After teaching a client who is diagnosed with new-onset status epilepticus and prescribed phenytoin (Dilantin), the nurse assesses the client’s understanding. Which statement by the client indicates a correct understanding of the teaching?

To prevent complications, I will drink at least 2 liters of water daily.

This medication will stop me from getting an aura before a seizure.

I will not drive a motor vehicle while taking this medication.

Even when my seizures stop, I will continue to take this drug.

Answer and Explanation

The Correct Answer is D

Choice A reason: Drinking 2 liters of water daily supports general health but is not specific to phenytoin therapy. It does not prevent complications like gingival hyperplasia or hepatotoxicity, which are more directly related to phenytoin’s pharmacological effects and monitoring needs.
Choice B reason: Phenytoin does not eliminate seizure auras, which are sensory warnings due to focal cortical activity. It stabilizes neuronal membranes via sodium channel blockade, reducing seizure frequency but not preventing prodromal symptoms like auras.
Choice C reason: Not driving is appropriate, as phenytoin can cause dizziness or ataxia, impairing motor coordination. However, this is a safety precaution, not the most comprehensive indicator of understanding the need for long-term adherence to prevent seizure recurrence.
Choice D reason: Continuing phenytoin even after seizures stop is critical, as abrupt cessation can cause rebound seizures due to unopposed neuronal excitability. This reflects understanding of lifelong therapy needs for status epilepticus to maintain seizure control and prevent recurrence.

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Correct Answer is C

Explanation

Choice A reason: Positioning with hips flexed at 90 degrees is inappropriate for Buck’s traction, which is a skin traction applied to the lower leg to align fractures. Excessive hip flexion can disrupt traction alignment and increase discomfort or complications.
Choice B reason: Weights in Buck’s traction must hang freely to maintain constant force for fracture alignment. Contact with the floor negates the traction’s effect, risking bone misalignment and delayed healing, making this an incorrect care practice.
Choice C reason: Checking for skin irritation is critical in Buck’s traction, as prolonged pressure from straps or bandages can cause pressure ulcers or skin breakdown. Regular skin assessment ensures early detection and prevention of complications, maintaining the traction’s safety and efficacy.
Choice D reason: Releasing weights disrupts the continuous force needed for fracture alignment in Buck’s traction. This can lead to bone displacement, increased pain, or delayed healing, making scheduled weight release an inappropriate and harmful practice.

A. I’ll report any signs of bleeding or bruising to my primary health care provider. B. I’ll take this drug only as prescribed by my primary health care provider. C. I’ll be sure to take this drug three times a day only on an empty stomach. D. I’ll monitor the amount of urine that I excrete every day and report any changes.

Correct Answer is C

Explanation

Choice A reason: Celecoxib, a COX-2 inhibitor, can increase bleeding risk by inhibiting platelet aggregation. Reporting signs of bleeding or bruising is critical, as it may indicate gastrointestinal or systemic bleeding, a known adverse effect. This statement shows appropriate understanding of monitoring for serious side effects.
Choice B reason: Taking celecoxib only as prescribed ensures adherence to the recommended dose and schedule, minimizing risks like gastrointestinal irritation or cardiovascular events. This statement reflects correct understanding of the importance of following medical guidance to optimize safety and efficacy.
Choice C reason: Celecoxib is typically taken once or twice daily, and it can be taken with or without food. Taking it three times daily on an empty stomach is incorrect and may increase gastrointestinal irritation, indicating a need for further education on proper dosing and administration.
Choice D reason: Monitoring urine output is relevant, as celecoxib can cause renal toxicity, leading to decreased urine output or acute kidney injury. This statement shows appropriate awareness of the need to monitor for renal side effects, which is critical for safe use.

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After teaching a client who is diagnosed with new-onset status epilepticus and prescribed phenytoin (Dilantin), the nurse assesses the client’s understanding. Which statement by the client indicates a correct understanding of the teaching?

Nursing Test Bank

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