A nurse is reviewing a client's peak and trough levels of gentamicin. The peak should be 6 to 8 mcg/mL and the trough should be 0.5 to 1 mcg/mL. The client's peak is10 mcg/mL and his trough is 2.3 mcg/mL. Which of the following clinical manifestations should the nurse expect with these findings? (Select all that apply.)

Insomnia

Constipation

Xerostomia

Persistent headache

Tinnitus

Answer and Explanation

Correct Answer : D,E

D. Persistent headache can occur with elevated levels of gentamicin, as it may indicate neurotoxicity. Gentamicin can cause neurotoxic effects, including headaches, especially when levels are elevated.

E. Tinnitus (ringing in the ears) is a classic symptom of gentamicin toxicity. Elevated gentamicin levels can lead to ototoxicity, which manifests as tinnitus among other auditory symptoms.

A. Insomnia is not typically associated with elevated levels of gentamicin. Elevated gentamicin levels are not known to cause insomnia.

B. Constipation is not typically associated with elevated levels of gentamicin. Elevated gentamicin levels are not known to cause constipation.

C. Xerostomia (dry mouth) is not typically associated with elevated levels of gentamicin. Elevated gentamicin levels are not known to cause xerostomia.

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Correct Answer is D

Explanation

A. A filter needle is used when withdrawing medication from an ampule, but it is not used to administer the injection. After withdrawal, the filter needle should be replaced with a regular IM needle for administration.
B. The ampule should be broken by snapping the neck away from the body, not by bending it to the side, to prevent injury.
C. The nurse should gently tap the top of the ampule, not the bottom, to move the solution downward before opening.
D. The correct technique is to insert the needle into the center of the ampule to withdraw medication, ensuring that the bevel remains below the fluid line to avoid drawing up air.

A. 60° B. 45° C. 75° D. 90°

Correct Answer is D

Explanation

D. A 90° angle (perpendicular to the skin surface) is typically used for IM injections into muscles where the needle needs to penetrate deeply into the muscle tissue.

A. 60° angle is commonly used for IM injections in the deltoid muscle or thigh. However, it may not be optimal for the ventrogluteal site, which typically requires a different approach due to its deeper location and muscle structure.

B. A 45° angle is typically used for subcutaneous injections, where the needle is inserted into the fatty layer just below the skin surface.

C. This angle is steeper than 60° and is sometimes used for IM injections into muscles with thicker tissue or larger muscle mass.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer an IM injection to a client using a medication from an ampule. Which of the following actions should the nurse plan to take?

Correct Answer is D

Explanation

A nurse is preparing to administer penicillin IM to an adult client. Which of the following angles should the nurse use for injection into the client's ventrogluteal muscle?

Correct Answer is D

Explanation

A nurse is collecting data from an older adult client who is receiving ondansetron IV, has a history of diabetes mellitus and cardiac myopathy, and is receiving chemotherapy to treat cancer. For which of the following adverse effects of ondansetron should the nurse monitor? (Select all that apply)

A nurse is collecting data on a client who has circulatory overload. Which of the following findings should the nurse expect?

A nurse is monitoring a client's IV site. The nurse should report which of the following findings as manifestations of phlebitis? (Select all that apply.)

A nurse is assisting with the care of a client who is receiving an IV infusion of dextrose 10% in water. The nurse should monitor the client for which of the following adverse effects?

For a patient who is experiencing an ECV excess, the nurse plans to determine the fluid status. The best way for the nurse to determine the fluid balance for the patient is to:

A nurse is assisting with supervising a newly licensed nurse replace a short-peripheral IV device for a client. Which of the following actions by the new nurse indicates an understanding of the procedure?

A nurse is reinforcing teaching with a client who has a new prescription for pantoprazole for heartburn. Which of the following information should the nurse include?

A nurse is assisting with care of a client who has a prescription for 3,000 mL of intravenous fluids over the next 24 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round to the nearest whole number)