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.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Signs of bone marrow depression are not typically associated with antiepileptic drugs. This adverse effect is more commonly seen with medications such as chemotherapy agents.
B. Increased risk of suicidal thoughts and behaviors is a well-documented concern with antiepileptic drugs, particularly when used for psychiatric indications or in certain patient populations. The FDA has issued warnings regarding this risk, and healthcare providers should monitor patients for changes in mood, behavior, and suicidal ideation.
C. While some antiepileptic drugs may have cardiovascular effects, such as prolongation of the QT interval, the FDA warning specifically highlights the risk of suicidal thoughts and behaviors rather than cardiovascular events like strokes.
D. Indications of drug addiction and dependency are not typically associated with antiepileptic drugs. These medications are not central nervous system depressants and do not produce the euphoria or withdrawal symptoms characteristic of addictive substances.
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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