A nurse in a clinic is caring for a client.
Click to highlight the findings that require immediate follow-up as
contraindications to the prescribed prescription. To deselect a finding click on the finding again.
|
Body System |
Findings |
|
Vital Signs/General History |
Temperature 35.4 °C (97.6 °F), oral Heart rate 75/min Respiratory rate 16/min Blood pressure 100/74 mmHg Oxygen saturation 99% on room air Client is a vegetarian and takes a multivitamin daily Client reports having three to four alcoholic beverages a couple times per week. |
|
Integumentary |
Skin color is consistent with genetic background. No rashes or lesions. The client has varicose veins. |
|
Cardiovascular/Respiratory |
S1S2 auscultated. No murmurs. All peripheral pulses 2+. Lung sounds clear bilaterally. |
|
Gastrointestinal/Genitourinary |
Abdomen soft, nontender. Normoactive bowel sounds in all 4 quadrants. Last bowel movement was 3 days ago. Voids four to five times a day. Urine is clear, yellow, and odorless. Last menstrual period was 3 months ago. |
|
Neurologic/Musculoskeletal |
Alert and oriented to person, place, and time. Client takes diazepam as needed for anxiety. Client has full range of motion and is able to maintain flexion against resistance in all four extremities. |
Temperature 35.4 °C (97.6 °F), oral
Blood pressure 100/74 mmHg
Client is a vegetarian
Client reports having three to four alcoholic beverages a couple times per week.
The client has varicose veins
All peripheral pulses 2+
Last bowel movement was 3 days ago
Last menstrual period was 3 months ago
Client takes diazepam as needed for anxiety
The Correct Answer is ["D","G","H"]
Client reports having three to four alcoholic beverages a couple times per week: Alcohol can interact with phenytoin, either enhancing its effects or reducing its efficacy. Chronic alcohol use can induce liver enzymes, altering phenytoin metabolism and potentially leading to subtherapeutic or toxic levels.
Client takes diazepam as needed for anxiety: Diazepam and phenytoin can interact, increasing the sedative effects and potentially leading to central nervous system depression. Monitoring is essential when these drugs are coadministered.
Last menstrual period was 3 months ago: This finding may indicate a possible pregnancy, which is critical because phenytoin is teratogenic and classified as a Pregnancy Category D drug. Immediate follow-up is required to rule out pregnancy before starting phenytoin therapy.
Temperature 35.4°C (97.6°F), oral: This is slightly lower than the normal range and does not require immediate follow-up.
Blood pressure 100/74 mmHg: This is within the expected range and does not contraindicate phenytoin use.
Client is a vegetarian and takes a multivitamin daily: A vegetarian diet is not a contraindication, though it may necessitate monitoring for folic acid levels since phenytoin can deplete folate.
Client has varicose veins: Varicose veins do not affect phenytoin use or metabolism.
Last bowel movement was 3 days ago: While mild constipation should be noted, it does not contraindicate phenytoin use.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","D","E","F"]
Explanation
A. "This medication should start to alleviate the headache within 1 hour.": Triptans typically provide relief within 1 to 2 hours after administration.
B. "You might experience a feeling of pressure in your chest after taking this medication.": Some clients report a sensation of tightness or pressure in the chest, which is a known, generally benign side effect of triptans.
C. "Do not take more than 200 milligrams of this medication within 24 hours.": A second dose can be taken at least 2 hours after the first dose if the headache persists, but the total dose should not exceed 200 mg in 24 hours for most formulations.
D. "You can take a second dose of this medication at least 2 hours after the initial dose if the headache persists.": A second dose can be taken at least 2 hours after the first dose if the headache persists, but the total dose should not exceed 200 mg in 24 hours for most formulations.
E. "You should discontinue this medication if pregnancy is planned or suspected." Triptans are classified as Category C drugs and should be avoided during pregnancy unless the potential benefit outweighs the risk.
F. "This medication can cause you to feel tired.": Feeling tired is a common side effect of triptans.
G. "You might experience a rash on your skin while taking this medication.": A rash is not a common or expected side effect of triptans. Skin reactions are not a primary concern with these medications unless the client has an allergic response.
Correct Answer is C
Explanation
A. "Your child will receive another MMR immunization and the hepatitis B immunization at 3 years of age.": The next MMR immunization is typically at 4-6 years, not 3 years.
B. "Your child will receive two more MMR immunizations over the next 2 years.": Only one more MMR vaccine is given at 4-6 years of age.
C. "Your child will receive another MMR immunization at 4 to 6 years of age.": The second dose of MMR is given between 4-6 years of age.
D. "Your child will have an MMR titer taken to determine the need for further immunizations.": Routine titers are not required for MMR unless there is a specific concern.
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