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

Anorexia nervosa is a condition characterized by severe weight loss and malnutrition. People with anorexia nervosa are often deficient in nutrients, including purines. Purines are broken down in the body to produce uric acid. When there is an excess of purines in the body, uric acid levels can rise, leading to gout.

Choice B is incorrect. While consuming foods low in purines can help to prevent gout attacks, it is not a risk factor for developing gout.
Choice C is incorrect. Children are not at risk for developing gout. Gout is more common in adults, especially men.
Choice D is incorrect. Ulcerative colitis is an inflammatory bowel disease that is not associated with an increased risk of gout.

A. Pitting edema of the hands and fingers B. Grey colored, non-purpuric papular rash C. Dry, red rash across the bridge of the nose and on the cheeks D. Subcutaneous nodules on the ulnar side of the arm

Correct Answer is C

Explanation

Choice A rationale:
Pitting edema of the hands and fingers is not a typical finding in SLE. It can occur in some cases, but it is more commonly associated with other conditions such as kidney disease or heart failure.

Choice B rationale:
Grey colored, non-purpuric papular rash is not a characteristic of SLE. This type of rash is more commonly seen in conditions such as lichen planus or sarcoidosis.

Choice C rationale:
A dry, red rash across the bridge of the nose and on the cheeks, also known as a malar rash, is a classic sign of SLE. It is often described as a "butterfly rash" because of its shape. The rash is caused by inflammation of the small blood vessels in the skin. It is typically worsened by sun exposure.

Choice D rationale:
Subcutaneous nodules on the ulnar side of the arm are a characteristic finding in rheumatoid arthritis, not SLE.

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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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