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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. The drug level is at a toxic level, and the dosage needs to be reduced. Phenytoin has a narrow therapeutic range, and levels above 20 mcg/mL are considered to be in the toxic range.
Symptoms of phenytoin toxicity can include nystagmus, ataxia, slurred speech, and confusion. Therefore, if a patient's phenytoin level is 23 mcg/mL, the nurse should be concerned about potential toxicity and consult with the healthcare provider to adjust the dosage.
B. The patient's seizures should be under control if she is also taking a second antiepileptic drug.
While combination therapy with multiple antiepileptic drugs can help control seizures, a phenytoin level of 23 mcg/mL is still concerning for toxicity and requires intervention.
C. The patient is at risk for seizures because the drug level is not at a therapeutic level. A phenytoin level of 23 mcg/mL is actually above the therapeutic range and is more indicative of toxicity rather than subtherapeutic levels.
D. The patient's seizures should be under control because this is a therapeutic drug level. A phenytoin level of 23 mcg/mL is not within the therapeutic range but rather in the toxic range, so the patient may experience symptoms of toxicity rather than having adequate seizure control.
Correct Answer is ["A","C","D","E"]
Explanation
A. Monitor the patient's respiratory rate: It's essential to monitor the patient for any adverse effects of morphine administration, particularly respiratory depression.
B. Ensure naloxone is readily available: While naloxone is an antidote for opioid overdose, administering it would depend on the patient's response and any signs of opioid toxicity, which may not be evident at this time.
C. Report the error to the facility through the proper paperwork: Reporting the medication error is crucial for documentation, investigation, and implementation of corrective actions.
D. Inform the patient's health care provider: The healthcare provider should be notified of the medication error to ensure appropriate follow-up and monitoring of the patient.
E. Document the dose of morphine given by the MedSurg nurse: Documenting the medication administration accurately is essential for the patient's medical record and continuity of care.
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