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 A
Explanation
A) Measure the client’s vital signs: The first priority after a fall is to assess the client's physical condition to determine if any immediate harm or injury has occurred. Taking the vital signs allows the nurse to assess for signs of shock, internal injury, or other complications that could require urgent intervention. This step should be done before notifying the provider or completing paperwork.
B) Notify the client's provider: While notifying the provider is important, it is not the first step. The nurse's priority is to assess the client’s condition and ensure they are stable. Once the client’s condition has been assessed, the provider can be notified if necessary.
C) Complete an incident report: An incident report should be completed after the client’s immediate needs are addressed. While documentation of the fall is important, the priority is the client’s safety and well-being. The nurse should first evaluate and stabilize the client before focusing on administrative tasks like the incident report.
D) Document the fall in the client's medical record: Although documentation is essential, the first priority should always be assessing and stabilizing the client. Once the client’s safety is ensured, then documenting the event and any findings is appropriate.
Correct Answer is C
Explanation
A) "You should lay down for 1 hour following a meal.":
Laying down after eating can exacerbate GERD symptoms by promoting acid reflux. The nurse should advise the client to remain upright for at least 30 minutes after eating to prevent reflux. Lying down increases the likelihood of gastric contents moving back into the esophagus.
B) "You should only drink 2 cups of coffee per day.":
Caffeine is a known trigger for GERD and can relax the lower esophageal sphincter, increasing the risk of acid reflux. The nurse should suggest limiting or avoiding coffee altogether, rather than recommending a specific quantity, as even small amounts may aggravate symptoms.
C) "You should elevate the head of the bed while sleeping.":
Elevating the head of the bed is a common and effective strategy for managing GERD. This helps prevent acid reflux during sleep by utilizing gravity to keep stomach contents from flowing back into the esophagus. A common recommendation is to elevate the head by 6-8 inches using blocks or a wedge pillow.
D) "You should eat three large meals and two snacks per day.":
Eating large meals can increase intra-abdominal pressure and promote acid reflux in clients with GERD. The nurse should recommend smaller, more frequent meals to reduce the risk of reflux and improve symptom control.
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