A male client with tuberculosis returns to the clinic for daily antibiotic injections for a urinary infection. The client has been taking antitubercular medications for 10 weeks and states he has ringing in his ears. Which prescribed medication should the practical nurse (PN) report to the healthcare provider?
Rifampin 600 mg PO daily
Gentamicin 160 mg IM daily.
Pyridoxine with a B complex multivitamin.
Isoniazid 300 mg PO daily.
The Correct Answer is B
A. Rifampin 600 mg PO daily: Rifampin is a standard antitubercular medication known for causing orange discoloration of body fluids and potential hepatotoxicity, but it is not associated with ototoxicity.
B. Gentamicin 160 mg IM daily: Gentamicin is an aminoglycoside antibiotic with a well-documented risk of ototoxicity and nephrotoxicity. The client’s report of tinnitus suggests early ototoxic damage, making it essential for the PN to report this finding immediately to prevent irreversible hearing loss.
C. Pyridoxine with a B complex multivitamin: Pyridoxine (vitamin B6) is commonly prescribed with isoniazid to prevent peripheral neuropathy caused by interference with vitamin metabolism. It does not contribute to tinnitus.
D. Isoniazid 300 mg PO daily: Isoniazid can cause peripheral neuropathy and hepatotoxicity but is not linked to ototoxic effects. The client’s auditory symptoms are unrelated to isoniazid therapy, making gentamicin the priority medication to report.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Mental status: Mental status assessment is broad and includes multiple components such as mood, orientation, and cognition. While important, it is not the primary focus of the Glasgow Coma Scale (GCS).
B. Cranial nerve status: Cranial nerve assessment evaluates specific neurological function, but the GCS specifically measures overall neurological responsiveness rather than individual cranial nerves.
C. Level of consciousness: The Glasgow Coma Scale is designed to assess a client’s level of consciousness through eye, verbal, and motor responses. Monitoring changes in consciousness provides critical information about brain function and potential deterioration.
D. Ability to communicate: Communication is one component of the GCS (verbal response), but the scale also incorporates eye and motor responses. Level of consciousness encompasses overall neurological status, making it the primary assessment.
Correct Answer is C
Explanation
A. Demonstrate how to use the equipment: Demonstrating proper technique is useful after identifying the source of the problem. However, before instructing, the PN must first assess whether the issue lies with the UAP’s technique, the thermometer, or both.
B. Return the thermometer for recalibration: Sending the thermometer for recalibration may be unnecessary unless the PN confirms that incorrect readings are due to equipment malfunction. It is more appropriate to verify the accuracy of the procedure before assuming the device is faulty.
C. Observe how UAP obtains temperatures: Direct observation allows the PN to assess whether the UAP is using correct technique, such as proper ear positioning and seal. This helps determine if the subnormal readings result from user error or equipment issues, guiding appropriate corrective action.
D. Show UAP how to chart temperatures: Documentation accuracy is important, but charting technique is not the cause of consistently abnormal readings. The PN must first identify and correct the underlying problem in the temperature-taking process.
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