HESI PHARMACOLOGY EXAM 1 2023/2024(100%
VERIFIED) LATEST UPDATED 2024
A patient receiving lamotrigine therapy has started using oral contraceptives. What is essential for the
nurse to teach the patient?
"With oral contraceptive use, you may need more lamotrigine."- When given with oral contraceptives,
lamotrigine [1] [2] may need an increased dose to be effective because the oralcontraceptives also
compete for the CYP450 enzyme pathway.
What is appropriate information for the nurse to give the patient who is taking an antiepileptic drug with
a narrow therapeutic index?
Make certain the drug is taken at the same time daily.
What is the appropriate way for the nurse to prepare a dosage of a suspension medication for a pediatric
patient?
Draw it up in an oral syringe
A patient is receiving carbamazepine to treat trigeminal neuralgia. What assessment indicates a
therapeutic response to the medication?
The patient states no facial pain.
A nurse is caring for a patient who has been started on antiepileptic drug therapy for seizures. What
information should be included in the teaching plan for the patient?
Take the medication at the sametime each day.
Which intervention will best maintain therapeutic levels of an antiepileptic drug?
Establish a drugregimen based on the half-life of the medication.
Which patient should the nurse assess first?
The patient taking carbamazepine who is not oriented to place or time.. - Any patient who is not
oriented has a potential risk to his safety. The patient who is notoriented and taking carbamazepine
could be experiencing adverse effects of therapy. This is the patient the nurse should assess first.
Which patient is most likely to have toxic effects of antiepileptic therapy?
The patient with a carbamazepine level of 15 mcg/mL- The only value listed that is above therapeutic
plasma levels is thecarbamazepine, which has a therapeutic range of 4 to 12 mcg/mL; this patient is
most likely to have toxic effects of therapy.
A patient is receiving phenobarbital. What information is essential to include in the discharge teaching
plan? Select all that apply.
"This medication may cause confusion.", "Good dental care is essential while on this medication."
"Don't drive until you determine how the medication affects you."- The most common adverse effects
are lethargy and cognitive changes as well as gingival hyperplasia. Confusion can be a result of this
,therapy. Good dental care is essential because the medication can cause gingival hyperplasia. The patient
should evaluate how the drug affects him before driving.
The nurse is caring for a patient with a phenytoin level of 12 mcg/mL. What is the nurse's best action?
Continue to monitor the patient on this medication.
The nurse instructs a patient receiving phenytoin to visit the dentist regularly and perform frequent oral
hygiene. What side effect will these interventions assist in preventing?
Gingival hyperplasia
What is the goal of antiepileptic therapy?
Maximally reducing seizure activity while minimizing sideeffects of medication therapy.
The patient was started on an antiepileptic medication 6 weeks ago. The nurse notes that the patient's
blood level of the medication is very low after 6 weeks of therapy. How will the nurse interpret this
result?
The patient may not be taking the medication as ordered.
The nurse is teaching a patient about therapy for a newly diagnosed seizure disorder. What statement
should the nurse include?"
Your medication is chosen based on your type of seizure."
What is the reason for many potential drug interactions with antiepileptic drug therapy?
Altered CYP450 enzyme metabolism
What is important to teach the patient taking valproic acid for seizure management?
Do not take the medication with milk or carbonated beverages. - Oral forms of valproic acid are not to be
given with milk,because this may cause the drug to dissolve early and irritate the mucosa. Carbonated
beverages must also be avoided during the time of drug administration.
The health care provider has ordered once-daily phenytoin for an 8-year-old child who has a seizure
disorder. The parents state the child cannot swallow pills. What intervention would the nurse
recommend to the health care provider?
Ask for a suspension form of the medication to be prescribed.
The nurse is administering intravenous diazepam. When will the nurse expect the onset of action to
occur?
Immediately
What intervention is appropriate to include in discharge teaching for a patient prescribed phenytoin
therapy?
Perform good oral hygiene.
The nurse is assessing a patient who is receiving antiepileptic drug therapy with phenytoin. What
assessment finding requires immediate action?
, Nystagmus - The patient who has nystagmus may be presenting with adverse effects to phenytoin
therapy and should be assessed for other signs of toxicity.
Which assessment is a priority for the patient starting on gabapentin therapy for a seizure disorder?
Neurologic assessment - Gabapentin requires a thorough neurologic assessment, including baseline
energy levels, vision level, sensory and motor functioning, and any changes in speech.
The nurse is caring for a patient who has been taking phenytoin for the past week and has developed a
rash. What is the first action the nurse should take?
Assess the patient.
A patient with a seizure disorder is taking oral phenytoin. He is nothing by mouth (NPO) for elective
surgery. What is the appropriate nursing action?
Call the health care provider to clarify medication orders.
What assessment indicates the patient is having a therapeutic response to valproic acid?
Absence of seizures
A patient has been taking valproic acid and is being switched to another medication due to elevated liver
function tests. What nursing action is appropriate?
Taper the valproic acid while starting the new medication.
A patient is admitted who has reportedly stopped taking her antiepileptic medication. What is the
appropriate nursing action?
Monitor for rebound seizure activity.
What intervention is essential before a patient starts therapy with lamotrigine?
Assessment of risk forStevens-Johnson syndrome
The nurse is administering intravenous phenytoin. When will the nurse expect the onset of the drug to
occur?
Within 1 to 2 hours
What information should the nurse provide to a patient who will self-administer an antiepileptic agent
for the first time at home?
"Wait to see how you react to the medication before driving."
The nurse is administering morning medications. Which administration technique is in error?
