The nurse is providing discharge instructions to a patient who has a prescription for phenytoin. Which of the following information should the nurse include?

Provide a urine sample to determine therapeutic levels of the medication

Take the medication at the same time every day

Watch for bleeding gums when taking the medication

Consider taking an antacid when on this medication

Answer and Explanation

The Correct Answer is B

Choice A rationale:
Providing a urine sample to determine therapeutic levels of phenytoin is not typically a part of routine discharge instructions. While monitoring of phenytoin levels is important, it's usually done through blood tests, and the frequency of testing is determined by the healthcare provider based on individual patient factors.

Choice C rationale:
Bleeding gums are not a common side effect of phenytoin. While some individuals might experience gum tenderness or overgrowth, significant bleeding is not expected.

Choice D rationale:
Antacids can actually interfere with the absorption of phenytoin, potentially reducing its effectiveness. Therefore, it's generally not recommended to take antacids regularly while on phenytoin therapy. If a patient needs to take an antacid for occasional heartburn or indigestion, it's best to take it at least 2 hours before or after the phenytoin dose.

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Correct Answer is A

Explanation

Choice A rationale:
Hydroxychloroquine can cause a rare but serious side effect called bone marrow suppression. This is a decrease in the production of blood cells in the bone marrow.
White blood cells (WBCs) are a key component of the immune system, and a decrease in WBCs can make a patient more susceptible to infections.
Therefore, it's crucial for nurses to monitor the patient's WBC count to detect any potential bone marrow suppression early and take necessary actions to prevent or manage infections.
Choice B rationale:
An increased blood cell count is not a typical side effect of hydroxychloroquine.
Some conditions, like polycythemia vera, can cause an increase in blood cell count, but they are not related to hydroxychloroquine use.

Choice C rationale:
While hydroxychloroquine can sometimes cause a decrease in platelet count, it's less common than bone marrow suppression affecting WBCs.
However, it's still essential for nurses to monitor platelet counts as well, as a significantly low platelet count can impair blood clotting and increase the risk of bleeding.
Choice D rationale:
Hydroxychloroquine does not typically affect red blood cell (RBC) counts.
Conditions that affect RBC counts, such as anemia, are not directly related to hydroxychloroquine use.

A. Develops an acute retroviral syndrome B. Has a CD4+ T lymphocyte level of less than 200 cells/mm C. Is capable of transmitting the virus to others D. Contracts HIV-specific antibodies A nurse is caring for a client who has been diagnosed as HIV positive.

Correct Answer is B

Explanation

Choice A rationale:
Acute retroviral syndrome (ARS) is an early stage of HIV infection that often presents with flu-like symptoms. It does not determine AIDS diagnosis.

Choice B rationale:
A CD4+ T lymphocyte level of less than 200 cells/mm is a defining criterion for AIDS diagnosis. This low count indicates a severely weakened immune system, leading to susceptibility to opportunistic infections and other AIDS-defining illnesses.

Choice C rationale:
A person with HIV can transmit the virus to others regardless of their CD4+ T cell count. Transmission risk is not a diagnostic criterion for AIDS.

Choice D rationale:
HIV-specific antibodies are produced by the immune system in response to HIV infection but their presence does not signify AIDS progression.

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The nurse is providing discharge instructions to a patient who has a prescription for phenytoin. Which of the following information should the nurse include?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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