A nurse is preparing to administer phenobarbital to a client who has status epilepticus. The nurse should be aware that phenobarbital has which of the following mechanisms of action?
It inhibits carbonic anhydrase in the brain, which reduces the production of cerebrospinal fluid and prevents seizures.
It inhibits GABA transaminase in the brain, which increases the availability of GABA and prevents seizures.
It enhances the binding of GABA to its receptors in the brain, which increases the influx of chloride and prevents seizures.
It enhances the binding of glutamate to its receptors in the brain, which increases the efflux of potassium and prevents seizures.
The Correct Answer is C
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Valproic acid can interact with warfarin and increase the risk of bleeding by inhibiting the metabolism of warfarin and displacing it from plasma protein binding sites¹. The nurse should monitor the client's international normalized ratio (INR) and prothrombin time (PT) and adjust the warfarin dose accordingly.
Choice B. Metformin is wrong because valproic acid does not have a significant interaction with metformin. Metformin is an oral antidiabetic drug that lowers blood glucose levels by decreasing hepatic glucose production and increasing insulin sensitivity².
Choice C. Ibuprofen is wrong because valproic acid does not have a significant interaction with ibuprofen. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that reduces inflammation, pain, and fever by inhibiting cyclooxygenase enzymes².
Choice D. Levothyroxine is wrong because valproic acid does not have a significant interaction with levothyroxine. Levothyroxine is a synthetic thyroid hormone that replaces the deficient endogenous hormone in hypothyroidism².
Correct Answer is ["A","B","C","D"]
Explanation
Choice A is correct because diazepam is a benzodiazepine that can cause respiratory depression, especially when given intravenously. The nurse should monitor the client's respiratory rate and oxygen saturation and be prepared to provide respiratory support if needed²⁴.
- Choice B is correct because diazepam should be diluted with normal saline or dextrose 5% in water before administration to prevent venous irritation and thrombophlebitis. The concentration of diazepam should not exceed 5 mg/mL²⁴.
- Choice C is correct because diazepam should be injected slowly over at least 3 minutes to avoid adverse effects such as hypotension, bradycardia, cardiac arrest, or apnea. The maximum rate of injection is 5 mg/min²⁴.
- Choice D is correct because diazepam is incompatible with many other drugs and solutions, and can precipitate or adsorb to plastic tubing. The nurse should flush the IV line with normal saline before and after administration to prevent drug interactions and ensure complete delivery of the medication²⁴.
- Choice E is wrong because repeating the dose of diazepam every 15 minutes until seizure activity stops is not recommended. Diazepam has a short duration of action and can accumulate in the body with repeated doses, increasing the risk of toxicity and respiratory depression. If seizures persist after the initial dose of diazepam, the nurse should start emergency IV antiepileptic drug therapy with levetiracetam, sodium valproate, or phenytoin³⁶.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today