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.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Carbidopa prevents the breakdown of levodopa in the periphery, specifically in the gastrointestinal tract and peripheral tissues, allowing more levodopa to reach the brain and be converted to dopamine. This enhances the effectiveness of levodopa therapy in managing the symptoms of Parkinson's disease.
B. Carbidopa is not the biologic precursor of dopamine. It is a peripheral decarboxylase inhibitor that does not cross the blood-brain barrier.
C. Carbidopa does not directly allow for larger doses of levodopa to be given. However, by
inhibiting the peripheral breakdown of levodopa, it enhances the availability of levodopa to the central nervous system, potentially improving therapeutic efficacy.
D. While levodopa-carbidopa combination therapy may have fewer drug-food interactions compared to levodopa alone, the primary reason for combining these medications is to enhance the effectiveness of levodopa by preventing its peripheral breakdown.
Correct Answer is A
Explanation
A. Menstrual cramps: Feverfew is commonly used as an herbal remedy for menstrual cramps and migraines due to its purported anti-inflammatory and smooth muscle relaxant properties.
B. Constipation: Feverfew is not typically used to treat constipation.
C. Muscle aches: While feverfew may have some anti-inflammatory properties, it is not commonly used specifically for muscle aches.
D. Incision pain after surgery: Feverfew is not typically used to manage post-surgical pain.
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