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 C
Explanation
A. Show the child's parent how to release tension on the bars: The tension on the halo vest is adjusted by the healthcare provider, not by the parent. The nurse should not instruct the parent to release tension, as improper adjustments can lead to complications.
B. Remove the vest for the child to sleep at night: The halo vest should remain in place at all times, including during sleep, to maintain proper cervical traction and stabilization. Removing it may interfere with the healing process and cause further injury.
C. Check the child's pupillary response: Monitoring the pupillary response is important in a child with cervical traction to assess for any neurological changes. It helps identify signs of increased intracranial pressure or other neurological complications.
D. Apply a cervical collar if the child reports neck pain: The halo vest itself is designed to stabilize the neck, and the application of a cervical collar without provider guidance could interfere with the proper use of the traction system.
Correct Answer is D
Explanation
A. "You should position the car seat at a 30-degree angle." The correct angle for rear-facing car seats is 45 degrees. A 30-degree angle may cause the infant’s head to fall forward, increasing the risk of airway obstruction.
B. "You should place a folded blanket to pad the back of the infant's head." Extra padding behind or around the infant's head is not recommended as it may interfere with the seat’s effectiveness and safety in a crash.
C. "You should use a car seat with a four-point harness." The recommended harness system is a five-point harness, which provides more secure restraint at the shoulders, hips, and between the legs.
D. "You should place the retainer clip at the level of the infant's armpits." Correct placement of the retainer (chest) clip is at armpit level. This ensures that the harness straps stay positioned over the shoulders, reducing the risk of injury during a crash.
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