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A male client has been receiving the antibiotic gentamicin sulfate, IV piggyback every 12 hours for several days. Which observation by the nurse indicates that the client may be experiencing an adverse effect of gentamicin?
Reference Range: White Blood Cell [5000 to 10,000/mm3 (5 to 10 x 109/L)]

White blood cell count of 6,000/mm3 (6 x 109/L).

Decreased blood urea nitrogen.

Hearing has decreased.

Reports of photophobia.

Answer and Explanation

The Correct Answer is C

Rationale:

A. A WBC count within the normal range does not indicate an adverse effect of gentamicin.

B. Gentamicin is more likely to increase BUN levels due to nephrotoxicity rather than decrease them.

C. Gentamicin is an aminoglycoside antibiotic known to cause ototoxicity, which can lead to hearing loss. Decreased hearing is a significant adverse effect that should be promptly addressed.

D. Photophobia is not a common side effect of gentamicin.

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A. Clavicle. B. Sternum. C. Aortic site. D. Lung apex.

Correct Answer is D

Explanation

Rationale:

A. The clavicle is an important landmark but not the ideal starting point for auscultating breath sounds.

B. The sternum is also not the correct starting location for breath sound auscultation.

C. The aortic site is unrelated to lung auscultation.

D. The lung apex, located above the clavicle, is the correct location to begin auscultating anterior breath sounds. This systematic approach ensures all areas of the lungs are assessed for normal and abnormal breath sounds.

A. Elevate the head of the bed to at least 45 degrees. B. Use at least two different methods to identify the client. C. Provide a fresh glass of water for taking the medications. D. Recheck the prepared medications against the medication administration record (MAR).

Correct Answer is B

Explanation

Rationale:

A. Elevating the head of the bed is important for swallowing and preventing aspiration but is secondary to ensuring correct patient identification.

B. Using at least two different methods to identify the client is the most important step to prevent medication errors. This ensures that the correct medication is given to the correct patient.

C. Providing water is helpful but not as critical as ensuring the correct patient is identified.

D. Rechecking the medications against the MAR is important but should be done in conjunction with proper patient identification.

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Correct Answer is D

Explanation

Correct Answer is B

Explanation

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When systematically auscultating a client's anterior breath sounds, the nurse should begin by placing the stethoscope over which location?

Correct Answer is D

Explanation

Which intervention is most important for the nurse to implement when administering medications?

Correct Answer is B

Explanation

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