NCLEX-RN Pharmacology Neurological System
Part 2 Practice Questions with Rationales |
20 Original NGN-Style MCQs |
Nursing Exam Prep
Question 1
Clinical Scenario A 45-year-old male with a new onset seizure
disorder is being discharged with a prescription for oral
phenytoin. The nurse is providing discharge education regarding
this medication.
Question Stem Which statement by the client indicates
understanding of the teaching regarding this medication?
A. I can stop taking this medication once I have been completely
seizure-free for a month. B. I should take this medication on an
empty stomach to maximize its absorption. C. I will brush my
teeth gently with a soft-bristled brush and schedule regular
dental visits. D. I will use a soft-bristled toothbrush and avoid
flossing completely to prevent gum bleeding.
,Correct Answer C. I will brush my teeth gently with a soft-
bristled brush and schedule regular dental visits.
Detailed Rationale Phenytoin is a hydantoin anticonvulsant that
commonly causes gingival hyperplasia (overgrowth of gum
tissue) as an adverse effect. Therefore, meticulous oral hygiene,
including gentle brushing with a soft-bristled toothbrush, daily
flossing, and regular dental check-ups, is a critical patient
teaching point to minimize this complication. Option A is
incorrect because antiepileptic medications should never be
stopped abruptly, as this can precipitate life-threatening status
epilepticus. Option B is incorrect because phenytoin should be
taken with food or milk to decrease gastrointestinal irritation,
not on an empty stomach. Option D is incorrect because
flossing is actively encouraged, not avoided, to prevent plaque
buildup that exacerbates gingival hyperplasia. The nurse must
emphasize adherence to the prescribed regimen and proactive
dental care to ensure medication safety.
Learning Objective • Identify common adverse effects of
phenytoin, specifically gingival hyperplasia. • Educate patients
on proper oral hygiene practices while taking anticonvulsants. •
Recognize the danger of abrupt discontinuation of antiepileptic
medications.
Medication Safety Focus Patient education
, ====================================================
=
Question 2
Clinical Scenario A 52-year-old female with a history of migraine
headaches and coronary artery disease (CAD) requests a
prescription for sumatriptan for her acute migraine attacks.
Question Stem Which action should the nurse take?
A. Administer the sumatriptan as prescribed by the healthcare
provider. B. Hold the medication and contact the healthcare
provider to discuss the prescription. C. Instruct the client to take
the medication with a high-fat meal to enhance absorption. D.
Assess the client's blood pressure and administer the
medication only if it is <140/90 mmHg.
Correct Answer B. Hold the medication and contact the
healthcare provider to discuss the prescription.
Detailed Rationale Sumatriptan is a serotonin 5-HT1 receptor
agonist that works by causing cranial vasoconstriction to abort
migraine attacks. However, this vasoconstrictive effect is
systemic, making it strictly contraindicated in patients with
coronary artery disease (CAD), uncontrolled hypertension, or a
history of myocardial infarction or stroke due to the high risk of
coronary vasospasm and ischemia. The nurse must recognize
this contraindication, hold the medication, and contact the
Part 2 Practice Questions with Rationales |
20 Original NGN-Style MCQs |
Nursing Exam Prep
Question 1
Clinical Scenario A 45-year-old male with a new onset seizure
disorder is being discharged with a prescription for oral
phenytoin. The nurse is providing discharge education regarding
this medication.
Question Stem Which statement by the client indicates
understanding of the teaching regarding this medication?
A. I can stop taking this medication once I have been completely
seizure-free for a month. B. I should take this medication on an
empty stomach to maximize its absorption. C. I will brush my
teeth gently with a soft-bristled brush and schedule regular
dental visits. D. I will use a soft-bristled toothbrush and avoid
flossing completely to prevent gum bleeding.
,Correct Answer C. I will brush my teeth gently with a soft-
bristled brush and schedule regular dental visits.
Detailed Rationale Phenytoin is a hydantoin anticonvulsant that
commonly causes gingival hyperplasia (overgrowth of gum
tissue) as an adverse effect. Therefore, meticulous oral hygiene,
including gentle brushing with a soft-bristled toothbrush, daily
flossing, and regular dental check-ups, is a critical patient
teaching point to minimize this complication. Option A is
incorrect because antiepileptic medications should never be
stopped abruptly, as this can precipitate life-threatening status
epilepticus. Option B is incorrect because phenytoin should be
taken with food or milk to decrease gastrointestinal irritation,
not on an empty stomach. Option D is incorrect because
flossing is actively encouraged, not avoided, to prevent plaque
buildup that exacerbates gingival hyperplasia. The nurse must
emphasize adherence to the prescribed regimen and proactive
dental care to ensure medication safety.
Learning Objective • Identify common adverse effects of
phenytoin, specifically gingival hyperplasia. • Educate patients
on proper oral hygiene practices while taking anticonvulsants. •
Recognize the danger of abrupt discontinuation of antiepileptic
medications.
Medication Safety Focus Patient education
, ====================================================
=
Question 2
Clinical Scenario A 52-year-old female with a history of migraine
headaches and coronary artery disease (CAD) requests a
prescription for sumatriptan for her acute migraine attacks.
Question Stem Which action should the nurse take?
A. Administer the sumatriptan as prescribed by the healthcare
provider. B. Hold the medication and contact the healthcare
provider to discuss the prescription. C. Instruct the client to take
the medication with a high-fat meal to enhance absorption. D.
Assess the client's blood pressure and administer the
medication only if it is <140/90 mmHg.
Correct Answer B. Hold the medication and contact the
healthcare provider to discuss the prescription.
Detailed Rationale Sumatriptan is a serotonin 5-HT1 receptor
agonist that works by causing cranial vasoconstriction to abort
migraine attacks. However, this vasoconstrictive effect is
systemic, making it strictly contraindicated in patients with
coronary artery disease (CAD), uncontrolled hypertension, or a
history of myocardial infarction or stroke due to the high risk of
coronary vasospasm and ischemia. The nurse must recognize
this contraindication, hold the medication, and contact the
