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. Diarrhea is not typically associated with ergotamine toxicity. Gastrointestinal symptoms such as nausea and vomiting are more common adverse effects of ergotamine use.
B. Delirium is a potential sign of ergotamine toxicity. At toxic levels, ergotamine can cause central nervous system symptoms such as confusion, hallucinations, and delirium.
C. Hypotension may occur as an adverse effect of ergotamine due to its vasoconstrictive properties. However, hypotension alone may not indicate ergotamine toxicity.
D. Bradycardia is not a typical adverse effect of ergotamine. Ergotamine is more commonly associated with vasoconstriction and can lead to hypertension or tachycardia rather than bradycardia.
A. Diarrhea is not typically associated with ergotamine toxicity. Gastrointestinal symptoms such as nausea and vomiting are more common adverse effects of ergotamine use.
B. Delirium is a potential sign of ergotamine toxicity. At toxic levels, ergotamine can cause central nervous system symptoms such as confusion, hallucinations, and delirium.
C. Hypotension may occur as an adverse effect of ergotamine due to its vasoconstrictive properties. However, hypotension alone may not indicate ergotamine toxicity.
D. Bradycardia is not a typical adverse effect of ergotamine. Ergotamine is more commonly associated with vasoconstriction and can lead to hypertension or tachycardia rather than bradycardia.
Correct Answer is ["A","C","E"]
Explanation
A. Attention deficit hyperactivity disorder (ADHD) - Correct. CNS stimulants like
methylphenidate and amphetamine derivatives are commonly used to treat ADHD by improving attention, focus, and impulse control.
B. Panic attacks - Incorrect. CNS stimulants are not typically used to treat panic attacks.
Medications such as benzodiazepines or selective serotonin reuptake inhibitors (SSRIs) are more commonly used for panic disorder.
C. Narcolepsy - Correct. CNS stimulants are used to treat narcolepsy, a sleep disorder characterized by excessive daytime sleepiness and sudden attacks of sleep.
D. Neonatal apnea - Incorrect. CNS stimulants are not indicated for neonatal apnea.
Management of neonatal apnea usually involves supportive measures, respiratory support, and caffeine citrate as a respiratory stimulant.
E. Obesity - Correct. CNS stimulants like phentermine are sometimes used as adjuncts to diet and exercise for short-term management of obesity
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