The nurse has given medication instructions to a patient receiving phenytoin. Which statement by the patient indicates that the patient has an adequate understanding of the instructions?
"I will need to take extra care of my teeth and gums while on this medication."
"I will be able to stop taking this drug once the seizures stop."
"I can go out for a beer while on this medication."
"I can skip doses if the side effects bother me."
The Correct Answer is A
A. "I will need to take extra care of my teeth and gums while on this medication.": Phenytoin can cause gum overgrowth (gingival hyperplasia), so taking extra care of oral hygiene is important.
B. "I will be able to stop taking this drug once the seizures stop.": Phenytoin is typically used as a long-term therapy for seizure control; stopping abruptly can lead to rebound seizures.
C. "I can go out for a beer while on this medication.": Alcohol consumption may interact with phenytoin and should be avoided or limited.
D. "I can skip doses if the side effects bother me.": Skipping doses of phenytoin can lead to inadequate seizure control and should not be done without consulting a healthcare provider.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
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.
Correct Answer is ["0.6"]
Explanation
To find out how many milliliters (mL) of methylnaltrexone should be administered to achieve a dose of 12 mg, we need to set up a proportion based on the available concentration.
Given:
- Methylnaltrexone concentration: 8 mg per 0.4 mL
- Desired dose: 12 mg
We can set up the proportion as follows:
8 /0.4 = 12 / x
Where ( x ) is the unknown amount of methylnaltrexone in milliliters.
To solve for ( x ), we can cross multiply and then divide:
8x = 0.4 12
8x = 4.8
x = 4.8/8
x = 0.6
Therefore, the nurse should administer 0.6 mL of methylnaltrexone.
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