A 25 year-old female patient will begin taking phenytoin for epilepsy. The patient tells the nurse she is taking oral contraceptives (OCPs). Which response will the nurse give?

"Continue taking OCPS because phenytoin is not safe during pregnancy."

"You should use a backup method of contraception along with OCPs."

"You should stop taking OCPs because of drug-drug interactions with phenytoin."

"You should take low-dose aspirin while taking these medications to reduce your risk of stroke."

Answer and Explanation

The Correct Answer is B

A. "Continue taking OCPS because phenytoin is not safe during pregnancy."

This statement is not accurate. While it's essential to address pregnancy risk, phenytoin can reduce the effectiveness of oral contraceptives. Women on phenytoin are often advised to use additional contraceptive measures.

B. "You should use a backup method of contraception along with OCPs."

This is the correct response. Phenytoin can accelerate the metabolism of oral contraceptives, potentially reducing their effectiveness. Using a backup method, such as condoms, is recommended to ensure adequate contraception.

C. "You should stop taking OCPs because of drug-drug interactions with phenytoin."

This advice is generally not recommended without consulting the healthcare provider. Abruptly stopping OCPs without an alternative form of contraception can increase the risk of unintended pregnancy.

D. "You should take low-dose aspirin while taking these medications to reduce your risk of stroke."

This statement is not relevant to the situation described. Low-dose aspirin is not typically recommended for contraception, and its use in this context does not address the potential interaction between phenytoin and oral contraceptives.

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Correct Answer is B

Explanation

A. Decreased ascites

Ascites (accumulation of fluid in the abdominal cavity) is more directly related to portal hypertension and liver cirrhosis. While lactulose may contribute to fluid balance, its primary therapeutic effect in hepatic encephalopathy is the reduction of ammonia levels.

B. Decreased ammonia level

Lactulose is a medication commonly used in the treatment of hepatic encephalopathy, a condition associated with liver disease. The therapeutic effect of lactulose in this context is to reduce blood ammonia levels. Lactulose works by promoting the excretion of ammonia in the form of ammonium ions in the colon, thereby lowering ammonia concentrations in the blood.

C. Decreased jaundice

Jaundice is often associated with liver dysfunction, but lactulose is not primarily used to address jaundice. Its primary role in liver disease is in the management of hepatic encephalopathy.

D. Decreased blood pressure

Blood pressure is not a direct therapeutic target of lactulose in the context of liver disease. Lactulose's primary therapeutic effect is related to reducing ammonia levels and managing hepatic encephalopathy.

A. increases peristalsis to produce a bowel movement. B. is incompatible with alcohol consumption. C. should be avoided during pregnancy as it is teratogenic. D. may lead to paralytic ileus.

Correct Answer is A

Explanation

A. "Bisacodyl (Dulcolax) increases peristalsis to produce a bowel movement." - This is correct. Bisacodyl is a stimulant laxative that works by irritating the intestines, leading to increased peristalsis and bowel movements.

B. "Bisacodyl (Dulcolax) is incompatible with alcohol consumption." - There is no specific information suggesting incompatibility with alcohol. However, excessive alcohol consumption can contribute to constipation, and it's generally advisable to stay hydrated, which can be affected by alcohol intake.

C. "Bisacodyl (Dulcolax) should be avoided during pregnancy as it is teratogenic." - There is no strong evidence to suggest that bisacodyl is teratogenic. However, it is recommended to use laxatives cautiously during pregnancy and under the guidance of a healthcare provider.

D. "Bisacodyl (Dulcolax) may lead to paralytic ileus." - Paralytic ileus is not a common side effect of bisacodyl. However, it's important to use laxatives cautiously in individuals with a history of bowel obstruction or other gastrointestinal issues.

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A 25 year-old female patient will begin taking phenytoin for epilepsy. The patient tells the nurse she is taking oral contraceptives (OCPs). Which response will the nurse give?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Lactulose is ordered for a patient with liver disease. What would indicate the medication is exerting a positive therapeutic effect on the patient?

Correct Answer is B

Explanation

Bisacodyl (Dulcolax) has been ordered for a patient who is constipated. The nurse realizes the drug:

Correct Answer is A

Explanation

Order: 1,000 mL. NS to infuse in eight hours. At what rate in mL/h will you set the pump?

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