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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Assessing the WBC count is not directly related to the administration of a nonselective adrenergic blocker. These medications primarily affect the cardiovascular system.
B. Assessing pulse and blood pressure is crucial before administering a nonselective adrenergic blocker. These medications can cause bradycardia and hypotension as side effects, so it's
important to ensure the client's baseline pulse and blood pressure are within acceptable ranges before giving the medication.
C. Assessing bowel sounds is not directly related to the administration of a nonselective adrenergic blocker. These medications primarily affect the cardiovascular system.
D. Assessing serum sodium and potassium levels is not directly related to the administration of a nonselective adrenergic blocker. These medications primarily affect the cardiovascular system.
Correct Answer is D
Explanation
A. Carbamazepine is an anticonvulsant medication used to treat seizures and certain mood disorders. It is not typically used in the treatment of Parkinson's disease.
B. Piperacillin/tazobactam is an antibiotic combination used to treat bacterial infections. It is not used in the treatment of Parkinson's disease.
C. Levothyroxine is a synthetic thyroid hormone used to treat hypothyroidism. It is not used in the treatment of Parkinson's disease.
D. Levodopa/carbidopa is a medication commonly used in the treatment of Parkinson's disease to manage motor symptoms such as tremor, rigidity, and bradykinesia. The nurse should provide
thorough education to the client regarding the indication, dosage, administration, potential side effects, and precautions associated with levodopa/carbidopa therapy.
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