A nurse is providing teaching to an older adult client who has a seizure disorder and a new prescription for phenytoin. Which of the following instructions should the nurse include?
"Plan to take this medication with food."
"Plan to take this medication with antacids."
"Limit foods that contain vitamin D while taking this medication."
"Limit foods that contain folic acid while taking this medication."
The Correct Answer is A
Choice A reason:
"Plan to take this medication with food." Is the correct statement. When providing instructions to an older adult client who has a seizure disorder and is prescribed phenytoin (an antiepileptic or anticonvulsant medication), the nurse should advise the client to take the medication with food. Phenytoin can cause gastrointestinal irritation, and taking it with food can help minimize this side effect.
Choice B reason:
"Plan to take this medication with antacids. “is not the appropriate instruction. Phenytoin should not be taken with antacids. Antacids can reduce the absorption of phenytoin, leading to decreased effectiveness of the medication. If antacids are needed for other reasons, they should be taken at least 2 hours before or after taking phenytoin.
Choice C reason:
"Limit foods that contain vitamin D while taking this medication. “This is not inappropriate instruction. There is no specific requirement to limit foods containing vitamin D while taking phenytoin. However, phenytoin may decrease the absorption of vitamin D, which could potentially affect the client's vitamin D levels. Therefore, it is essential for the client to have regular check-ups and possibly discuss the need for vitamin D supplementation with their healthcare provider.
Choice D reason:
"Limit foods that contain folic acid while taking this medication. “This is not the correct statement. Phenytoin can interfere with the absorption of folic acid (a B-vitamin). Long-term use of phenytoin may lead to folic acid deficiency. Therefore, the nurse should instruct the client to consume foods rich in folic acid and discuss the potential need for folic acid supplementation with their healthcare provider.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is choice A, administer a fluid bolus.
Choice A rationale:
Administering a fluid bolus is appropriate when a client’s urine output is low, which in this case is less than the minimum expected output of 30 mL/hr. The dark yellow color of the urine also suggests dehydration or concentrated urine, which can be addressed with increased fluid intake.
Choice B rationale:
Initiating continuous bladder irrigation is typically done to clear the urinary tract of blood clots or debris following urologic surgery, not for low urine output or dark urine. Therefore, this intervention is not indicated based on the given scenario.
Choice C rationale:
Obtaining a urine specimen for culture and sensitivity is an action taken when there is a suspicion of a urinary tract infection. The scenario does not provide evidence of infection, such as fever or cloudy urine with a strong odor, so this would not be the first intervention to anticipate.
Choice D rationale:
Clamping the catheter tubing is done in preparation for catheter removal or to assess if the client can void without the catheter. It is not an appropriate intervention for low urine output or dark urine and could potentially cause bladder distention or discomfort.
Correct Answer is D
Explanation
The correct answer is choice D. Administer a cathartic suppository 30 min prior to scheduled defecation times. This is because a cathartic suppository stimulates the nerve endings in the rectum, causing a contraction of the bowel and facilitating defecation. This is especially helpful for clients who have an upper motor neuron or reflexic bowel, which means they have lost the ability to feel when the rectum is full and have a tight anal sphincter muscle. A
bowel program is a way of controlling or moving the bowels after a spinal cord injury, which may affect normal bowel function depending on the spinal level involved. A bowel program aims to achieve regular bowel movements, prevent constipation or impaction, and avoid accidents.
Choice A is wrong because encouraging a maximum fluid intake of 1,500 mL per day is not enough to prevent constipation and promote bowel health. A fluid intake of at least 2,000 mL per day is recommended for most adults.
Choice B is wrong because increasing the amount of refined grains in the client’s diet can worsen constipation and reduce stool bulk.
Refined grains are low in fiber, which is essential for normal bowel function. A high-fiber diet of at least 20 to 35 grams per day is advised for clients with spinal cord injury.
Choice C is wrong because providing the client with a cold drink prior to defecation can have the opposite effect of stimulating the bowel.
Cold drinks can slow down the digestive process and reduce peristalsis, which is the movement of food through the intestines. Warm or hot drinks can help stimulate the bowel and increase peristalsis.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.