Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
Which of these self-care measures should be emphasized in client education regarding phenytoin?
A. Gradually reduce prescribed dose if seizures do not occur for one month
Gradually reducing the prescribed dose of an antiepileptic like phenytoin without consulting the healthcare provider can lead to increased seizure activity. This is not a recommended self care measure.
B. Expect green urine due to medication metabolites
Expecting green urine is not associated with phenytoin. This statement is not accurate.
C. Brush after every meal and floss teeth daily
Phenytoin can cause gingival hyperplasia and other oral health issues. Emphasizing good oral hygiene practices, such as brushing after every meal and flossing daily, is crucial.
D. Instill mineral oil into both ears once a week
Instilling mineral oil into both ears is not a self-care measure related to phenytoin.
This question is an excerpt from Nurse Dive's nursing test bank - Ramsussen Section 4 Module 11. Pharmocology For Professional Nursing Proctored Exam. Take the full exam now
Full Explanation
A) Gradually reducing the prescribed dose of an antiepileptic like phenytoin without consulting the healthcare provider can lead to increased seizure activity. This is not a recommended self care measure.
B) Expecting green urine is not associated with phenytoin. This statement is not accurate.
C) Phenytoin can cause gingival hyperplasia and other oral health issues. Emphasizing good oral hygiene practices, such as brushing after every meal and flossing daily, is crucial.
D) Instilling mineral oil into both ears is not a self-care measure related to phenytoin.
Similar Questions
Which of these findings would cause the nurse to hold the administration of oral metoprolol 25 mg?
A. Blood pressure of 92/44 mmHg
The nurse should hold the administration of oral metoprolol 25 mg if the blood pressure of the patient is 92/44 mmHg, as this indicates hypotension, which can be worsened by the beta blocker effect of metoprolol.
B. Respiratory rate of 26 breaths per minute
A respiratory rate of 26 breaths per minute is within the acceptable range for administering metoprolol.
C. Heart rate of 92 beats per minute
A heart rate of 92 beats per minute is within the acceptable range for administering metoprolol.
D. Oxygen saturation level of 95% on room air
Holding the administration of metoprolol may be appropriate if the oxygen saturation level is low. Metoprolol is primarily used for heart rate and blood pressure control and may not be the immediate concern in a client with low oxygen saturation. The healthcare provider should be consulted for further guidance.
Full Explanation
A) The nurse should hold the administration of oral metoprolol 25 mg if the blood pressure of the patient is 92/44 mmHg, as this indicates hypotension, which can be worsened by the beta blocker effect of metoprolol.
B) A respiratory rate of 26 breaths per minute is within the acceptable range for administering metoprolol.
C) A heart rate of 92 beats per minute is within the acceptable range for administering metoprolol.
D) Holding the administration of metoprolol may be appropriate if the oxygen saturation level is low. Metoprolol is primarily used for heart rate and blood pressure control and may not be the immediate concern in a client with low oxygen saturation. The healthcare provider should be consulted for further guidance.
The nurse is caring for a client who is receiving vancomycin. The nurse notes the client is experiencing flushing, rash, pruritus, and urticaria. The client's heart rate is 120 beats/min, and blood pressure is 92/57 mm Hg. What complication is the client experiencing?
A. Rhabdomyolysis
Rhabdomyolysis is a serious condition characterized by the breakdown of skeletal muscle tissue and is not associated with the symptoms described.
B. Red man syndrome
Red man syndrome is an infusion reaction associated with the rapid infusion of vancomycin. Symptoms include flushing, rash, pruritus, urticaria, tachycardia, and hypotension.
C. Side effects
Side effects are general and can include a range of symptoms. Red man syndrome is a specific reaction associated with vancomycin.
D. Stevens-Johnson syndrome
Stevens-Johnson syndrome is a severe skin reaction that involves blistering and peeling of the skin. It is not associated with the rapid infusion of vancomycin.
Full Explanation
A) Rhabdomyolysis is a serious condition characterized by the breakdown of skeletal muscle tissue and is not associated with the symptoms described.
B) Red man syndrome is an infusion reaction associated with the rapid infusion of vancomycin. Symptoms include flushing, rash, pruritus, urticaria, tachycardia, and hypotension.
C) Side effects are general and can include a range of symptoms. Red man syndrome is a specific reaction associated with vancomycin.
D) Stevens-Johnson syndrome is a severe skin reaction that involves blistering and peeling of the skin. It is not associated with the rapid infusion of vancomycin.
The nurse notices that an order for intravenous gentamicin for a newly admitted client is half of the normal dose usually ordered for an adult. Before calling the provider for confirmation of the order, the nurse reviews the client's history to check for which preexisting condition that could have prompted the adjustment to the normal dose?
A. Antibiotic resistance
Antibiotic resistance is not a reason to adjust the dose of gentamicin.
B. Renal disease
Gentamicin is primarily excreted by the kidneys. In the presence of renal disease, the dose may need to be adjusted to prevent toxicity.
C. Liver disease
Liver disease does not directly impact the metabolism or excretion of gentamicin, so it is not typically a factor in dose adjustment.
D. Interpatient variation
Interpatient variation alone may not prompt a specific dose adjustment; individual patient factors, especially renal function, are crucial in determining gentamicin dosage.
Full Explanation
A) Antibiotic resistance is not a reason to adjust the dose of gentamicin.
B) Gentamicin is primarily excreted by the kidneys. In the presence of renal disease, the dose may need to be adjusted to prevent toxicity.
C) Liver disease does not directly impact the metabolism or excretion of gentamicin, so it is not typically a factor in dose adjustment.
D) Interpatient variation alone may not prompt a specific dose adjustment; individual patient factors, especially renal function, are crucial in determining gentamicin dosage.