The nurse interviews a client admitted for an outpatient procedure and enters a long list of home medications into the medical record.

The nurse observes several medications that are prescribed for the same indications.

Which instruction is best for the nurse to communicate to the client regarding the multiple prescriptions?

Bring all medications, supplements, and herbs currently being taken to the next clinic appointment.

Use a medication reminder system to prevent omitting to take the right medications at the right time.

Make certain a family member knows the name and use of all medications currently being taken.

Do not take any over-the-counter drugs while taking medications prescribed by a healthcare provider

Remove resuscitation equipment from the room.

Answer and Explanation

The Correct Answer is A

Choice A rationale:

Instructing the client to bring all medications, supplements, and herbs currently being taken to the next clinic appointment (Choice A) is the best course of action. This allows the healthcare provider to review the client's entire medication regimen, identify any potential interactions or duplications, and make appropriate adjustments. It promotes medication safety and ensures that the client receives the most effective and safe treatment.

Choice B rationale:

Using a medication reminder system (Choice B) is a helpful suggestion but does not address the issue of potential duplications or interactions between medications. While a reminder system can improve adherence, it does not provide a comprehensive solution to the problem of multiple prescriptions for the same indication.

Choice C rationale:

Making certain a family member knows the name and use of all medications currently being taken (Choice C) is a useful practice for medication safety but may not be sufficient to address the issue of multiple prescriptions. Relying solely on a family member's knowledge may lead to misunderstandings or omissions in the medication regimen.

Choice D rationale:

Do not take any over-the-counter drugs while taking medications prescribed by a healthcare provider (Choice D) is a relevant piece of advice for medication safety. However, it does not directly address the issue of multiple prescriptions for the same indication. It is essential for the client to have a complete and accurate record of all medications, both prescribed and over-the-counter, to ensure safe and effective treatment.

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Correct Answer is B

Explanation

The correct answer is choice B.

Choice A rationale: Metabolic alkalosis is caused by a loss of acid or a gain of base. It is not typically associated with anxiety or hyperventilation.

Choice B rationale: Respiratory alkalosis is caused by hyperventilation, which leads to a decrease in carbon dioxide levels in the blood. This can occur in response to anxiety, pain, or other stressors.

Choice C rationale: Metabolic acidosis is caused by a buildup of acid in the blood or a loss of bicarbonate. It is not typically associated with anxiety or hyperventilation.

Choice D rationale: Respiratory acidosis is caused by hypoventilation, which leads to an increase in carbon dioxide levels in the blood. It is not typically associated with anxiety or hyperventilation.

A. Check for changes in vision. B. Monitor the client's hearing. C. Observe the skin for a rash. D. Measure the urinary output.

Correct Answer is B

Explanation

This is the correct answer because it is the best way to assess for signs of ototoxicity, which is a potential adverse eﬀect of aminoglycosides. Ototoxicity is the damage or injury to the inner ear or auditory nerve caused by certain drugs or chemicals. It can result in hearing loss, tinnitus, vertigo, or balance problems. Aminoglycosides are a class of antibiotics that are eﬀective against gram-negative bacteria, but they can also cause ototoxicity by interfering with the function of the hair cells in the cochlea. The practical nurse (PN) should monitor the client's hearing by asking about any changes in hearing acuity, ringing in the ears, or difficulty understanding speech. The PN should also perform a hearing test using a tuning fork or an audiometer if available. The PN should report any signs of ototoxicity to the health care provider and discontinue the aminoglycoside as ordered.

a) Check for changes in vision.

This is not the correct answer because it is not related to ototoxicity. Vision is the ability to see and perceive objects and colors using the eyes and the brain. Vision may be aﬀected by various factors, such as age, genetics, eye diseases, injuries, infections, or medications. However, aminoglycosides do not cause vision problems or impairments. The PN should check for changes in vision in a client who is receiving other drugs that can cause ocular toxicity, such as ethambutol, chloroquine, or digoxin.

c) Observe the skin for a rash.

This is not the correct answer because it is not related to ototoxicity. A rash is a change in the color, texture, or appearance of the skin that may be caused by various factors, such as allergies, infections, inﬂammation, or medications. A rash may present as redness, itching, swelling, blisters, bumps, or scales.
Aminoglycosides can cause skin reactions such as rash or urticaria in some clients who are hypersensitive or allergic to them. The PN should observe the skin for a rash in a client who is receiving an aminoglycoside and report any signs of an allergic reaction to the health care provider. However, a rash is not a sign of ototoxicity.

d) Measure the urinary output.

This is not the correct answer because it is not related to ototoxicity. Urinary output is the amount of urine produced and excreted by the kidneys and bladder. It is an indicator of renal function and ﬂuid balance. The normal range for urinary output is 0.5 to 1 mL/kg/hour for adults. Urinary output may be aﬀected by various factors, such as ﬂuid intake, dehydration, diuretics, kidney disease, or medications. Aminoglycosides can cause nephrotoxicity, which is another potential adverse eﬀect of these drugs. Nephrotoxicity is the damage or injury to the kidneys caused by certain drugs or chemicals. It can impair the kidneys' ability to filter waste products from the blood, resulting in reduced urine production and oliguria. The PN should measure the urinary output in a client who is receiving an aminoglycoside and report any signs of nephrotoxicity to the health care provider. However, urinary output is not a sign of ototoxicity

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Naxlex Comprehensive Predictor Exams

An adolescent who is brought to the emergency department (ED) with a fever and persistent lower right quadrant abdominal pain is anxious, fearful, and hyperventilating. The nurse anticipates the client developing which acid-base imbalance?

Correct Answer is B

Explanation

The practical nurse (PN) is providing care for a client who is receiving an aminoglycoside to treat a bacterial infection. To assess for signs of ototoxicity, which action should the PN take?

Correct Answer is B

Explanation

Patient Data Exhibits What is the rationale for the order of supplemental oxygen 10 L/min via nasal cannula? Select the best answer.

After receiving a change of shift report for clients on a medical surgical unit, which task should the nurse assign to an unlicensed assistive personnel (UAP)?

An unlicensed assistive personnel (UAP) reports that a client's right hand and fingers spasm when taking the blood pressure using the same arm. After confirming the presence of the spasms, which action should the nurse take?

A 5-year-old child with a history of a waddling gait and frequent falls is brought into the hospital for diagnostic testing. When explaining the diagnostic testing to the parents, the nurse should provide information based on which understanding of the underlying disease pathology?

A nurse is reviewing laboratory results for a client who has been taking amoxicillin-clavulanate (Augmentin) for a bacterial respiratory tract infection. Which of the following findings should alert the nurse to a possible adverse effect of this medication? (Select all that apply.).

An adult male was diagnosed with stage IV lung cancer three weeks ago. His wife approaches the nurse and asks how she will know that her husband's death is imminent because their two adult children want to be there when he dies. Which is the best response by the nurse?

A client has been diagnosed with depression and has a history of suicide attempts. What intervention is essential for the nurse to implement?