The nurse is administering valproic acid to a client for seizures and finds a serum range for valproic acid of 130 mcg/mL. What does the nurse anticipate the provider will do?
Make no changes.
Increase the daily dose.
Change the medication.
Decrease the dose.
The Correct Answer is B
The therapeutic range for valproic acid is 50-100 mcg/mL ¹. In this case, the client has a serum range for valproic acid of 130 mcg/mL, which is above the therapeutic range but below the toxic level of >100 mcg/mL ¹. The nurse would anticipate that the provider will increase the daily dose of valproic acid to bring the serum range within the therapeutic range.
Option A is incorrect because the serum range is above the therapeutic range and changes may be needed.
Option C is incorrect because changing the medication may not be necessary if adjusting the dose can bring the serum range within the therapeutic range.
Option D is incorrect because decreasing the dose would lower the serum range further below the therapeutic range.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The client's symptoms of high fever, unstable blood pressure, increased confusion, and rigidity are consistent with neuroleptic malignant syndrome (NMS) ⁴. NMS is a rare but life-threatening reaction that can occur in response to neuroleptic or antipsychotic medication ⁴. In this case, the client was taking olanzapine and was recently prescribed chlorpromazine, both of which are antipsychotic medications that can cause NMS ⁴.
Option A is incorrect because accelerated dementia would not cause the sudden onset of these symptoms.
Option B is incorrect because an infection would not explain the sudden onset of these symptoms after starting a new medication.
Option C is incorrect because aspiration would not cause rigidity or unstable blood pressure.
Correct Answer is C
Explanation
Ethosuximide is the medication of choice for the management of absence seizures ³⁵. It is a first-line medication that has been shown to be effective in treating absence seizures ⁵.
Options A and B are incorrect because carbamazepine and phenytoin are not considered first-line medications for absence seizures.
Option D is incorrect because while valproate can be used to treat absence seizures, ethosuximide is preferred due to its effectiveness and safety profile ³.
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