When a patient is on gentamicin therapy, the nurse will monitor for which indicator of potential toxicity?

Ringing in the ears

Elevated WBC count

Decreased blood urea nitrogen (BUN) levels

Increased body temperature

Answer and Explanation

The Correct Answer is A

Choice A reason: Gentamicin, an aminoglycoside, causes ototoxicity, manifesting as ringing in the ears (tinnitus). It damages cochlear hair cells, leading to hearing loss or balance issues. Monitoring for tinnitus is critical, as ototoxicity is often irreversible, requiring dose adjustment or discontinuation to prevent further auditory damage.

Choice B reason: Elevated WBC count is not a typical indicator of gentamicin toxicity. Gentamicin’s primary toxicities are nephrotoxicity and ototoxicity. Elevated WBCs suggest infection or inflammation, not a direct effect of gentamicin, which targets bacterial protein synthesis, making this an incorrect monitoring parameter.

Choice C reason: Decreased BUN levels are not associated with gentamicin toxicity. Gentamicin causes nephrotoxicity, increasing BUN and creatinine due to renal tubular damage. Monitoring for elevated, not decreased, BUN is essential to detect kidney injury early, making this an incorrect toxicity indicator.

Choice D reason: Increased body temperature is not a direct indicator of gentamicin toxicity. Fever may indicate infection persistence or a drug reaction, but gentamicin’s primary toxicities are ototoxicity and nephrotoxicity. Monitoring for tinnitus or renal function changes is more relevant than temperature for toxicity assessment.

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Correct Answer is C

Explanation

Choice A reason: Hydroxychloroquine is not used for intestinal tapeworms, which are treated with antiparasitic drugs like praziquantel. Hydroxychloroquine inhibits lysosomal function and is used for malaria or autoimmune diseases like lupus, not helminth infections, which require drugs targeting parasitic metabolism.

Choice B reason: Lyme disease, caused by Borrelia burgdorferi, is treated with antibiotics like doxycycline, not hydroxychloroquine. Hydroxychloroquine’s antimalarial and immunomodulatory effects are irrelevant to bacterial infections like Lyme disease, which requires antimicrobial therapy to eliminate the spirochete.

Choice C reason: Hydroxychloroquine is commonly used for systemic lupus erythematosus (SLE). It modulates the immune system by inhibiting toll-like receptor signaling, reducing inflammation and autoantibody production. This makes it effective for managing SLE symptoms like joint pain or rashes, even in non-travelers, as it is not exclusively an antimalarial.

Choice D reason: Toxoplasmosis, caused by Toxoplasma gondii, is treated with pyrimethamine and sulfadiazine, not hydroxychloroquine. Hydroxychloroquine’s mechanism does not target protozoal infections like toxoplasmosis, which require drugs that inhibit folate synthesis in the parasite, making this an incorrect indication.

A. Drug therapy will last until the symptoms have stopped. B. You will be on this drug therapy for the rest of your life. C. You should expect to take these drugs for 6 to 9 months or more. D. Drug therapy will continue until the tuberculosis develops resistance.

Correct Answer is C

Explanation

Choice A reason: Tuberculosis therapy does not stop when symptoms resolve, as residual bacteria may persist, leading to relapse. Standard regimens (e.g., isoniazid, rifampin) last 6-9 months to ensure complete eradication of Mycobacterium tuberculosis, guided by sputum cultures and imaging, not just symptom cessation.

Choice B reason: Lifelong tuberculosis therapy is not typical for active disease. Standard treatment lasts 6-9 months for drug-susceptible tuberculosis, achieving cure in most cases. Lifelong therapy may apply to certain chronic infections, but for tuberculosis, finite regimens are effective, making this statement incorrect.

Choice C reason: Standard treatment for active tuberculosis involves a 6- to 9-month regimen of first-line drugs (isoniazid, rifampin, ethambutol, pyrazinamide). This duration ensures complete bacterial eradication, preventing relapse or resistance. Longer durations may be needed for resistant strains or extrapulmonary disease, aligning with clinical guidelines.

Choice D reason: Therapy does not continue until resistance develops, as this would indicate treatment failure. The goal is to eradicate Mycobacterium tuberculosis before resistance emerges, using combination therapy for 6-9 months. Continuing until resistance occurs is counterproductive and increases the risk of multidrug-resistant tuberculosis.

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When a patient is on gentamicin therapy, the nurse will monitor for which indicator of potential toxicity?

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Naxlex Comprehensive Predictor Exams

A patient is receiving hydroxychloroquine therapy but tells the nurse that she has never traveled out of her city. The nurse knows that a possible reason for this drug therapy is which of these conditions?

Correct Answer is C

Explanation

A patient who has started drug therapy for tuberculosis wants to know how long he will be on the medications. Which response by the nurse is correct?

Correct Answer is C

Explanation

A woman is traveling to a country where she will be at high risk for malarial infection. What will the nurse teach her regarding prophylactic therapy with hydroxychloroquine?

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