The nurse caring for a client who is taking an aminoglycoside should monitor the client for which adverse effects of the medication?

Correct Answer: B

Rationale: The correct answer is B: Ototoxicity. Aminoglycosides are known to cause damage to the inner ear, resulting in hearing loss and balance issues. The nurse should monitor for symptoms such as tinnitus, dizziness, and hearing loss. Seizures (A) are not a common adverse effect of aminoglycosides. Renal toxicity (C) is a potential side effect, but ototoxicity is more specific to aminoglycosides. Hepatotoxicity (D) is not a typical adverse effect associated with aminoglycosides. Therefore, monitoring for ototoxicity is essential in clients taking aminoglycosides.

Correct Answer: D

Rationale: The correct answer is D: MRI scan of spine. For a patient with thoracic pain, leg weakness, and incontinence during chemo for breast cancer, an MRI of the spine is crucial to evaluate for spinal cord compression, a serious complication. This can present with the mentioned symptoms and requires urgent intervention. Serum calcium (A) is not the most important study as it is less likely to explain the patient's symptoms. A bone scan (B) and plain radiographs (C) may not provide detailed imaging of the spinal cord to assess for compression. An MRI scan of the spine (D) offers the best visualization to identify spinal cord compression and guide appropriate management.

Correct Answer: D

Rationale: The correct answer is D: Adjuvant hormonal therapy. For ER/PR+ breast cancer, hormonal therapy is the standard treatment to reduce the risk of recurrence. This patient has a high-risk tumor with positive lymph nodes, making hormonal therapy crucial to target any remaining cancer cells. No further treatment (A) is not appropriate given the high-risk features. Radiation to mammary nodes (B) is not the standard of care for ER/PR+ breast cancer. Platinum chemotherapy (C) is not indicated for ER/PR+ breast cancer and is reserved for other subtypes.

Correct Answer: D

Rationale: The correct answer is D: No further testing. In this scenario, the patient has a clear risk factor for DVT (long flight) and is already on anticoagulation therapy. Further diagnostic tests are not necessary for the management of acute DVT in this case. Testing for Factor V Leiden or Protein C, S, antithrombin III levels would not change the management at this point. Antiphospholipid antibody test is not indicated as there are no signs or symptoms suggestive of antiphospholipid syndrome. The most appropriate action is to continue the current treatment and monitor the patient's response.

Correct Answer: A

Rationale: The correct answer is A: Thalassemia. Thalassemia is a genetic disorder characterized by reduced production of hemoglobin, leading to microcytic anemia. Normal iron studies in this case suggest that iron deficiency anemia (choice B) is unlikely. Sideroblastic anemia (choice C) is characterized by abnormal iron utilization, not normal iron studies. Anemia of chronic disease (choice D) typically presents with normocytic or mildly microcytic anemia and is associated with underlying chronic inflammatory conditions. Therefore, given the clinical presentation of microcytic anemia with normal iron studies in an 18-year-old man, thalassemia is the most likely diagnosis.