During a routine appointment, a patient with a history of seizures is found to have a phenytoin level of 23 mcg/mL. What concern will the nurse have, if any?
The drug level is at a toxic level, and the dosage needs to be reduced.
The patient's seizures should be under control if she is also taking a second antiepileptic drug.
The patient is at risk for seizures because the drug level is not at a therapeutic level.
The patient's seizures should be under control because this is a therapeutic drug level.
The Correct Answer is A
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Bupropion is primarily used as an antidepressant and smoking cessation aid. It is not typically used for opioid withdrawal.
B. Methadone is a synthetic opioid agonist commonly used in the management of opioid withdrawal. It helps to alleviate withdrawal symptoms and can be used as part of a long-term maintenance program for opioid dependence.
C. Disulfiram is used in the treatment of alcohol dependence by creating unpleasant effects when alcohol is consumed. It is not indicated for opioid withdrawal.
D. Phenobarbital is a barbiturate with sedative and anticonvulsant properties. While it can be used to manage certain withdrawal symptoms, such as seizures associated with alcohol withdrawal, it is not typically used as a first-line treatment for opioid withdrawal.
Correct Answer is ["28"]
Explanation
2 cups of coffee: 2 cups 8 oz/cup = 16 oz
1 soft drink: 12 oz
Total intake from 1500 to 2100 = 16 oz (coffee) + 12 oz (soft drink) = 28 oz
From 2100 to 2300 (2 hours):
No additional intake mentioned in the question.
Total intake from 1500 to 2300 = 28 oz (from 1500 to 2100)
Therefore, the total intake from 1500 to 2300 is 28 ounces.
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