A male client has been receiving the antibiotic gentamicin sulfate IV piggyback every 12 hours for several days. Which observations by the nurse indicate that the client may be experiencing an adverse effect of gentamicin?
Hearing has decreased.
Decreased blood urea nitrogen.
White blood cells count 6,000/mm3 (6x109/L).
Reports of photophobia.
The Correct Answer is A
Gentamicin sulfate is an aminoglycoside antibiotic that can cause ototoxicity, which is damage to the inner ear leading to hearing loss or balance problems. Therefore, a decrease in hearing is an indication that the client may be experiencing an adverse effect of gentamicin.
Option b, decreased blood urea nitrogen, is not an adverse effect of gentamicin, but it may indicate improvement in kidney function, which can be a positive outcome of treatment.
Option c, a white blood cell count of 6,000/mm3 (6x109/L), is within the normal range and is not necessarily an adverse effect of gentamicin.
Option d, photophobia, is not a common adverse effect of gentamicin and may indicate a different condition or medication effect.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Cyclosporine is an immunosuppressive medication commonly used to prevent graft rejection after organ transplantation. St. John's Wort is known to induce cytochrome P450 enzymes, which can increase the metabolism and decrease the effectiveness of many medications, including cyclosporine. This interaction can lead to decreased plasma concentrations of cyclosporine, which can increase the risk of graft rejection. Therefore, it is important to advise the client to discontinue the use of St. John's Wort and inform their healthcare provider about any herbal or supplement use to prevent potential interactions with prescribed medications. Options a, c, and d are not directly related to the client's current condition and are not as significant as option b.

Correct Answer is D
Explanation
The client is experiencing syncope (fainting) due to a drop in blood pressure to 70/40 mm Hg, which is too low. This suggests that the client's blood pressure medications are reducing their blood pressure too much, resulting in hypotension. The rationale for the nurse's decision to hold the client's scheduled antihypertensive medications is to prevent further hypotension and allow the client's blood pressure to stabilize at a safer level.
Option a is incorrect because diuresis (increased urine output) is not a likely cause of the client's hypotension.
Option b is incorrect because the client's symptoms suggest hypotension due to reduced blood pressure, rather than drug toxicity.
Option c is incorrect because the antagonistic interaction among blood pressure medications would result in reduced effectiveness but would not necessarily cause hypotension.
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