A nurse is caring for an adult client who reports having trouble getting to sleep at night. Which of the following recommendations should the nurse make?

Choice A reason: Responding to family requires clinical judgment and communication skills beyond AP scope. Nurses handle this in mass casualty for accuracy.

Choice B reason: Triage prioritization needs nursing assessment skills, not AP training. Determining care order is a licensed responsibility in emergencies like this.

Choice C reason: Cleaning and dressing wounds involves sterile technique and assessment, outside AP scope. Nurses perform this in mass casualty settings.

Choice D reason: Taking vital signs is within AP scope, providing data for nurse triage. It’s a routine task, safely assigned in a mass casualty event.

Choice A reason: Hearing loss is a known gentamicin ototoxicity effect, damaging cochlear hair cells irreversibly. Scientifically, this aminoglycoside targets the inner ear, causing tinnitus or deafness, a critical adverse reaction to monitor in pyelonephritis treatment per pharmacology evidence.

Choice B reason: Slurred speech suggests neurological issues (e.g., stroke), not gentamicin effects. Scientifically, this drug affects kidneys and ears, not speech centers, making this unrelated to its toxicity profile, which focuses on auditory and renal damage.

Choice C reason: Constipation isn’t linked to gentamicin; it’s more typical of opioids or immobility. Scientifically, this antibiotic’s side effects center on nephrotoxicity and ototoxicity, not gastrointestinal motility, rendering this an unlikely adverse reaction in this context.

Choice D reason: Hypotension may occur with rapid IV gentamicin, but it’s less common than ototoxicity. Scientifically, hearing loss is a hallmark toxicity, outweighing transient blood pressure drops, which are manageable and less specific to this drug’s adverse profile.