What assessment technique should the nurse use to monitor a client for a common untoward effect of phenytoin (Dilantin)?

Bladder palpation.

Blood glucose monitoring.

Inspection of the mouth.

Auscultation of breath sounds.

Answer and Explanation

The Correct Answer is C

Choice A: This is not specifically related to the side effects of phenytoin.

Choice B: This is not directly related to the common side effects of phenytoin, which primarily affect the oral cavity.

Choice C: Phenytoin (Dilantin) is known to cause gingival hyperplasia (enlargement of the gums) as a common side effect. The nurse should regularly inspect the client's mouth to monitor for this adverse effect.

Choice D: This is not specifically relevant to monitoring for phenytoin's side effects.

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Correct Answer is D

Explanation

Choice A: A complete blood count (CBC) is important for monitoring various aspects of the blood, including the number of red blood cells, white blood cells, and platelets. While important for assessing overall health, a CBC is not the primary laboratory finding used to assess the effectiveness of warfarin in managing atrial fibrillation.

Choice B: Serum troponin levels are typically measured to assess cardiac muscle damage, such as in myocardial infarction (heart attack). They are not the primary indicator for assessing the effectiveness of warfarin in atrial fibrillation.

Choice C: Creatinine clearance is a measure of kidney function and is not the primary laboratory finding used to evaluate the effectiveness of warfarin.

Choice D: Prothrombin time (PT) is the most relevant laboratory finding for monitoring the effectiveness of warfarin in clients with atrial fibrillation. Warfarin's therapeutic effect is primarily assessed through PT measurements, with the goal of maintaining the client's international normalized ratio (INR) within a specific target range to prevent excessive bleeding or clotting.

A. Increased Ca+ influx with sympathetic stimulation that raises the heart rate. B. Sympathetic activation boosts K+ efflux and increases the inotropic effect. C. Sympathetic activation decreases dromotrophy by lowering conduction speed. D. Increased Na+ influx with sympathetic stimulation reduces pacemaker firing.’

Correct Answer is A

Explanation

Choice A: Increased Ca+ influx with sympathetic stimulation that raises the heart rate is a manifestation of sympathetic innervation. Sympathetic activation leads to the release of norepinephrine, which enhances the influx of calcium ions (Ca+) into cardiac muscle cells, resulting in increased contractility and heart rate.

Choice B: Sympathetic activation does increase the inotropic effect (contractility) of the heart, but it is primarily mediated by the increased influx of calcium ions (Ca+).

Choice C: Sympathetic activation does not decrease dromotrophy (conduction speed). Instead, it can increase the conduction speed through the cardiac conduction system.

Choice D: Increased Na+ influx with sympathetic stimulation does not reduce pacemaker firing; instead, it contributes to the enhanced excitability and automaticity of cardiac cells.

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What assessment technique should the nurse use to monitor a client for a common untoward effect of phenytoin (Dilantin)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who was recently diagnosed with atrial fibrillation is receiving warfarin. To see the drug's effectiveness, which laboratory finding should the practical nurse (PN) review?

Correct Answer is D

Explanation

Which pathology of autonomic cardiac regulation is mediated by sympathetic innervation?

Correct Answer is A

Explanation

An adult client with a diagnosis of bipolar disorder arrives in an elated state on admission to the psychiatric unit. What is the best room assignment the nurse can make for this client?

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