What assessment technique should the nurse use to monitor a client for a common untoward effect of phenytoin (Dilantin)?

Bladder palpation.

Blood glucose monitoring.

Inspection of the mouth.

Auscultation of breath sounds.

Answer and Explanation

The Correct Answer is C

Choice A: This is not specifically related to the side effects of phenytoin.

Choice B: This is not directly related to the common side effects of phenytoin, which primarily affect the oral cavity.

Choice C: Phenytoin (Dilantin) is known to cause gingival hyperplasia (enlargement of the gums) as a common side effect. The nurse should regularly inspect the client's mouth to monitor for this adverse effect.

Choice D: This is not specifically relevant to monitoring for phenytoin's side effects.

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Correct Answer is B

Explanation

Choice A: This is important for the client's overall health but is not the most immediate priority in managing diabetes.

Choice B: The most important intervention for this client is to address lifestyle factors that contribute to diabetes and overall health. Weight loss and dietary changes are key components of managing type 2 diabetes. The client's weight is significantly above a healthy range, and losing 2 pounds (1 kg) per week is a reasonable and safe goal.

Choice C: Encouraging family members to be tested for diabetes is relevant but does not directly address the client's own management of the condition.

Choice D: Determining the client's feelings about the diagnosis is important for emotional support but does not directly address the client's physical health and diabetes management.

A. Mechanical soft diet. B. Soft low-residue diet. C. Full liquid diet. D. Pureed diet.

Correct Answer is D

Explanation

Choice A: A mechanical soft diet may still require some degree of chewing, which may be difficult for a client with no teeth. A pureed diet would be a more appropriate choice.

Choice B: A soft low-residue diet may include soft foods that require chewing, which could be challenging for a client with no teeth.

Choice C: A full liquid diet consists of liquids and foods that are in liquid form at room temperature, which may not provide adequate nutrition for the client.

Choice D: A pureed diet involves blending foods to a smooth consistency, making them suitable for clients with no teeth or difficulty chewing. It would be the most appropriate choice.

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What assessment technique should the nurse use to monitor a client for a common untoward effect of phenytoin (Dilantin)?

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Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

During the admission assessment, an older male client who has no teeth tells the nurse that he cannot find his dentures at home. His dietary prescription is a regular diet. What diet request should the nurse recommend for this client?

Correct Answer is D

Explanation

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