A nurse is caring for a client who is receiving gentamicin. Which of the following findings indicates the client is developing toxicity?
Lethargy
Weight gain
Tinnitus
Slurred vision
The Correct Answer is C
A. Lethargy: Lethargy can be a nonspecific symptom of many conditions, including infection or general illness, but it is not a hallmark sign of gentamicin toxicity. While monitoring overall status is important, lethargy alone does not indicate ototoxicity or nephrotoxicity.
B. Weight gain: Weight gain may reflect fluid retention or other metabolic changes, but it is not a primary indicator of gentamicin toxicity. Nephrotoxicity could eventually cause fluid retention, but weight gain is a delayed and nonspecific finding.
C. Tinnitus: Tinnitus, or ringing in the ears, is a classic early sign of ototoxicity associated with aminoglycosides like gentamicin. It indicates damage to the inner ear and requires immediate assessment and potential discontinuation of the drug to prevent permanent hearing loss.
D. Slurred vision: Slurred vision is not typically associated with gentamicin toxicity. Visual changes are not a known adverse effect of aminoglycosides, so this finding would prompt evaluation for other causes rather than drug toxicity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. 3 months: At 3 months, infants typically have a smaller head circumference, weigh less (around 12–13 lb), have fewer teeth, and have not yet demonstrated standing or significant weight-bearing when held. The developmental milestones observed in this infant exceed those expected at 3 months.
B. 6 months: The infant’s weight (14.5 lb), height (24 inches), presence of two lower central incisors, ability to bear weight when held in a standing position, hold a bottle, and exhibit a social smile align with typical developmental milestones for a 6-month-old. Neurologic reflexes such as Moro and tonic neck reflexes usually disappear by this age.
C. 9 months: By 9 months, infants are usually able to sit without support, may begin crawling, and have more teeth. The inability to sit unsupported indicates the infant is younger than 9 months.
D. 12 months: At 12 months, infants generally are able to stand independently, may begin walking, and have more advanced fine motor skills and additional teeth. The developmental abilities and physical measurements of this infant suggest she is younger than 12 months.
Correct Answer is D
Explanation
A. A barrel chest: A barrel-shaped chest is a common structural change in clients with long-standing COPD. While it reflects chronic disease, it is not an acute change requiring immediate provider notification.
B. Coughing and wheezing after eating: This may indicate mild aspiration or gastroesophageal reflux, which should be monitored and addressed, but it is not immediately life-threatening if the client remains stable.
C. Abdominal bloating: Abdominal bloating can occur due to air swallowing or gastrointestinal changes in COPD, but it is not an urgent concern unless accompanied by severe pain, distention, or other acute symptoms.
D. A drop in oxygen saturation to 91% while eating: A sudden decrease in oxygen saturation indicates hypoxemia and potential respiratory compromise, especially in a client with COPD. This acute change requires immediate provider notification and possible intervention, making it the highest priority finding.
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