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A nurse is providing discharge teaching for a patient who had a seizure disorder and is prescribed phenytoin (Dilantin).

Which of the following instructions should the nurse include?

(Select all that apply.).

Avoid drinking grapefruit juice while taking this medication.

Brush your teeth gently with a soft-bristled toothbrush

Wear a medical alert bracelet or necklace at all times.

Stop taking this medication if you develop a rash or fever.

Have your blood levels checked regularly as directed by your provider.

Answer and Explanation

Correct Answer : B,C,E

The correct answer is B, C, and E.

Phenytoin (Dilantin) is an anticonvulsant medication that is used to control seizures.

It can have several side effects, some of which are serious and require medical attention.

Here are some explanations for each choice:.

A. Avoid drinking grapefruit juice while taking this medication.

This is wrong because grapefruit juice does not interact with phenytoin. However, grapefruit juice can affect the levels of other medications, such as statins, calcium channel blockers, and some antidepressants.

B. Brush your teeth gently with a soft-bristled toothbrush. This is right because phenytoin can cause gingival hyperplasia, which is an overgrowth of the gums that can lead to bleeding, infection, and difficulty chewing.

To prevent this, patients should practice good oral hygiene, avoid alcohol and tobacco, and see a dentist regularly.

A. Avoid drinking grapefruit juice while taking this medication B.

Brush your teeth gently with a soft-bristled toothbrush C.

Wear a medical alert bracelet or necklace at all times D.

Stop taking this medication if you develop a rash or fever E.

Have your blood levels checked regularly as directed by your provider

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Correct Answer is A

Explanation

The correct answer is A.“Do you drive your own car or use public transportation?.” This question is appropriate for the domain ofmode of transportation, which is one of the eight areas of occupational performance assessed by the Lawton Instrumental Activities of Daily Living (IADLs) Scale.The scale evaluates a person’s ability to engage in more complex activities thought necessary for functioning in community settings.

Choice B is wrong because it is not related to the domain of mode of transportation, but rather to the domain ofability to use a telephone.The scale asks about the person’s ability to operate a telephone, dial numbers, and answer calls.

Choice C is wrong because it is not related to the domain of mode of transportation, but rather to the domain ofshopping.The scale asks about the person’s ability to take care of all shopping needs independently, shop for small purchases, or need assistance with shopping.

Choice D is wrong because it is not related to the domain of mode of transportation, but rather to the domain ofmobility.The scale does not assess mobility directly, but it may be inferred from the person’s ability to travel by public transportation or car.

The Lawton IADLs Scale has a summary score that ranges from 0 (low function, dependent) to 8 (high function, independent) for women, and 0 to 5 for men.The score identifies areas of need in regard to care and support.

A. Acetaminophen B. Diphenhydramine C. Metformin D. Lisinopril

Correct Answer is B

Explanation

The correct answer is B.

Diphenhydramine.Diphenhydramine is an antihistamine and sedative medication that can causedeliriumin older adults, especially when used in high doses or for a long time.Delirium is a serious change in mental abilities that results in confused thinking and reduced awareness of the surroundings.It can be caused by various factors, such as infections, medications, surgery, or alcohol or drug use or withdrawal.Delirium can have serious consequences, such as increased risk of falls, complications, and death.

Choice A is wrong because acetaminophen is a pain reliever and fever reducer that does not usually cause delirium in older adults.

However, acetaminophen overdose can cause liver damage and altered mental status.

Choice C is wrong because metformin is an oral medication that lowers blood sugar levels in people with type 2 diabetes.

Metformin does not typically cause delirium in older adults.

However, metformin can cause a rare but serious condition called lactic acidosis, which can cause confusion and other symptoms.

Choice D is wrong because lisinopril is an angiotensin-converting enzyme (ACE) inhibitor that lowers blood pressure and prevents heart failure.

Lisinopril does not usually cause delirium in older adults.

However, lisinopril can cause a rare but serious condition called angioedema, which can cause swelling of the face, tongue, or throat and difficulty breathing.

Normal ranges for some relevant laboratory tests are:.

• Albumin: 3.5-5.0 g/dL.

• Potassium: 3.5-5.0 mEq/L.

• Total cholesterol: <200 mg/dL.

• Hemoglobin: 13.5-17.5 g/dL for men; 12.0-15.5 g/dL for women.

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A nurse is providing discharge teaching for a patient who had a seizure disorder and is prescribed phenytoin (Dilantin). Which of the following instructions should the nurse include? (Select all that apply.).

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is conducting a functional status assessment for an older adult client using the Lawton Instrumental Activities of Daily Living (IADLs) Scale. The nurse asks the client about his ability to use transportation. Which of the following questions is appropriate for this domain?

Correct Answer is A

Explanation

A nurse is reviewing the medication list of an older adult client who has delirium. Which of the following medications can contribute to delirium in older adults?

Correct Answer is B

Explanation

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A nurse is providing discharge teaching for a patient who had a seizure disorder and is prescribed phenytoin (Dilantin).

Which of the following instructions should the nurse include?

(Select all that apply.).