NUR-635 final review 2024 questions and answers

NUR-635 final review 2024 questions and answers A patient is to begin taking phenytoin [Dilantin] for seizures. The patient tells the nurse that she is taking oral contraceptives. What will the nurse tell the patient? a. She may need to increase her dose of phenytoin while taking oral contraceptives. b. She should consider a different form of birth control while taking phenytoin. c. She should remain on oral contraceptives, because phenytoin causes birth defects. d. She should stop taking oral contraceptives, because they reduce the effectiveness of phenytoin. - Correct Answer ️️ -b. She should consider a different form of birth control while taking phenytoin. Because phenytoin can reduce the effects of oral contraceptive pills (OCPs) and because avoiding pregnancy is desirable when taking phenytoin, patients should be advised to increase the dose of oral contraceptives or use an alternative method of birth control. A nurse is caring for a patient who recently immigrated from a third world country. The patient is thin and appears malnourished. The nurse notes that the patient has loose and missing teeth, gingivitis, and bleeding gums. The patient has multiple sores and ecchymoses. The nurse will expect the provider to order? a. Cyanocobalamin (vitamin B12) b. High-dose nicotinic acid c. Intramuscular thiamine for 1 to 2 weeks d. Intravenous ascorbic acid - Correct Answer ️️ -d. Intravenous ascorbic acid This patient has scurvy with acute, severe symptoms, and needs intravenous vitamin C. First line drug of choice for community acquired pneumonia in a previously healthy is? a. Penicillin b. Amoxicillin c. Azithromycin d. Levaquin - Correct Answer ️️ -c. Azithromycin One month after starting phenytoin for seizures, a 28-year-old male presents with complaints of fever, rash, and swollen lymph nodes. The NP suspects which syndrome? a. Phenytoin toxicity b. Phenytoin hypersensitivity reaction c. Normal side effects of phenytoin d. Mononucleosis - Correct Answer ️️ -b. Phenytoin hypersensitivity reaction A patient with previous compliant levels of carbamazepine now presents with subtherapeutic blood levels. The NP suspects? a. Noncompliance b. Patient financial strain c. Malnutrition d. Expected lab finding - Correct Answer ️️ -d. Expected lab finding Carbamazepine auto induces metabolism leading to lower levels of the drug. The nurse is performing a physical assessment on a patient who is receiving treatment with abacavir, zidovudine, and lamivudine [Trizivir]. The patient complains of fatigue. Upon further assessment, the nurse finds a rash and notes that the patient has a temperature of 101.1 F. What is the nurse's best course of action? a. Tell the patient that this is an expected response to these medications and to continue the agents as prescribed b. Have the patient hold the medications and arrange for an immediate evaluation by the prescriber c. Have the patient continue the abacavir but discontinue the other two agents for 3 weeks d. Instruct the patient to continue all three medications and administer an antihistamine for the symptoms - Correct Answer ️️ -b. Have the patient hold the medications and arrange for an immediate evaluation by the prescriber a. ANS: B- The patient is showing early symptoms of a fatal hypersensitivity reaction. The NP educates the patient regarding the black box warning on carbamazepine by advising the patient to report signs and symptoms indicative of? a. Liver toxicity b. Kidney failure c. Skin reaction d. Suicidal tendencies - Correct Answer ️️ -c. Skin reaction Carbamazepine can cause SJS and TEN (toxic epidermal necrolysis) Carbamazepine monitoring should include all of the following except? a. Routine CBC b. Osteoporosis screening c. Carbamazepine drug levels d. Monthly glucose - Correct Answer ️️ -d. Monthly glucose A patient with bipolar disorder takes lamotrigine [Lamictal]. Which statement by the patient would prompt the nurse to hold the drug and notify the prescriber for further assessment? a. "I get a little dizzy sometimes" b. "I had a headache last week that lasted for about an hour" c. "I've broken out in a rash on my chest and back" d. "Last night I woke up twice with a bad dream" - Correct Answer ️️ -c. "I've broken out in a rash on my chest and back" Rash may indicate development of Stevens-Johnson Syndrome. A young woman taking Lamictal for seizures presents to the office requesting birth control. She has decided she wants daily oral contraceptives. The NP educates the patient regarding the fact? a. Oral contraceptives will interact with Lamictal and are not a good option b. Oral contraceptives can cause Lamictal levels to become toxic c. Lamictal doses will need to be increased while taking oral contraceptives d. Back up contraceptives will need to be used if taking Lamictal - Correct Answer ️️ - c. Lamictal doses will need to be increased while taking oral contrace