1The nurse administers carbamazepine with grapefruit juice.
VERIFIED) LATEST UPDATED 2024
A patient receiving lamotrigine therapy has started using oral contraceptives. What is essential for the
nurse to teach the patient?
"With oral contraceptive use, you may need more lamotrigine."- When given with oral contraceptives,
lamotrigine [1] [2] may need an increased dose to be effective because the oralcontraceptives also
compete for the CYP450 enzyme pathway.
What is appropriate information for the nurse to give the patient who is taking an antiepileptic drug with
a narrow therapeutic index?
Make certain the drug is taken at the same time daily.
What is the appropriate way for the nurse to prepare a dosage of a suspension medication for a pediatric
patient?
Draw it up in an oral syringe
A patient is receiving carbamazepine to treat trigeminal neuralgia. What assessment indicates a
therapeutic response to the medication?
The patient states no facial pain.
A nurse is caring for a patient who has been started on antiepileptic drug therapy for seizures. What
information should be included in the teaching plan for the patient?
Take the medication at the sametime each day.
Which intervention will best maintain therapeutic levels of an antiepileptic drug?
Establish a drugregimen based on the half-life of the medication.
Which patient should the nurse assess first?
The patient taking carbamazepine who is not oriented to place or time.. - Any patient who is not
oriented has a potential risk to his safety. The patient who is notoriented and taking carbamazepine
could be experiencing adverse effects of therapy. This is the patient the nurse should assess first.
Which patient is most likely to have toxic effects of antiepileptic therapy?
The patient with a carbamazepine level of 15 mcg/mL- The only value listed that is above therapeutic
plasma levels is thecarbamazepine, which has a therapeutic range of 4 to 12 mcg/mL; this patient is
most likely to have toxic effects of therapy.
A patient is receiving phenobarbital. What information is essential to include in the discharge teaching
plan? Select all that apply.
"This medication may cause confusion.", "Good dental care is essential while on this medication."
"Don't drive until you determine how the medication affects you."- The most common adverse effects
are lethargy and cognitive changes as well as gingival hyperplasia. Confusion can be a result of this
,therapy. Good dental care is essential because the medication can cause gingival hyperplasia. The patient
should evaluate how the drug affects him before driving.
The nurse is caring for a patient with a phenytoin level of 12 mcg/mL. What is the nurse's best action?
Continue to monitor the patient on this medication.
The nurse instructs a patient receiving phenytoin to visit the dentist regularly and perform frequent oral
hygiene. What side effect will these interventions assist in preventing?
Gingival hyperplasia
What is the goal of antiepileptic therapy?
Maximally reducing seizure activity while minimizing sideeffects of medication therapy.
The patient was started on an antiepileptic medication 6 weeks ago. The nurse notes that the patient's
blood level of the medication is very low after 6 weeks of therapy. How will the nurse interpret this
result?
The patient may not be taking the medication as ordered.
The nurse is teaching a patient about therapy for a newly diagnosed seizure disorder. What statement
should the nurse include?"
Your medication is chosen based on your type of seizure."
What is the reason for many potential drug interactions with antiepileptic drug therapy?
Altered CYP450 enzyme metabolism
What is important to teach the patient taking valproic acid for seizure management?
Do not take the medication with milk or carbonated beverages. - Oral forms of valproic acid are not to be
given with milk,because this may cause the drug to dissolve early and irritate the mucosa. Carbonated
beverages must also be avoided during the time of drug administration.
The health care provider has ordered once-daily phenytoin for an 8-year-old child who has a seizure
disorder. The parents state the child cannot swallow pills. What intervention would the nurse
recommend to the health care provider?
Ask for a suspension form of the medication to be prescribed.
The nurse is administering intravenous diazepam. When will the nurse expect the onset of action to
occur?
Immediately
What intervention is appropriate to include in discharge teaching for a patient prescribed phenytoin
therapy?
Perform good oral hygiene.
The nurse is assessing a patient who is receiving antiepileptic drug therapy with phenytoin. What
assessment finding requires immediate action?
, Nystagmus - The patient who has nystagmus may be presenting with adverse effects to phenytoin
therapy and should be assessed for other signs of toxicity.
Which assessment is a priority for the patient starting on gabapentin therapy for a seizure disorder?
Neurologic assessment - Gabapentin requires a thorough neurologic assessment, including baseline
energy levels, vision level, sensory and motor functioning, and any changes in speech.
The nurse is caring for a patient who has been taking phenytoin for the past week and has developed a
rash. What is the first action the nurse should take?
Assess the patient.
A patient with a seizure disorder is taking oral phenytoin. He is nothing by mouth (NPO) for elective
surgery. What is the appropriate nursing action?
Call the health care provider to clarify medication orders.
What assessment indicates the patient is having a therapeutic response to valproic acid?
Absence of seizures
A patient has been taking valproic acid and is being switched to another medication due to elevated liver
function tests. What nursing action is appropriate?
Taper the valproic acid while starting the new medication.
A patient is admitted who has reportedly stopped taking her antiepileptic medication. What is the
appropriate nursing action?
Monitor for rebound seizure activity.
What intervention is essential before a patient starts therapy with lamotrigine?
Assessment of risk forStevens-Johnson syndrome
The nurse is administering intravenous phenytoin. When will the nurse expect the onset of the drug to
occur?
Within 1 to 2 hours
What information should the nurse provide to a patient who will self-administer an antiepileptic agent
for the first time at home?
"Wait to see how you react to the medication before driving."
The nurse is administering morning medications. Which administration technique is in error?
1The nurse administers carbamazepine with grapefruit juice.
