Nursing Elites

1. A client diagnosed with seizures is prescribed phenytoin. Which medication instruction should the practical nurse (PN) reinforce to this client?

• A. Maintain consistent sodium intake.
• B. Use sunscreen when outdoors.
• C. Return for monthly urinalysis.
• D. Brush and floss teeth daily.

Correct answer: D

Rationale: The correct answer is to reinforce the instruction to brush and floss teeth daily. Phenytoin therapy can lead to gingival hyperplasia (gum disease), which can be prevented by maintaining good oral hygiene practices such as brushing and flossing daily. Choices A, B, and C are incorrect because they are not directly related to the side effects or management of phenytoin therapy. Maintaining consistent sodium intake is not a specific concern with phenytoin. Using sunscreen when outdoors is important to prevent sunburn but is not directly related to phenytoin therapy. Returning for monthly urinalysis may be necessary for other medications, but it is not specifically required for monitoring phenytoin therapy.

2. A client with a history of seizures is prescribed valproic acid. The nurse should monitor for which potential adverse effect?

• A. Liver toxicity
• B. Kidney stones
• C. Weight gain
• D. Pancreatitis

Correct answer: A

Rationale: Corrected Valproic acid is known to cause liver toxicity as a potential adverse effect. Regular monitoring of liver function tests is crucial to detect any signs of liver damage early on and prevent serious complications. Kidney stones, weight gain, and pancreatitis are not typically associated with valproic acid use, making them incorrect choices in this scenario.

3. A client with a diagnosis of schizophrenia is prescribed risperidone. The nurse should monitor for which potential side effect?

• A. Weight gain
• B. Tremors
• C. Insomnia
• D. Hyperglycemia

Correct answer: A

Rationale: The correct answer is A: Weight gain. When a client is prescribed risperidone, monitoring weight is crucial due to the potential side effect of weight gain associated with this medication. This side effect can be significant as it may lead to other health issues. Choice B, Tremors, is not typically associated with risperidone use. Choice C, Insomnia, is less likely to be a direct side effect of risperidone compared to weight gain. Choice D, Hyperglycemia, is a possible side effect of some antipsychotic medications, but it is not commonly associated with risperidone.

4. A client is prescribed phenobarbital 100 mg daily for the treatment of seizures. Which statement made by the client indicates an accurate understanding of the medication phenobarbital?

• A. I will take my medicine at 10 PM before retiring to bed.
• B. The medication will turn the color of my urine to a pink color.
• C. I should not eat or drink anything for at least 2 hours before taking my medicine.
• D. In the event a seizure occurs in the middle of the day, I need to take an extra dose of my medicine.

Correct answer: A

Rationale: The correct answer is A. Phenobarbital should be taken at the same time every day to maintain blood levels and enhance compliance. Common side effects of phenobarbital include drowsiness, lethargy, dizziness, and nausea; therefore, it is best to take it before bedtime to minimize these effects and improve sleep quality. Choice B is incorrect because phenobarbital does not affect the color of urine. Choice C is incorrect because there is no need to fast before taking phenobarbital. Choice D is incorrect because taking extra doses without healthcare provider guidance can lead to overdose and adverse effects.

5. A client with chronic obstructive pulmonary disease (COPD) is prescribed albuterol. The nurse should monitor for which potential side effect?

• A. Tachycardia
• B. Nausea
• C. Dry mouth
• D. Weight gain

Correct answer: A

Rationale: Correct Answer: A. Albuterol, a bronchodilator commonly used in COPD, can cause tachycardia as a potential side effect due to its beta-agonist properties that can stimulate the heart. Nausea (Choice B), dry mouth (Choice C), and weight gain (Choice D) are less likely associated with albuterol use. Nausea and dry mouth are not common side effects of albuterol, and weight gain is not typically linked to its use. Therefore, the nurse should primarily monitor for tachycardia when a client is prescribed albuterol for COPD.

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