What would the nurse include when creating a teaching plan that includes the long-term administration of phenytoin (Dilantin)?

The medication should be given on an empty stomach.

Insomnia can be a significant side effect.

Gums should be massaged regularly to prevent hyperplasia.

Blood pressure should be closely monitored.

Answer and Explanation

The Correct Answer is C

Choice A reason: Phenytoin can be taken with or without food, as food does not significantly affect its absorption. Taking it on an empty stomach is not necessary and may cause gastrointestinal upset, making this an incorrect teaching point for long-term use.
Choice B reason: Insomnia is not a common side effect of phenytoin. Common neurological effects include dizziness, ataxia, or sedation due to its action on sodium channels, stabilizing neuronal membranes. Teaching about insomnia is irrelevant and does not address key management concerns.
Choice C reason: Phenytoin commonly causes gingival hyperplasia due to fibroblast proliferation in gum tissue. Regular gum massage and good oral hygiene can reduce this risk by promoting circulation and preventing tissue overgrowth, making this a critical teaching point for long-term use.
Choice D reason: Blood pressure monitoring is not a primary concern with phenytoin, which primarily affects the central nervous system and liver. While rare cardiovascular effects may occur, gingival hyperplasia and blood level monitoring are more significant for long-term management.

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Correct Answer is C

Explanation

Choice A reason: Methotrexate typically takes 6–12 weeks to achieve therapeutic effects in rheumatoid arthritis by suppressing immune-mediated inflammation. Stating 1–2 weeks is inaccurate, as it underestimates the time needed for the drug to modulate immune response and reduce joint inflammation.
Choice B reason: Discussing cost and pharmacy plans is not a priority in health teaching about methotrexate’s clinical effects. While cost may be a concern, it is not relevant to the drug’s pharmacological action or patient safety education.
Choice C reason: Methotrexate is an immunosuppressant, reducing immune response to control RA inflammation. This increases infection risk, as immune cells like neutrophils are suppressed. Avoiding crowds minimizes exposure to pathogens, making this a critical and appropriate teaching point for patient safety.
Choice D reason: Alcohol consumption, even in moderation (2–3 glasses of wine weekly), is discouraged with methotrexate due to its hepatotoxic effects. Alcohol exacerbates liver damage risk, as methotrexate is metabolized by the liver, potentially leading to elevated liver enzymes or hepatotoxicity.

A. The seizure lasts more than 5 minutes. B. The child is sleepy and lethargic after the seizure. C. The child fell at the onset of the seizure. D. The child is confused and has slurred speech after the seizure.

Correct Answer is A

Explanation

Choice A reason: A seizure lasting over 5 minutes is considered status epilepticus, a medical emergency requiring immediate intervention to prevent brain hypoxia or injury. Prolonged seizures increase glutamate release, causing excitotoxicity, neuronal damage, and systemic complications like respiratory failure, necessitating urgent 911 response.
Choice B reason: Postictal sleepiness and lethargy are common after generalized seizures due to neuronal exhaustion and temporary metabolic changes in the brain. This is expected and not an emergency unless prolonged or accompanied by other concerning symptoms like respiratory distress.
Choice C reason: Falling at seizure onset is typical in generalized seizures due to loss of muscle control. Unless injury (e.g., head trauma) is suspected, it does not warrant an immediate 911 call, as it is a common seizure manifestation.
Choice D reason: Postictal confusion and slurred speech are normal after a generalized seizure, reflecting temporary cortical dysfunction. These resolve within minutes to hours and do not require emergency services unless persistent or associated with other critical symptoms like unresponsiveness.

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What would the nurse include when creating a teaching plan that includes the long-term administration of phenytoin (Dilantin)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The primary health care provider prescribes methotrexate for a client with a new diagnosis of rheumatoid arthritis. The nurse provides health teaching about the drug. What statement by the nurse is appropriate to include about methotrexate?

Correct Answer is C

Explanation

An adolescent has just had a generalized seizure and collapsed in the school nurse’s office. When should the nurse call 911?

Correct Answer is A

Explanation

What does the nurse explain to parents of a child with febrile seizures?

The nurse assesses a client with long-term rheumatoid arthritis (RA) for late signs and symptoms. Which assessment findings will the nurse document as late signs and symptoms of RA? (Select all that apply)

A client who had a surgical fractured femur repair reports new-onset shortness of breath and increased respirations. What is the nurse’s first action?

What would the nurse include when creating a teaching plan that includes the long-term administration of phenytoin (Dilantin)?

A nurse is providing education to a community women’s group about lifestyle changes helpful in preventing osteoporosis. What topics does the nurse cover? (Select all that apply)

When treating patients with medications for Parkinson’s disease, the nurse knows that the wearing-off phenomenon occurs for which reason?

A nurse cares for a client who had a wrist cast applied 3 days ago. The client states, “The cast is loose enough to slide off.” How would the nurse respond?

A nurse is caring for a child who has otitis media with effusion. The nurse should identify that which of the following manifestations indicates a tympanic membrane rupture?