A patient has been taking phenobarbital for 2 weeks as part of his therapy for epilepsy. He tells the nurse that he feels tense and that the least little thing bothers him now. Which is the correct explanation for this problem?

These are adverse effects that usually subside after a few weeks.

The drug must be stopped immediately because of possible adverse effects.

This drug causes deprivation of REM sleep and may cause the inability to deal with normal stress.

This drug causes the rapid eye movement (REM) sleep period to increase, resulting in nightmares and restlessness.

Answer and Explanation

The Correct Answer is C

A.   These are adverse effects that usually subside after a few weeks: While some adverse effects of phenobarbital may diminish over time, the symptoms described by the patient are more likely related to its impact on REM sleep.
B.   The drug must be stopped immediately because of possible adverse effects: Stopping phenobarbital abruptly can lead to withdrawal symptoms and potential rebound seizures; discontinuation should be done gradually under medical supervision.
C.   This drug causes deprivation of REM sleep and may cause the inability to deal with normal stress: Phenobarbital is known to disrupt REM sleep, leading to emotional lability, irritability, and difficulty coping with stress.
D.   This drug causes the rapid eye movement (REM) sleep period to increase, resulting in nightmares and restlessness: Phenobarbital actually decreases REM sleep, which can lead to disturbances in sleep patterns and mood changes.

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Correct Answer is C

Explanation

A. The 21-year-old patient who has never had surgery before: While lack of previous surgery experience may contribute to anxiety, it doesn't inherently increase the risk of altered response to anesthesia.
B. The 40-year-old patient who is to have kidney stone removed: While the type of surgery may influence anesthesia considerations, being 40 years old alone doesn't significantly increase the risk of altered response to anesthesia.
C. The 82-year-old patient who is to have gallbladder removal: Advanced age is a significant risk factor for altered response to anesthesia due to age-related changes in physiology, metabolism, and drug clearance.
D. The 35-year-old patient who stopped smoking 8 years ago: While smoking history can impact anesthesia considerations, stopping smoking 8 years ago likely reduces the associated risks compared to current smokers.

A. "I know that I cannot switch brands of this medication." B. "I have made an appointment to see my dentist next week." C. "I will notify my doctor before taking any other medications." D. "I'll be glad when I can stop taking this medicine."

Correct Answer is D

Explanation

A. "I know that I cannot switch brands of this medication." - This statement indicates an understanding of the importance of consistency in medication use. Phenytoin requires consistent dosing and should not be switched between different brands without consulting a healthcare provider.
B. "I have made an appointment to see my dentist next week." - This statement shows awareness of the need for dental care while taking phenytoin. Phenytoin can cause gum hyperplasia, so regular dental check-ups are recommended.

C. "I will notify my doctor before taking any other medications." - This statement demonstrates understanding of the potential for drug interactions with phenytoin. Phenytoin can interact with many other medications, so it's crucial to consult a doctor before starting any new medications.
D. "I'll be glad when I can stop taking this medicine." - This statement indicates a

misunderstanding about the management of epilepsy. Phenytoin is typically a long-term medication used to control seizures, and it's not usually discontinued unless directed by a healthcare provider. Further teaching is needed to address this misconception.

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A patient has been taking phenobarbital for 2 weeks as part of his therapy for epilepsy. He tells the nurse that he feels tense and that the least little thing bothers him now. Which is the correct explanation for this problem?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When assessing patients in the preoperative area, the nurse knows that which patient is at a higher risk for an altered response to anesthesia

Correct Answer is C

Explanation

A nurse is performing discharge teaching for a client who has seizures and a new prescription for phenytoin. Which of the following statements by the client indicates a need for further teaching?

Correct Answer is D

Explanation

The U.S. Food and Drug Administration has issued a warning for users of antiepileptic drugs. Based on this report, the nurse will monitor for which potential problems with this class of drugs?

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