A nurse is caring for a client who has an infection and is starting to take gentamicin. Which of the following client laboratory tests should the nurse monitor to detect an adverse effect of the medication?
B-type natriuretic peptide (BNP).
Creatinine.
Amylase level.
Erythrocyte sedimentation rate (ESR).
The Correct Answer is B
Choice A rationale
BNP is used to diagnose heart failure, not to monitor gentamicin’s adverse effects.
Choice B rationale
Creatinine levels should be monitored as gentamicin can cause nephrotoxicity, leading to impaired kidney function.
Choice C rationale
Amylase levels are not relevant for detecting gentamicin’s adverse effects.
Choice D rationale
ESR is used to detect inflammation, not specific to gentamicin’s adverse effects.
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Correct Answer is D
Explanation
Choice A rationale
Asthma is not a contraindication for sumatriptan. Sumatriptan is a selective serotonin receptor agonist used to treat migraines by constricting blood vessels in the brain. It does not have a significant impact on respiratory conditions like asthma.
Choice B rationale
Kidney disease is not a contraindication for sumatriptan. However, caution is advised when using sumatriptan in patients with severe renal impairment due to potential accumulation of the drug and its metabolites.
Choice C rationale
Rheumatoid arthritis is not a contraindication for sumatriptan. Sumatriptan’s mechanism of action does not interfere with the inflammatory processes involved in rheumatoid arthritis.
Choice D rationale
Coronary artery disease (CAD) is a contraindication for sumatriptan. Sumatriptan can cause vasoconstriction of coronary arteries, which can exacerbate CAD and increase the risk of myocardial infarction or other cardiac events.
Correct Answer is ["B","C","D","E"]
Explanation
Choice A rationale:
The client’s temperature has decreased from 37.8°C (100°F) to 37.2°C (99°F). While this is a slight reduction, it indicates a move towards a more normal body temperature. Elevated temperatures can be associated with stress, anxiety, or other underlying conditions. A decrease in temperature suggests that the client’s body is stabilizing and that any potential underlying issues causing the elevated temperature are being managed effectively.
Choice B rationale:
The client’s mood has improved as she appears less anxious and more composed during the physical examination. Anxiety can significantly impact a person’s overall well-being, and a reduction in anxiety levels is a positive indicator of improvement. The client also expresses optimism about her recovery, which is a good sign of mental health improvement.
Choice C rationale:
The client has gained weight, increasing from 53 kg (117 lb) to 55 kg (121 lb). Weight gain in this context is a positive sign, indicating that the client’s body is responding well to treatment and that her nutritional status is improving. Unintentional weight loss can be a symptom of underlying health issues, so reversing this trend is a good indicator of recovery.
Choice D rationale:
The client reports better sleep, which is a significant improvement from her previous insomnia. Sleep is crucial for physical and mental health, and improved sleep patterns can lead to better overall health outcomes. Insomnia can exacerbate anxiety and other health issues, so better sleep is a positive sign.
Choice E rationale:
The client’s heart rate has decreased from 120/min to 95/min. A high heart rate can be a sign of anxiety, stress, or other health issues. A reduction in heart rate indicates that the client’s anxiety levels are decreasing and that her cardiovascular system is stabilizing. This is a positive sign of improvement in her overall health.
Choice F rationale:
The client's abdominal findings remained normal from the initial to the follow-up visit, so this does not indicate improvement. These findings were normal to begin with and have stayed unchanged.