An adult client has pulmonary tuberculosis. He is receiving isoniazid (INH) 300 mg PO, ethambutol 1 g PO daily, and streptomycin 1 g IM three times a week. When he comes in for a checkup, he tells the nurse that he hates getting shots and his ears ring most of the time. What is the best interpretation for the nurse to make regarding the client's complaints?
- A. He may be receiving too much ethambutol.
- B. He should be evaluated for adverse reaction to streptomycin.
- C. Tuberculosis may have spread to the brain.
- D. He is experiencing a reaction commonly seen when INH and streptomycin are given at the same time.
Correct Answer: B
Rationale: Streptomycin is ototoxic, and ringing in the ears (tinnitus) is a sign of potential eighth cranial nerve damage, requiring evaluation.
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The client with arthritis is self-medicating with aspirin, a nonsteroidal anti-inflammatory medication. Which complication should the nurse discuss with the client?
- A. Tinnitus.
- B. Diarrhea.
- C. Tetany.
- D. Paresthesia.
Correct Answer: A
Rationale: High-dose aspirin can cause tinnitus, an early sign of salicylate toxicity, requiring education. Diarrhea, tetany, or paresthesia are less common.
A client is receiving erythromycin 500 mg IV every 6 hours to treat a pneumonia. Which of the following is the most common side effect of the medication?
- A. Blurred vision
- B. Nausea and vomiting
- C. Severe headache
- D. Insomnia
Correct Answer: B
Rationale: Nausea and vomiting. Nausea is a common side-effect of erythromycin in both oral and intravenous forms.
The nurse is assessing a 7 year-old after several days of treatment for a documented strep throat. Which of the following statements suggests that further teaching is needed?
- A. Sometimes I take my medicine with fruit juice.'
- B. My mother makes me take my medicine right after school.'
- C. Sometimes I take the pills in the morning and other times at night.'
- D. I am feeling much better than I did last week.'
Correct Answer: C
Rationale: Sometimes I take the pills in the morning and other times at night.' Inconsistency in taking the prescribed medication indicates more teaching is needed.
An adult woman has been diagnosed as having hypothyroidism. She is taking Cytomel (liothyronine sodium) 50 mcg daily. Which of the following side effects should the nurse be especially alert for?
- A. Angina
- B. Fatigue
- C. Rash
- D. Gastritis
Correct Answer: A
Rationale: Cytomel increases metabolic rate, potentially causing angina in patients with cardiovascular risk due to increased cardiac demand.
The use of atropine for treatment of symptomatic bradycardia is contraindicated for a client with which of the following conditions?
- A. Urinary incontinence
- B. Glaucoma
- C. Increased intracranial pressure
- D. Right sided heart failure
Correct Answer: B
Rationale: Glaucoma. Atropine is contraindicated in clients with angle-closure glaucoma because it can cause pupillary dilation with an increase in aqueous humor, leading to a resultant increase in optic pressure.
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