A nurse is reinforcing teaching with a female client who is taking phenytoin. Which of the following statements should the nurse include in the teaching?
"You should expect to have blood work every 6 months while taking this medication."
*You can safely take this medication if you become pregnant."
"You might experience swollen gums while taking this medication."
"You can skip a dose of this medication if you are nauseated."
The Correct Answer is C
A) "You should expect to have blood work every 6 months while taking this medication.": While it is important for clients on phenytoin to have regular blood work, especially to monitor drug levels and assess for potential side effects (e.g., liver function, complete blood count), the frequency of blood work is typically more frequent than every 6 months. Blood work is often performed at least every 3-6 months, or more frequently if there are concerns about phenytoin levels or side effects. Therefore, this statement is not accurate.
B) "You can safely take this medication if you become pregnant.": Phenytoin is classified as a Category D medication in pregnancy, meaning it has been shown to cause potential harm to the fetus. It is not considered safe during pregnancy, and women who are pregnant or planning to become pregnant should discuss alternative medications with their healthcare provider.
C) "You might experience swollen gums while taking this medication.": Gingival hyperplasia (swelling of the gums) is a common side effect of phenytoin. Clients taking this medication should be aware of this potential side effect and should be instructed on proper oral hygiene and regular dental checkups to help minimize this risk. This statement is accurate and should be included in the teaching.
D) "You can skip a dose of this medication if you are nauseated.": It is important not to skip doses of phenytoin, as maintaining therapeutic levels of the drug is crucial for its effectiveness in preventing seizures. If a client experiences nausea or difficulty taking the medication, they should contact their healthcare provider for guidance rather than skipping doses. Skipping doses could lead to breakthrough seizures.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A) "I should eat a high fat diet for several weeks": After a laparoscopic cholecystectomy, the client is typically advised to avoid high-fat foods for a period of time as the body adjusts to the absence of the gallbladder. High-fat foods can trigger discomfort, nausea, or diarrhea. Therefore, recommending a high-fat diet is not appropriate post-surgery.
B) "I should expect to have diarrhea until my diet changes": Diarrhea is a possible side effect following gallbladder removal, particularly due to the changes in bile flow. However, the client should not expect diarrhea indefinitely. Over time, the digestive system adjusts, and with dietary modifications, diarrhea often resolves. The client should not assume this will persist unless directed by the healthcare provider.
C) "I should expect to have nausea for several days": Nausea is not typically expected to last for several days following a laparoscopic cholecystectomy. While mild nausea can occur shortly after surgery, it should subside within a short time. If nausea persists beyond this period, the client should notify their healthcare provider for further evaluation.
D) "I should leave my steri-strips on until they fall off.": Steri-strips are used to help close the incision site and should remain in place until they naturally fall off, which usually occurs within 7–10 days after surgery. This statement indicates that the client understands the proper care for their incision site. It is important not to remove them prematurely to avoid disrupting the healing process.
Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"B"}
Explanation
Fear of abandonment: Clients with borderline personality disorder (BPD) often have an intense fear of abandonment, leading to unstable relationships and emotional outbursts. The client’s fluctuating behavior towards the nurse (from anger to admiration) suggests this pattern.
Emotional instability: BPD is characterized by rapid mood changes and intense emotional reactions. The client displays aggression, impulsivity, and mood shifts, as seen in their outbursts and sudden praise for the nurse.
Incorrect:
Elevated body temperature: Fever is not a characteristic of BPD. It is more commonly associated with infections or inflammatory conditions.
Tactile hallucinations: Hallucinations are more common in psychotic disorders or substance withdrawal rather than BPD.
Increased heart rate: Tachycardia is a physiological response to stress, anxiety, or substance use but is not a defining feature of BPD.
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