Page 2218 - Saunders Comprehensive Review For NCLEX-RN

784. Answer: 3

Rationale: Amikacin is an aminoglycoside. Adverse effects of aminoglycosides
include ototoxicity (hearing problems), confusion, disorientation, gastrointestinal
irritation, palpitations, blood pressure changes, nephrotoxicity, and hypersensitivity.
The nurse instructs the client to report hearing loss to the PHCP immediately.
Lethargy and muscle aches are not associated with the use of this medication. It is
not necessary to contact the PHCP immediately if nausea occurs. If nausea persists
or results in vomiting, the PHCP should be notified.
Test-Taking Strategy: Note the strategic word, immediately. Recalling that this
medication is an aminoglycoside (most aminoglycoside medication names end in -
cin) and that aminoglycosides are ototoxic will direct you to the correct option.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Teaching and Learning
Content Area: Pharmacology: Immune Medications: Aminoglycosides
Health Problem: Adult Health: Immune: Infections
Priority Concepts: Client Education; Safety
Reference: Burchum, Rosenthal (2016), pp. 1052-1053.

785. Answer: 4

Rationale: Foscarnet is toxic to the kidneys. The serum creatinine level is
monitored before therapy, two or three times per week during induction therapy,
and at least weekly during maintenance therapy. Foscarnet also may cause
decreased levels of calcium, magnesium, phosphorus, and potassium. Thus, these
levels also are measured with the same frequency.
Test-Taking Strategy: Focus on the subject, the laboratory value to be monitored.
Recalling that this medication is nephrotoxic will direct you to the correct option.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Assessment
Content Area: Pharmacology: Immune Medications: Antivirals
Health Problem: Adult Health: Immune: Immunodeficiency Syndrome
Priority Concepts: Clinical Judgment; Safety
Reference: Hodgson, Kizior (2018), pp. 501-502.

786. Answer: 1

Rationale: Stavudine is an antiretroviral used to manage human
immunodeficiency virus infection in clients who do not respond to or who cannot
tolerate conventional therapy. The medication can cause peripheral neuropathy, and
the nurse should monitor the client’s gait closely and ask the client about
paresthesia. Options 2, 3, and 4 are unrelated to this medication.
Test-Taking Strategy: Note the strategic word, most. Focus on the name of the
medication. Recalling that this medication causes peripheral neuropathy will direct
you to the correct option.

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