A nurse is assisting in the care of an adolescent in an outpatient clinic.
Complete the following sentence by using the lists of options.
The adolescent is at risk for
The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"C"}
Rationale for correct choices:
• pregnancy: The adolescent is taking phenytoin, an antiseizure medication known to induce hepatic enzymes that can reduce the effectiveness of hormonal contraceptives. This interaction increases the risk of unintended pregnancy despite adherence to the oral contraceptive regimen. Monitoring and counseling are essential to ensure adequate contraceptive protection.
• a medication interaction: Phenytoin accelerates the metabolism of ethinyl estradiol and drospirenone, the active components in combined oral contraceptives, through induction of cytochrome P450 enzymes. This pharmacokinetic interaction diminishes hormone levels, potentially compromising contraceptive efficacy and increasing the risk for pregnancy.
Rationale for incorrect choices:
• anaphylaxis: The adolescent has documented allergies to penicillin and sulfa medications, but neither phenytoin nor the combined oral contraceptive contains these allergens. There is no immediate risk of anaphylaxis related to the current medications.
• phenytoin toxicity: Laboratory results indicate phenytoin levels are within the therapeutic range. There are no signs of toxicity such as nystagmus, ataxia, or gingival hyperplasia at this time, so the adolescent is not currently at risk for phenytoin toxicity.
• their dosing schedule: The adolescent reports adherence to the prescribed phenytoin and oral contraceptive schedule. The risk of contraceptive failure is related to the drug-drug interaction rather than improper timing or missed doses.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D","E"]
Explanation
A. Sensation of tingling: Tingling or paresthesia is an early sign of nerve compression from increased compartment pressure. It indicates impaired circulation and nerve function, which are key manifestations of compartment syndrome.
B. Pain relieved by analgesia: In compartment syndrome, pain is often severe, persistent, and not relieved by analgesics. Relief with medication suggests typical postoperative discomfort rather than the pathological pressure buildup of compartment syndrome.
C. Decreased skin turgor: Dehydration affects skin turgor but is not a manifestation of compartment syndrome. Skin turgor changes are unrelated to increased intracompartmental pressure.
D. Diminished capillary refill: Impaired perfusion from elevated compartment pressure can slow capillary refill, signaling compromised circulation to distal tissues. This is a critical clinical indicator requiring prompt intervention.
E. Pale-colored toes: Pallor in the toes reflects reduced arterial blood flow distal to the affected compartment. It is a hallmark sign of ischemia associated with compartment syndrome.
Correct Answer is A
Explanation
A. Red meat: Red meat contains heme, which can produce false-positive results on fecal occult blood tests by reacting with the guaiac reagent. Clients are advised to avoid beef, lamb, and liver for at least 3 days prior to testing to ensure accurate detection of gastrointestinal bleeding.
B. Milk: Dairy products do not contain heme or other substances that interfere with the chemical reaction in guaiac-based fecal occult blood testing. Consumption of milk is generally safe and does not affect test accuracy.
C. Almonds: Nuts are plant-based and do not contain heme. They may contribute to stool bulk but do not produce false-positive results in fecal occult blood tests. Avoidance is unnecessary.
D. Whole wheat bread: Whole grains do not contain animal-derived heme and do not interfere with fecal occult blood detection. They are safe to consume prior to testing and do not affect test specificity.
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