6-year-old post surgery. The child is awake and lying very still,
won't respond when the RN asks about pain. What should the
RN do? Correct Answer Evaluate the child's pain using an
"ouch scale"
*could use faces pain scale, want to use something relatable to
the child
A nurse is caring for a patient (a documented overproducer of
uric acid) who was recently prescribed lesinurad 200 mg PO
daily for management of gout. In addition to lesinurad, the
patient is also receiving colchicine for gout and amlodipine for
hypertension. Which rationale explains why the nurse would call
the health care provider before administering lesinurad? Correct
Answer Lesinurad must be administered with allopurinol or
febuxostat.
*The nurse would call the health care provider before
administering lesinurad because this drug must be given with a
xanthine oxidase inhibitor such as febuxostat or allopurinol. It
cannot be given as monotherapy. The patient is not currently
receiving a xanthine oxidase inhibitor.
,A nurse is monitoring a pt receiving atropine. Which finding
requires nursing action? Correct Answer A blood pressure of
90/40 mm Hg
A nurse is providing care to a patient who has been newly
prescribed lesinurad and allopurinol. The patient is also taking
carbamazepine for seizures and atorvastatin for dyslipidemia.
The nurse would notify the health care provider of which
potential drug interaction? Correct Answer Carbamazepine,
because it will decrease levels of lesinurad
A nurse is providing care to a patient with gout who presents
with a fever, rash, eosinophilia, kidney failure, and
pancytopenia. Which antigout drug would the nurse suspect has
led to this patient's clinical manifestations? Correct Answer
Allopurinol
*Allopurinol is the likely culprit. This drug is associated with a
potentially fatal hypersensitivity syndrome that may be
characterized by a rash, fever, eosinophilia, end-organ disease,
and bone marrow toxicity, which accurately describes this
patient's clinical manifestations.
A nurse would instruct patients taking phenytoin to report which
side effects? Correct Answer Fever
Patients may develop blood dyscrasias, including neutropenia,
which can be indicated by a fever. Patients with neutropenia are
at greater risk for infection, and this should be reported
immediately to the health care provider.
Dizziness
,Dizziness may be a sign of central nervous system effects and
should be reported to the health care provider. This may be a
sign of excessive dosing.
Bleeding gums
Bleeding gums may occur with thrombocytopenia and should be
reported to the health care provider.
A patient asks the nurse about ways to prevent gingival
symptoms while taking phenytoin. Which activity will the nurse
recommend? Correct Answer Use a soft-bristled toothbrush.
*A soft-bristled toothbrush should be used to prevent gum
irritation and bleeding. Additional mechanisms to reduce
gingival symptoms include proper flossing and gum massage.
A patient calls the clinic 1 week after beginning therapy with
phenytoin to report urine that is pinkish red. How would the
nurse respond? Correct Answer Reassure the patient that this is
a harmless side effect of phenytoin.
*A pinkish-red or reddish-brown color to the urine is a harmless
side effect of phenytoin. The patient should continue the
medication as prescribed.
a patient exhibiting which condition would be an unsuitable
candidate for sympathomimetic agent? Correct Answer
Hypertension
*may cause further increase in blood pressure or increase risk of
heart failure.
, A patient has a seizure disorder. The RN notes reddened gums
that bleed with oral care. The RN knows the finding is Correct
Answer an adverse effect of the phenytoin
A patient is receiving bethanechol at 0900. At which time does
the nurse anticipate the onset of action for the drug? Correct
Answer 1000
*The expected onset of action for bethanechol is 30 to 90
minutes, so the nurse would anticipate that the onset of action
for bethanechol given at 0900 would be between 0930 and 1030.
A patient is scheduled for dental surgery in 1 month and asks the
nurse whether to stop taking a regular daily dose of 100 mg of
aspirin before surgery. Which response by the nurse is
appropriate? Correct Answer "You should continue the dose of
aspirin because this type of surgery is associated with a low risk
of bleeding."
A patient prescribed phenytoin reports using over-the-counter
medications to treat acid reflux. Which response by the nurse is
correct? Correct Answer "Use an antacid that does not contain
calcium."
*Calcium binds with phenytoin to decrease absorption and will
alter the therapeutic effects. Patients should be instructed to use
antacids that do not contain calcium.
A patient presents to the emergency department with intense
itching, ringing in the ears, changes in breathing pattern, and
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