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.

Answer and Explanation

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.

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Correct Answer is A

Explanation

Lithium carbonate is a mood stabilizer commonly used to treat bipolar disorder. However, it has a narrow therapeutic index and requires careful monitoring of serum levels to avoid toxicity. One of the major concerns with lithium therapy is the potential for drug interactions and toxicity. NSAIDs such as ibuprofen and naproxen can increase lithium levels by reducing its excretion and can lead to lithium toxicity. Therefore, it is essential to instruct the client to eliminate the use of NSAIDs while taking lithium.

Option b) Avoid consuming all foods that contain iodine is incorrect because iodine is not contraindicated with lithium. However, excessive iodine intake can interfere with thyroid function, which can exacerbate mood instability.

Option c) Notify healthcare provider prior to dental procedures is not specific to lithium therapy and is a general precaution that patients with bipolar disorder should follow before any medical or dental procedures.

Option d) Monitor blood glucose levels daily is also not directly related to lithium therapy. While lithium can cause diabetes insipidus, which can lead to excessive thirst and urination, it does not typically aﬀect blood glucose levels.

A. Monitor for signs of sodium and ﬂuid retention. B. Wound and blood specimen for culture and sensitivity. C. Irrigation and tropical antibiotic application to wound area. D. Complete the blood count and serum electrolytes.

Correct Answer is B

Explanation

Before administering the first dose of any antibiotic, it is essential to obtain a culture and sensitivity test to identify the causative organism and determine the most eﬀective antibiotic to use. Administering a broad- spectrum antibiotic before obtaining a culture and sensitivity test may lead to the development of antibiotic-resistant strains of bacteria, making it more difficult to treat the infection in the future.

Options a, c, and d are not as important as obtaining a culture and sensitivity test. Monitoring for signs of sodium and ﬂuid retention, irrigation and topical antibiotic application to the wound area, and completing blood count and serum electrolytes are important, but obtaining a culture and sensitivity test is the priority.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with bipolar disorder admitted with severe depression and suicidal ideation receives a prescription for lithium carbonate, which instruction should the nurse provide to the client?

Correct Answer is A

Explanation

On admission, the healthcare provider describes a broad spectrum of antibiotic, ticarcillin for a client with a gram-negative infection. Before administering the first dose, it is most important for the nurse to implement which prescription?

Correct Answer is B

Explanation

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