Amikacin is prescribed for a client with a bacterial infection. The nurse instructs the client to contact the primary health care provider (PHCP) immediately if which occurs?

Correct Answer: C

Rationale: The correct answer is C: Hearing loss. Amikacin, an aminoglycoside antibiotic, is known to cause ototoxicity, which can manifest as hearing loss. The client should contact the PHCP immediately if hearing loss occurs as it may be a sign of irreversible damage. Nausea (A), lethargy (B), and muscle aches (D) are common side effects of Amikacin but are not urgent or indicative of a serious adverse reaction requiring immediate medical attention.

Correct Answer: A

Rationale: The correct answer is A: CT scan of abdomen. In a 69-year-old man with weight loss, back pain, and hyperglycemia, a CT scan of the abdomen is the most likely diagnostic study to identify potential underlying causes such as pancreatic cancer or other abdominal malignancies. This imaging modality can provide detailed information on the pancreas, surrounding structures, and possible metastases. Summary: B: Glucose tolerance test is not the most appropriate initial study for a patient presenting with these symptoms. C: Colonoscopy is indicated for evaluating lower gastrointestinal symptoms, not typically for weight loss, back pain, and hyperglycemia. D: Whole-body PET scan may be used for cancer staging, but a CT scan of the abdomen is more specific for identifying abdominal malignancies.

Correct Answer: C

Rationale: The correct next diagnostic study for a 26-year-old man with testicular mass and periaortic lymphadenopathy is to measure α-fetoprotein, β-hCG, and LDH levels (Choice C). This is because these tumor markers (α-fetoprotein, β-hCG, LDH) are essential in the evaluation of testicular cancer. Elevated levels of these markers can indicate the presence of germ cell tumors. Needle biopsy of a retroperitoneal mass (Choice A) would not be the initial step as it does not directly evaluate the testicular mass. Needle aspiration of the testicular mass (Choice B) may yield limited information compared to tumor marker levels. PET scan (Choice D) is typically not the first-line investigation for testicular cancer evaluation.

Correct Answer: B

Rationale: The correct answer is B: Thalassemia. Thalassemia is a genetic disorder characterized by abnormal hemoglobin production, leading to microcytic anemia with low MCV. In this case, the patient's low MCV of 62 indicates microcytic anemia, which is consistent with thalassemia. Normal iron studies rule out iron deficiency anemia (Choice C). Anemia of chronic disease (Choice D) typically presents with normocytic or mildly microcytic anemia, unlike the severe microcytic anemia seen in thalassemia. Sideroblastic anemia (Choice A) is characterized by ringed sideroblasts in the bone marrow and elevated ferritin, which are not present in this patient.

Correct Answer: C

Rationale: The correct answer is C because the patient post-colonoscopy with chronic GI bleeding requires close monitoring and immediate intervention if any complications arise. The float nurse from PACU is experienced in handling post-operative patients and can provide appropriate care for this patient's needs. Choice A is incorrect because a patient with thalassemia major receiving deferoxamine does not require immediate post-operative care. Choice B is incorrect as the patient with multiple myeloma needing discharge teaching can be managed by a regular floor nurse. Choice D is incorrect as the patient with pernicious anemia does not have urgent post-operative care needs.