A client with mild parkinsonism is started on oral amantadine (Symmetrel). What statement accurately describes the action of this medication?

Dopamine in central nervous system is increased

Dopamine in central nervous system is decreased

Acetylcholine in central nervous system is increased

Acetylcholine in central nervous system is decreased

Answer and Explanation

The Correct Answer is A

This statement accurately describes the action of amantadine, which is a medication that has both antiviral and antiparkinsonian effects. The mechanism of action of amantadine in the treatment of parkinsonism is not fully understood, but it may involve increasing dopamine release in the brain, stimulating norepinephrine response, or activating dopaminergic receptors¹². The other choices are incorrect for the following reasons:

- B. "Dopamine in the central nervous system is decreased". This statement is incorrect because amantadine does not decrease dopamine levels, but rather enhances them. Decreasing dopamine levels would worsen the symptoms of parkinsonism, which are caused by a deficiency of dopamine in the basal ganglia.

- C. "Acetylcholine in the central nervous system is increased". This statement is incorrect because amantadine does not affect acetylcholine levels or activity. Acetylcholine is another neurotransmitter that is involved in the regulation of movement and cognition. Increasing acetylcholine levels would have anticholinergic effects, such as dry mouth, blurred vision, constipation, and confusion.

- D. "Acetylcholine in the central nervous system is decreased". This statement is incorrect because amantadine does not affect acetylcholine levels or activity. Decreasing acetylcholine levels would have cholinergic effects, such as salivation, lacrimation, urination, and diarrhea.

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Correct Answer is C

Explanation

Phenytoin (Dilantin) can cause overgrowth of gum tissue, also known as gingival hyperplasia, in some people¹. This can lead to swelling, bleeding, and infection of the gums¹. Good oral hygiene, such as brushing, flossing, and using mouthwash, can help prevent or reduce gum problems¹. The client should also see the dentist regularly for check-ups and cleaning¹.

Choice A is wrong because the client should not stop taking phenytoin without consulting the provider. Stopping phenytoin suddenly can increase the risk of seizures or status epilepticus, which is a life-threatening condition¹. If the client wants to switch to another anticonvulsant medication, the provider should advise on how to do so safely and gradually¹.

Choice B is wrong because the client should not reduce the dose of phenytoin without consulting the provider. Reducing the dose of phenytoin can lower the blood level of the medication and make it less effective in controlling seizures¹. The provider should monitor the blood level of phenytoin and adjust the dose accordingly¹.

Choice D is wrong because the client should not take ibuprofen (Motrin) or aspirin (Ecotrin) to relieve the inflammation and pain in the gums. These medications are nonsteroidal anti-inflammatory drugs (NSAIDs) that can interact with phenytoin and increase its blood level and side effects². They can also increase the risk of bleeding, especially in people with low platelet count or clotting problems². The client should consult the provider before taking any other medications with phenytoin¹.

A. Blurred vision B. Gingival hyperplasia C. Skin rash D. Constipation

Correct Answer is C

Explanation

Skin rash is an adverse effect of ethosuximide (Zarontin) that should be reported to the provider¹. Ethosuximide can cause allergic reactions, such as hives, itching, and skin rash, in some people¹. A skin rash may indicate a serious condition, such as Stevens-Johnson syndrome or toxic epidermal necrolysis, which can be life-threatening¹.

Choice A is wrong because blurred vision is not a common side effect of ethosuximide. Ethosuximide is not known to affect vision or eye health¹.

Choice B is wrong because gingival hyperplasia is not a common side effect of ethosuximide. Ethosuximide is not known to cause overgrowth of the gums or dental problems¹. Gingival hyperplasia is more commonly associated with other anticonvulsants, such as phenytoin (Dilantin)².

Choice D is wrong because constipation is not a common side effect of ethosuximide. Ethosuximide may cause gastrointestinal side effects, such as nausea, vomiting, stomach pain, and loss of appetite, but not constipation¹³. Constipation is more commonly associated with other anticonvulsants, such as carbamazepine (Tegretol)⁴.

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A client with mild parkinsonism is started on oral amantadine (Symmetrel). What statement accurately describes the action of this medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who has been taking phenytoin (Dilantin) for several years to control tonic-clonic seizures. The client tells the nurse that he wants to stop taking the medication because it makes his gums swell and bleed. What is the most appropriate response by the nurse?

Correct Answer is C

Explanation

A client is prescribed ethosuximide (Zarontin) for absence seizures. The nurse should instruct the client to report which adverse effect?¹

Correct Answer is C

Explanation

A nurse is caring for a client who has been prescribed phenobarbital (Luminal) for status epilepticus. The nurse should monitor the client for which adverse effect of this drug?¹

A client with mild parkinsonism is started on oral amantadine (Symmetrel). What statement accurately describes the action of this medication?

A nurse is teaching a client who has a new prescription for gabapentin for partial seizures. Which of the following instructions should the nurse include in the teaching?

The nurse is caring for a patient who has been receiving intravenous phenytoin (Dilantin). The patient complains of pain and burning at the IV site, and the nurse notes redness and swelling at the site. What will the nurse do?

The healthcare provider prescribes captopril (Capoten) 37.5 mg. The medication is available in 25 mg tablets. What should the nurse administer?

A nurse is reviewing discharge instructions with a patient who has epilepsy and has been prescribed lamotrigine (Lamictal). Which of the following statements by the patient indicates a need for further teaching?

A nurse is caring for a patient who experiences seizure activity while in bed. What action by the nurse takes priority?

A nurse is preparing to administer intravenous phenytoin (Dilantin) to a patient who has status epilepticus. Which of the following actions should the nurse take?