A nurse is teaching a client who has a new prescription for phenytoin to treat a seizure disorder. Which of the following adverse effects should the nurse instruct the client to report immediately to the provider?
Tender, bleeding gums.
Increased facial hair.
Constipation.
Skin rash.
The Correct Answer is A
Choice A rationale:
Tender, bleeding gums could be a sign of phenytoin-induced gingival hyperplasia, a serious adverse effect of phenytoin. This condition requires immediate medical attention to prevent further complications.
Choice B rationale:
Increased facial hair is not a common adverse effect of phenytoin and may not require immediate medical attention. It could be due to other factors or conditions.
Choice C rationale:
Constipation is a common side effect of many medications, including phenytoin. While it should be monitored, it does not require immediate reporting to the provider unless severe or persistent.
Choice D rationale:
A skin rash can be an adverse effect of phenytoin, but it does not necessarily require immediate reporting unless it is severe, accompanied by other symptoms, or indicative of a serious allergic reaction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Answer: D. The nurse refers a client who has chronic obstructive pulmonary disease for palliative care services:
Rationale:
A) The nurse files an incident report regarding a medication error:
Filing an incident report about a medication error is an important action for ensuring safety and quality improvement within the healthcare setting. However, it is primarily a procedural and administrative task rather than an act of direct advocacy for an individual client's needs or rights.
B) The nurse provides wound care to a client at the time promised to the client:
Providing wound care as promised demonstrates reliability and adherence to care plans, which is essential for trust and effective nursing practice. While this action shows respect for the client's needs and preferences, it does not specifically address the broader role of advocacy, which often involves intervening on behalf of the client's best interests in more complex situations.
C) The nurse declines to inform a client's neighbor about the client's prognosis:
Maintaining client confidentiality by not sharing private information with unauthorized individuals is a fundamental aspect of ethical nursing practice. This action protects the client's privacy but is more about upholding legal and ethical standards than actively advocating for the client's overall well-being or specific needs.
D) The nurse refers a client who has chronic obstructive pulmonary disease for palliative care services:
Referring a client with chronic obstructive pulmonary disease (COPD) to palliative care services exemplifies client advocacy. This action recognizes the client's need for comprehensive support, focusing on improving quality of life, managing symptoms, and providing holistic care. It involves proactive steps to address the client's complex health needs, ensuring they receive appropriate and compassionate care beyond standard medical treatment.
Correct Answer is D
Explanation
Answer: D. A client whose medications to manage Parkinson's disease are no longer effective.
Rationale:
A) A client who is newly diagnosed with type 1 diabetes mellitus and cannot afford insulin:
While this client has a significant medical issue, the primary concern here is financial rather than palliative. Palliative care focuses on providing relief from symptoms and improving quality of life for those with serious illnesses. Addressing the client's financial issues might involve social services or community resources rather than palliative care.
B) A client who has Meniere's disease and cannot safely ambulate due to vertigo:
Meniere's disease, while debilitating, may not necessarily require palliative care unless the symptoms are severely impacting the client's quality of life in a way that is not manageable with current treatments. Palliative care could be considered if the disease is severely limiting function and other supportive care is needed.
C) A client who had a stroke and cannot eat or drink without choking:
This client is experiencing a significant functional impairment due to the stroke, which might benefit from rehabilitative services rather than palliative care. Palliative care would be more appropriate if the client's condition is progressive, severe, and not responsive to treatment, leading to a focus on comfort and quality of life.
D) A client whose medications to manage Parkinson's disease are no longer effective:
When medications for Parkinson's disease are no longer effective, the client may be experiencing advanced symptoms and a decline in quality of life. Palliative care can provide symptom management, support, and enhance the client's quality of life when conventional treatments are no longer effective in controlling symptoms.
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