a nurse is providing teaching to a client who has a prescription for phenytoin which of the following instructions should the nurse include
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Nursing Elites

ATI RN

ATI Pharmacology Proctored Exam

1. A client has a prescription for Phenytoin. Which of the following instructions should the nurse include?

Correct answer: C

Rationale: The correct answer is C: 'Brush and floss your teeth regularly.' Phenytoin can cause gingival hyperplasia, a condition that leads to overgrowth of gum tissue. Good oral hygiene practices such as regular brushing and flossing can help prevent or minimize this side effect. In contrast, choices A, B, and D are not directly related to managing the side effects of Phenytoin. Taking the medication at bedtime (choice A) is not a specific instruction related to oral hygiene. Increasing calcium-rich foods intake (choice B) may be beneficial for bone health but is not directly related to preventing gingival hyperplasia. Avoiding foods high in potassium (choice D) is not a necessary instruction for a client taking Phenytoin.

2. Which of the following is not a side effect of loop diuretics?

Correct answer: B

Rationale: Nausea is not commonly associated with loop diuretics. Loop diuretics are known to cause electrolyte imbalances such as potassium deficits, metabolic alkalosis, and hypotension due to excessive fluid loss. Nausea is not a typical side effect of loop diuretics.

3. A client has a new prescription for Labetalol. Which of the following instructions should the nurse include?

Correct answer: B

Rationale: The correct instruction for a client on Labetalol is to avoid sudden discontinuation of the medication. Labetalol is a beta-blocker that, if abruptly stopped, can lead to rebound hypertension and other cardiac issues. It is essential for patients to taper off this medication under medical supervision to prevent adverse effects.

4. A client in a long-term care facility has Hypothyroidism and a new prescription for Levothyroxine. Which of the following dosage schedules should the nurse expect for this client?

Correct answer: D

Rationale: The nurse should expect that levothyroxine will be started at a low dose and gradually increased over several weeks. This cautious approach is crucial, especially in older adult clients, to prevent toxicity and ensure optimal therapeutic outcomes for managing hypothyroidism. Choice A is incorrect because starting at a high dose and tapering as needed is not the standard approach for levothyroxine. Choice B is incorrect because the initial dosage is typically adjusted to reach the optimal therapeutic dose. Choice C is incorrect as adjusting the dosage daily based on blood levels is not necessary for levothyroxine, as it has a long half-life and requires time to reach a steady state.

5. A client has a new prescription for Spironolactone. Which of the following adverse effects should the nurse instruct the client to monitor?

Correct answer: A

Rationale: Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia due to its mechanism of action. Hyperkalemia can cause muscle weakness and cardiac dysrhythmias. Therefore, the nurse should educate the client to monitor for signs and symptoms of hyperkalemia while taking Spironolactone.

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