A nurse is caring for a client who is receiving tobramycin. The nurse should monitor the client for which of the following adverse effects?

Increased salivation

Bruising

joint pain

Tinnitus

Answer and Explanation

The Correct Answer is D

A. Increased salivation. Tobramycin, an aminoglycoside antibiotic, does not cause increased salivation. It primarily affects the kidneys and auditory system, with no significant impact on saliva production. Increased salivation is more commonly associated with medications affecting the autonomic nervous system, such as cholinergic agents.

B. Bruising. While some antibiotics may impact platelet function, aminoglycosides like tobramycin do not commonly cause thrombocytopenia or increased bruising. Clients experiencing unexplained bruising should be evaluated for other underlying causes, such as coagulation disorders or concurrent medication use.

C. Joint pain. Joint pain is not a typical adverse effect of tobramycin. While some antibiotics, like fluoroquinolones, are associated with tendonitis or joint issues, aminoglycosides primarily affect the kidneys and inner ear, leading to nephrotoxicity and ototoxicity rather than musculoskeletal symptoms.

D. Tinnitus. Tobramycin is ototoxic and can cause tinnitus, hearing loss, or balance disturbances due to its toxic effects on the auditory and vestibular nerves. Clients receiving tobramycin should be monitored for early signs of ototoxicity, and the medication should be discontinued if symptoms develop to prevent permanent hearing damage.

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Correct Answer is B

Explanation

A. Anorexia. While gastrointestinal side effects such as nausea and esophageal irritation can occur with alendronate, anorexia is not a common adverse effect. If severe nausea leads to decreased appetite, the client should report this to their provider, but it is not a primary concern compared to more serious side effects.

B. Jaw pain. Jaw pain can indicate osteonecrosis of the jaw (ONJ), a rare but serious adverse effect associated with long-term bisphosphonate use. This condition involves poor bone healing, especially after dental procedures, and can lead to bone deterioration. Clients taking alendronate should report any persistent jaw pain and undergo regular dental exams to monitor bone health.

C. Insomnia. Alendronate does not typically cause insomnia. While some medications, such as corticosteroids and stimulants, are linked to sleep disturbances, alendronate does not affect the central nervous system in a way that would disrupt sleep patterns.

D. Bruising. Alendronate does not interfere with platelet function or coagulation, making bruising an unlikely adverse effect. Clients who experience unexplained bruising should be evaluated for other underlying causes, such as blood disorders or medication interactions.

A. Jaundice B. Urticaria C. Bradycardia D. Hypertension

Correct Answer is B

Explanation

A. Jaundice. Jaundice, or yellowing of the skin and eyes, is a sign of liver dysfunction and may indicate hepatotoxicity rather than an allergic reaction. Some medications can cause drug-induced liver injury (DILI), but jaundice is not a typical symptom of an immediate hypersensitivity reaction.

B. Urticaria. Urticaria (hives) is a classic allergic reaction that appears as raised, red, itchy welts on the skin. It occurs due to the release of histamine in response to an allergen, which increases capillary permeability and leads to swelling and itching. Urticaria may be accompanied by angioedema, respiratory distress, or anaphylaxis, requiring immediate intervention if severe.

C. Bradycardia. Bradycardia (slow heart rate) is not a typical manifestation of an allergic reaction. While anaphylaxis can cause hypotension and tachycardia due to systemic vasodilation, bradycardia is more commonly associated with beta-blockers, heart block, or vagal stimulation rather than an allergic response.

D. Hypertension. Allergic reactions, especially severe ones like anaphylaxis, typically cause vasodilation and hypotension, not hypertension. While stress or anxiety related to an allergic episode may lead to a temporary rise in blood pressure, persistent hypertension is not a direct sign of an allergic reaction.

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A nurse is caring for a client who is receiving tobramycin. The nurse should monitor the client for which of the following adverse effects?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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