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 C

Explanation

Epoetin alfa is a medication that stimulates the production of red blood cells and is commonly used to treat anemia in patients with chronic kidney disease. Hemoglobin level is the most important parameter to monitor the eﬀectiveness of epoetin alfa therapy. An increase in hemoglobin level indicates an improvement in the patient's anemia and suggests that the medication is eﬀective.

While options a, b, and d are also important considerations in the management of anemia, they do not provide a definitive indication of the eﬀectiveness of epoetin alfa therapy. Reports of increased energy levels and decreased fatigue can be subjective and inﬂuenced by many factors. Taking concurrent iron therapy without adverse eﬀects is important to support the production of red blood cells but does not confirm the eﬀectiveness of epoetin alfa. Increased consumption of iron-rich foods can be helpful in managing anemia, but it does not provide a direct indication of the eﬀectiveness of epoetin alfa therapy.

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 anemia secondary to chronic kidney disease started a prescription for epoetin alfa two months ago. Which client finding best indicates that the medication is eﬀective?

Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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