A 73-year-old male with Parkinson's disease, emphysema, and benign prostatic hyperplasia presents to the clinic for routine care. Following detailed assessment, the provider has prescribed an anticholinergic drug for the client. What is the nurse's priority teaching point to the client in regard to his new medication?

Do slow position changes to avoid falls from lowering blood pressure."

if you feel short of breath, use a rescue inhaler.

"If possible, try to avoid rooms that are cold."

"Make sure to seek care immediately if you're not able to urinate."

Answer and Explanation

The Correct Answer is D

A.   Do slow position changes to avoid falls from lowering blood pressure: This is not the priority teaching point for an anticholinergic medication. While some anticholinergics can cause orthostatic hypotension, the risk of urinary retention is a more significant concern.
B.   If you feel short of breath, use a rescue inhaler: This instruction is unrelated to the use of anticholinergic medication and may be more relevant for patients with emphysema.
C.   "If possible, try to avoid rooms that are cold.": Avoiding cold rooms is not directly related to the use of anticholinergic medication. The priority teaching point should address potential adverse effects specific to the medication.
D.   "Make sure to seek care immediately if you're not able to urinate.": Anticholinergic medications can exacerbate urinary retention, particularly in older adults with benign prostatic hyperplasia. It's crucial for the patient to understand the importance of seeking medical attention if they experience difficulty urinating.

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Correct Answer is A

Explanation

A. "I will need to take extra care of my teeth and gums while on this medication.": Phenytoin can cause gum overgrowth (gingival hyperplasia), so taking extra care of oral hygiene is important.
B. "I will be able to stop taking this drug once the seizures stop.": Phenytoin is typically used as a long-term therapy for seizure control; stopping abruptly can lead to rebound seizures.
C. "I can go out for a beer while on this medication.": Alcohol consumption may interact with phenytoin and should be avoided or limited.
D. "I can skip doses if the side effects bother me.": Skipping doses of phenytoin can lead to inadequate seizure control and should not be done without consulting a healthcare provider.

A. The lithium level is too low B. The lithium level is therapeutic C. Lithium is not usually monitored with blood levels D. The lithium level is too high

Correct Answer is B

Explanation

A. A lithium level of 0.9 mEq/L falls within the therapeutic range for lithium, so it is not too low.

B. A lithium level of 0.9 mEq/L is within the therapeutic range for lithium maintenance therapy, which typically ranges from 0.6 to 1.2 mEq/L. Therefore, it is considered therapeutic.
C. Lithium is commonly monitored with blood levels to ensure therapeutic efficacy and to prevent toxicity.
D. A lithium level of 0.9 mEq/L is not too high; it is within the therapeutic range.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse has given medication instructions to a patient receiving phenytoin. Which statement by the patient indicates that the patient has an adequate understanding of the instructions?

Correct Answer is A

Explanation

A patient has been taking lithium for 1 year, and the most recent lithium level is 0.9 mEq/L. Which statement about the laboratory result is correct?

Correct Answer is B

Explanation

The nurse is reviewing the food choices of a patient who is taking a monoamine oxidase inhibitor (MAOI). Which food choice would indicate the need for additional teaching?

During a routine appointment, a patient with a history of seizures is found to have a phenytoin level of 23 mcg/mL. What concern will the nurse have, if any?

The U.S. Food and Drug Administration has issued a warning for users of antiepileptic drugs. Based on this report, the nurse will monitor for which potential problems with this class of drugs?

A nurse is providing teaching to a client who has a new diagnosis of Parkinson's disease. On which of the following medications should the nurse prepare to instruct the client?

A nurse is performing discharge teaching for a client who has seizures and a new prescription for phenytoin. Which of the following statements by the client indicates a need for further teaching?

A nurse is teaching a patient who has schizophrenia strategies to cope with anticholinergic effects of fluphenazine. Which of the following should the nurse suggest to the patient to minimize anticholinergic effects?