A nurse is administering phenytoin to a client. The nurse should monitor for which of the following adverse effects?

Tinnitus

Bleeding gums

Jaundice

Deep vein thrombosis

Answer and Explanation

The Correct Answer is B

A. Tinnitus. Phenytoin is not commonly associated with tinnitus. Ototoxicity is more frequently linked to medications such as aminoglycoside antibiotics, loop diuretics, or high-dose aspirin. While phenytoin affects the nervous system, it does not typically cause ringing in the ears.

B. Bleeding gums. Gingival hyperplasia, characterized by swollen and bleeding gums, is a well-known adverse effect of phenytoin, especially with long-term use. It occurs due to an overgrowth of gum tissue and can be minimized with good oral hygiene and regular dental care. Clients should be advised to brush with a soft-bristled toothbrush and visit the dentist regularly.

C. Jaundice. Although phenytoin is metabolized by the liver, hepatotoxicity and jaundice are not common side effects. However, liver function should still be monitored, particularly in clients with pre-existing liver conditions or those taking other hepatotoxic medications.

D. Deep vein thrombosis. Phenytoin does not significantly increase the risk of deep vein thrombosis (DVT). While some anticonvulsants may affect coagulation factors, phenytoin is not known to cause hypercoagulability or clot formation. Clients at risk for DVT should be monitored for other contributing factors, such as immobility or genetic predisposition.

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Correct Answer is C

Explanation

A. Deferoxamine. Deferoxamine is a chelating agent used to treat iron overload or toxicity. It has no role in managing an acute allergic reaction or respiratory distress caused by nafcillin, a penicillin-type antibiotic.

B. Vitamin K. Vitamin K is used to reverse the effects of warfarin-induced anticoagulation and is not indicated for treating an allergic reaction. Anaphylaxis is not related to coagulation disturbances, making this an inappropriate intervention.

C. Epinephrine. Epinephrine is the first-line treatment for anaphylaxis, which can present with difficulty breathing, bronchospasm, and hypotension. It works by stimulating alpha- and beta-adrenergic receptors, leading to bronchodilation, increased cardiac output, and vasoconstriction to counteract severe allergic reactions. Immediate administration is necessary to prevent further airway compromise and circulatory collapse.

D. Prednisone. Prednisone is a corticosteroid used to reduce inflammation and prevent delayed allergic reactions. While it may be prescribed as part of long-term management, it does not provide the rapid bronchodilation and vasoconstriction needed for emergency treatment of anaphylaxis.

A. Rash B. Diarrhea C. Nausea D. Metallic taste in mouth

Correct Answer is A

Explanation

A. Rash. A rash while taking allopurinol can indicate a serious hypersensitivity reaction, including Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN). These life-threatening conditions involve widespread skin blistering, mucosal involvement, and systemic symptoms. Immediate discontinuation of allopurinol and medical intervention are required to prevent severe complications.

B. Diarrhea. Mild gastrointestinal disturbances, including diarrhea, are common with allopurinol use. While bothersome, diarrhea is not life-threatening and can often be managed by adjusting the dose or taking the medication with food. It does not require immediate discontinuation unless severe or persistent.

C. Nausea. Nausea is a common, mild side effect of allopurinol that usually resolves with time or by taking the medication after meals. It is not an emergency and does not require urgent intervention unless accompanied by other concerning symptoms such as vomiting or severe abdominal pain.

D. Metallic taste in mouth. A metallic taste can occur with allopurinol use but is not harmful. It is a minor side effect that does not indicate toxicity or severe adverse reactions. Clients can be reassured that this effect is temporary and not a reason to stop the medication.

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A nurse is administering phenytoin to a client. The nurse should monitor for which of the following adverse effects?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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