Exhibits
The nurse has reviewed information regarding the adolescent's medication for home use with the guardian and adolescent.
Select the 2 statements that demonstrate the guardian's understanding of their child's medication.
"There is nothing we can do to minimize overgrowth of their gum tissue."
"They will need to take 400 IU of vitamin E while on this medication."
"We will need to periodically have their blood drawn to check phenytoin levels."
"This medication may cause their eyes to, at times, move quickly back and forth."
Correct Answer : C,D
A. "There is nothing we can do to minimize overgrowth of their gum tissue.": Incorrect. Gingival hyperplasia is a known side effect of phenytoin, but good oral hygiene and regular dental care can help minimize its severity.
B. "They will need to take 400 IU of vitamin E while on this medication.": Incorrect. Routine vitamin E supplementation is not standard or necessary with phenytoin unless specifically indicated by a provider.
C. "We will need to periodically have their blood drawn to check phenytoin levels.": Correct. Phenytoin has a narrow therapeutic index, so serum drug levels must be monitored regularly to avoid toxicity or subtherapeutic dosing.
D. "This medication may cause their eyes to, at times, move quickly back and forth.": Correct. Nystagmus is a known dose-related side effect of phenytoin, especially at higher levels.
E. "This drug won't decrease the effectiveness of their oral contraceptive medication.": Incorrect. Phenytoin is a hepatic enzyme inducer and can reduce the effectiveness of hormonal contraceptives, so alternate or additional contraceptive methods should be recommended.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. "You should chill your medication before administration." Insulin should not be chilled before administration. It should be stored in a cool place, but administering insulin directly from the refrigerator can cause discomfort.
B. "You should rotate sites when administering the medication." Rotating injection sites helps prevent tissue damage and the formation of lumps or scar tissue. It is recommended to rotate sites within the same area (e.g., abdomen, thigh, etc.) to ensure absorption and prevent complications.
C. "You should administer your medication at a 45-degree angle." Insulin should generally be administered at a 90-degree angle for subcutaneous injection, not a 45-degree angle. A 45-degree angle may be appropriate.
D. "You should administer your insulin into a muscle." Insulin should be administered subcutaneously (into the fat layer just under the skin), not into the muscle. Injecting insulin into a muscle can alter its absorption rate and may cause irritation or pain.
Correct Answer is C
Explanation
A. Temperature: A temperature of 38.6°C (101.5°F) is elevated, but fever is a common symptom of bacterial pneumonia. It is important to monitor, but it is not the most critical finding in this case.
B. Skin condition: Hives and flushing could be signs of an allergic reaction to medication, but this is not immediately life-threatening. The nurse should report it, but the priority in this case is the oxygen saturation, which reflects the patient's respiratory status.
C. Oxygen saturation: Oxygen saturation of 93% is below the typical threshold of 95-100% and indicates mild hypoxemia. In a patient with bacterial pneumonia, low oxygen saturation signify worsening respiratory function. This requires immediate attention and reporting.
D. Lung sounds: Coarse crackles in the right lower lobe are expected in pneumonia due to lung consolidation. While it is important to monitor lung sounds, the priority is addressing the oxygen saturation level, which is directly related to the patient's ability to breathe effectively.
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