A 25 year-old female patient will begin taking phenytoin for epilepsy. The patient tells the nurse she is taking oral contraceptives (OCPs). Which response will the nurse give?
"Continue taking OCPS because phenytoin is not safe during pregnancy."
"You should use a backup method of contraception along with OCPs."
"You should stop taking OCPs because of drug-drug interactions with phenytoin."
"You should take low-dose aspirin while taking these medications to reduce your risk of stroke."
The Correct Answer is B
A. "Continue taking OCPS because phenytoin is not safe during pregnancy."
This statement is not accurate. While it's essential to address pregnancy risk, phenytoin can reduce the effectiveness of oral contraceptives. Women on phenytoin are often advised to use additional contraceptive measures.
B. "You should use a backup method of contraception along with OCPs."
This is the correct response. Phenytoin can accelerate the metabolism of oral contraceptives, potentially reducing their effectiveness. Using a backup method, such as condoms, is recommended to ensure adequate contraception.
C. "You should stop taking OCPs because of drug-drug interactions with phenytoin."
This advice is generally not recommended without consulting the healthcare provider. Abruptly stopping OCPs without an alternative form of contraception can increase the risk of unintended pregnancy.
D. "You should take low-dose aspirin while taking these medications to reduce your risk of stroke."
This statement is not relevant to the situation described. Low-dose aspirin is not typically recommended for contraception, and its use in this context does not address the potential interaction between phenytoin and oral contraceptives.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Before breakfast or lunch
Methylphenidate (Ritalin), a stimulant medication commonly used to treat attention deficit hyperactivity disorder (ADHD), is usually administered before breakfast or lunch for maximum effectiveness. This schedule helps align the peak concentration of the medication with the times when increased focus and attention are often needed, such as during school hours.
B. With meals
While it can be administered with meals, the goal is often to have the medication take effect before meals to help with focus and attention during activities like school or work.
C. After dinner
Administering methylphenidate after dinner may interfere with the patient's ability to fall asleep, as the medication can cause insomnia. It is generally recommended to avoid administering it in the late afternoon or evening.
D. At bedtime
Administering methylphenidate at bedtime is not appropriate due to the potential for insomnia. The stimulant effect of the medication is not aligned with the patient's sleep-wake cycle.
Correct Answer is D
Explanation
A. Administer the dose since the patient is not toxic.
This is not the appropriate action. With a drowsy patient and a high serum phenytoin level, there is a concern for toxicity. Administering the next dose could worsen the toxicity.
B. Contact the provider to discuss decreasing the phenytoin dose.
While adjusting the dose may be a consideration, the immediate action should be to withhold the next dose and report the elevated level to the healthcare provider. The provider can then determine the appropriate course of action.
C. Give the drug and monitor closely for adverse effects.
Giving the drug without further intervention is not appropriate when there are signs of potential toxicity, such as drowsiness. Monitoring alone is not sufficient in this case.
D. Report drug toxicity to the providers.
This is the correct choice. With a drowsy patient and a serum phenytoin level of 18 mcg/mL, which is considered high, reporting the drug toxicity to the healthcare provider is the immediate and appropriate action. The provider can then determine the next steps, such as adjusting the dose or ordering additional tests.
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