During a routine appointment, a patient with a history of seizures is found to have a phenytoin level of 23 mcg/mL. What concern will the nurse have, if any?

The drug level is at a toxic level, and the dosage needs to be reduced.

The patient's seizures should be under control if she is also taking a second antiepileptic drug.

The patient is at risk for seizures because the drug level is not at a therapeutic level.

The patient's seizures should be under control because this is a therapeutic drug level.

Answer and Explanation

The Correct Answer is A

A. The drug level is at a toxic level, and the dosage needs to be reduced. Phenytoin has a narrow therapeutic range, and levels above 20 mcg/mL are considered to be in the toxic range.
Symptoms of phenytoin toxicity can include nystagmus, ataxia, slurred speech, and confusion. Therefore, if a patient's phenytoin level is 23 mcg/mL, the nurse should be concerned about potential toxicity and consult with the healthcare provider to adjust the dosage.
B. The patient's seizures should be under control if she is also taking a second antiepileptic drug.

While combination therapy with multiple antiepileptic drugs can help control seizures, a phenytoin level of 23 mcg/mL is still concerning for toxicity and requires intervention.
C. The patient is at risk for seizures because the drug level is not at a therapeutic level. A phenytoin level of 23 mcg/mL is actually above the therapeutic range and is more indicative of toxicity rather than subtherapeutic levels.

D. The patient's seizures should be under control because this is a therapeutic drug level. A phenytoin level of 23 mcg/mL is not within the therapeutic range but rather in the toxic range, so the patient may experience symptoms of toxicity rather than having adequate seizure control.

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Correct Answer is B

Explanation

A. Bupropion is primarily used as an antidepressant and smoking cessation aid. It is not typically used for opioid withdrawal.

B. Methadone is a synthetic opioid agonist commonly used in the management of opioid withdrawal. It helps to alleviate withdrawal symptoms and can be used as part of a long-term maintenance program for opioid dependence.
C. Disulfiram is used in the treatment of alcohol dependence by creating unpleasant effects when alcohol is consumed. It is not indicated for opioid withdrawal.
D. Phenobarbital is a barbiturate with sedative and anticonvulsant properties. While it can be used to manage certain withdrawal symptoms, such as seizures associated with alcohol withdrawal, it is not typically used as a first-line treatment for opioid withdrawal.

A. Decreased urine output B. Increased cardiac output C. Volume restoration D. Reduced anxiety

Correct Answer is B

Explanation

A. Decreased urine output is not the primary intended effect of an adrenergic agonist in the

treatment of shock. While adrenergic agonists may increase blood pressure, leading to a decrease in urine output due to vasoconstriction, the primary goal of administering these drugs in shock is to improve tissue perfusion and cardiac output.
B. Increased cardiac output is the primary intended effect of adrenergic agonists in the treatment of shock. These medications stimulate adrenergic receptors, leading to increased heart rate, contractility, and stroke volume, ultimately improving cardiac output and tissue perfusion.
C. Volume restoration may be a secondary effect of administering fluids along with adrenergic agonists in the treatment of shock, but it is not the primary intended effect of the medication
itself.

D. Reduced anxiety is not a primary goal of administering adrenergic agonists in the treatment of shock. While these medications may have anxiolytic effects in certain situations, the primary goal is to improve cardiovascular function and tissue perfusion.

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During a routine appointment, a patient with a history of seizures is found to have a phenytoin level of 23 mcg/mL. What concern will the nurse have, if any?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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