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 B

Explanation

Orlistat works by inhibiting the absorption of dietary fat in the intestines. The side eﬀects of faty stools and ﬂatus can be managed by reducing the intake of dietary fat. The nurse should ask the client to describe her dietary intake history for the last several days to determine if she has been consuming a diet high in fat.

Based on this information, the nurse can provide appropriate dietary advice to help manage these side eﬀects.

A. Weight change in the last month. B. Recent use of other antidepressants. C. Liver function lab results. D. Family history of mental illness.

Correct Answer is C

Explanation

The correct answer is C. Liver function lab results.

Choice A: Weight change in the last month

Weight change is a relevant factor to monitor in patients starting on antidepressants, including duloxetine, as some antidepressants can cause weight gain or loss. However, it is not the most critical information to obtain initially. Monitoring weight can help manage potential side effects and ensure the patient’s overall health, but it does not directly impact the immediate safety and efficacy of starting duloxetine.

Choice B: Recent use of other antidepressants

Recent use of other antidepressants is crucial information because combining duloxetine with other antidepressants, especially MAOIs (Monoamine Oxidase Inhibitors), can lead to serious interactions such as serotonin syndrome. This condition can be life-threatening and requires careful management. However, while this information is important, it is not as immediately critical as liver function tests when starting duloxetine.

Choice C: Liver function lab results

Liver function lab results are the most important information for the nurse to obtain. Duloxetine is metabolized in the liver, and patients with pre-existing liver conditions or impaired liver function are at higher risk for hepatotoxicity. Monitoring liver function is essential to prevent severe liver damage, which can be life-threatening. Baseline liver function tests help ensure that the patient can safely metabolize the medication and identify any potential issues early.

Choice D: Family history of mental illness

Family history of mental illness can provide valuable context for understanding the patient’s condition and potential genetic predispositions. It can also help in tailoring the treatment plan and anticipating the patient’s response to medication. However, while this information is useful for long-term management, it is not as immediately critical as liver function tests when initiating duloxetine therapy.

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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

After taking orlistat for one week, a female client tells the home health nurse that she is experiencing increasingly frequent faty stools and ﬂatus. Which action should the nurse take?

Correct Answer is B

Explanation

The nurse is planning care for a patient with major depression who is receiving a new prescription for duloxetine. Which information is most important for the nurse to obtain?

Correct Answer is C

Explanation

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