates the client may be at risk for an adverse effect of the medication?
- A. Hypertension
- B. Hypokalemia
- C. Increased urine output
- D. Hyperglycemia
Correct Answer: B
Rationale: The correct answer is B: Hypokalemia. Furosemide is a loop diuretic that can cause potassium depletion, leading to hypokalemia, which is a common adverse effect. Hypokalemia can result in serious complications like cardiac arrhythmias. Choices A, C, and D are not directly associated with the adverse effects of furosemide. Hypertension is a condition that furosemide is often used to treat, increased urine output is an expected effect of furosemide, and hyperglycemia is not a typical adverse effect of this medication.
A nurse is reviewing a client's medication regimen. Which of the following medications places the client at increased risk for digoxin toxicity?
- A. Calcium channel blockers
- B. Potassium-sparing diuretics
- C. Beta blockers
- D. Loop diuretics
Correct Answer: D
Rationale: The correct answer is D, Loop diuretics. Loop diuretics can lead to hypokalemia, which increases the risk for digoxin toxicity. Loop diuretics cause potassium loss, and hypokalemia can potentiate the toxic effects of digoxin. Choices A, B, and C are incorrect because calcium channel blockers, potassium-sparing diuretics, and beta blockers do not directly increase the risk of digoxin toxicity.