Nokea
The nurse suspects that the client is developing toxicity if assessment reveals which of the following?
- A. Constipation
- B. Slurred speech
- C. Diarrhea
- D. Urinary frequency
Correct Answer: B
Rationale: The nurse should monitor the client for slurred speech, which is a sign of toxicity. Constipation, diarrhea, and urinary frequency are not signs of ethotoin toxicity.
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A nurse should monitor a client closely for increased CNS depressant effects when an/ColorExtension anticonvulsant is used concomitantly with which of the following? Select all that apply.
- A. Analgesics
- B. Oral contraceptives
- C. Alcohol
- D. Antibiotics
- E. Antidiabetic medications
Correct Answer: A,C
Rationale: The concomitant use of anticonvulsants and analgesics or alcohol can result in increased CNS depressant effects.
After reviewing information about anticonvulsants, a nursing student demonstrates understanding of this group of drugs, identifying which of the following as acting to elevate the seizure threshold by decreasing postsynaptic excitation? Select all that apply.
- A. Clonazepam (Klonopin)
- B. Valproic acid (Depakote)
- C. Gabapentin (Neurontin)
- D. Lorazepam (Ativan)
- E. Trimethadione (Tridione)
Correct Answer: A,D
Rationale: Benzodiazepines (clonazepam and lorazepam) exert their effect by elevating the seizure threshold by decreasing postsynaptic excitation. Valproic acid increases the levels of GABA, gabapentin is a GABA agonist, and trimethadione decreases the repetitive synaptic transmission of nerve impulses.
A client comes to the clinic for a follow-up visit. The client is prescribed lamotrigine for seizure control. The nurse suspects that the client may be experiencing Stevens-Johnson syndrome based on which of the following?
- A. Complaints of muscle pain
- B. Lesions on the mucous membranes
- C. Blisters on the face and neck
- D. Recurrence of seizure activity
- E. Dizziness
Correct Answer: A,B,C
Rationale: Stevens-Johnson syndrome (SJS) is manifested by fever, cough, muscular aches and pains, headache, and lesions of the skin, mucous membranes, and eyes; the lesions appear as red wheals or blisters, often starting on the face, in the mouth, or on the lips, neck, and extremities. Recurrence of seizure activity and dizziness are not associated with this condition.
A nurse is preparing to administer phenytoin to a client. The nurse understands the need to administer this drug cautiously if the client has a history of which of the following? Select all that apply.
- A. Hyperthyroidism
- B. Hypotension
- C. Diabetes
- D. Asthma
- E. Hepatic impairment
Correct Answer: B,E
Rationale: Phenytoin (Dilantin) is used cautiously in clients with hypotension, severe myocardial insufficiency, and hepatic impairment.
A nurse at a health care center has been asked to prepare a teaching plan for a client on oxazolidinedione therapy. Which of the following points should the nurse include?
- A. Avoiding exposure to ultraviolet light
- B. Taking the drug 2 hours after a meal
- C. Taking the drug with milk
- D. Avoiding carbonated drinks during therapy
Correct Answer: A
Rationale: The nurse should suggest avoiding exposure to ultraviolet light in the teaching plan of the client on oxazolidinedione therapy because of the risk for photosensitivity. The nurse need not include taking the drug 2 hours after a meal, taking the drug with milk, or avoiding carbonated drinks.