Page 2091 - Saunders Comprehensive Review For NCLEX-RN

bradycardia, and akinesia are frequent side effects of the medication.
Test-Taking Strategy: Focus on the subject, an adverse effect. Options 2 and 3 are
comparable or alike and are cardiac-related options, so these options can be
eliminated first. Next, focus on the client’s diagnosis and select the correct option
over option 1 because it relates to the neurological system.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Assessment
Content Area: Pharmacology: Neurological Medications: Antiparkinsonian
Health Problem: Adult Health: Neurological: Parkinson’s disease
Priority Concepts: Clinical Judgment; Safety
Reference: Lewis et al. (2017), p. 1390.

725. Answer: 3

Rationale: Phenytoin enhances the rate of estrogen metabolism, which can
decrease the effectiveness of some birth control pills. Options 1, 2, and 4 are
inappropriate instructions. Pregnancy does not need to be “avoided” while taking
phenytoin; however, because phenytoin may cause some risk to the fetus (Pregnancy
Category D medication), consultation with the primary health care provider should
be done if pregnancy is considered. Telling a client that there is an increased risk of
thrombophlebitis is incorrect and inappropriate and could cause anxiety in the
client. A client should not be instructed to stop antiseizure medication.
Test-Taking Strategy: Focus on the subject, teaching points for the client taking
phenytoin. Eliminate option 1 because of the words must be avoided. Use general
medication guidelines to eliminate option 2; the client would not be advised to stop a
medication. For the remaining options, eliminate option 4, as it will cause anxiety in
the client.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Teaching and Learning
Content Area: Pharmacology: Neurological Medications: Anticonvulsants
Health Problem: Adult Health: Neurological: Seizure disorder/epilepsy
Priority Concepts: Client Education; Safety
Reference: Burchum, Rosenthal (2016), pp. 236-237.

726. Answer: 4

Rationale: The antidote for acetaminophen is acetylcysteine. The normal
therapeutic serum level of acetaminophen is 10 to 20 mcg/mL. A toxic level is higher
than 50 mcg/mL, and levels higher than 200 mcg/mL 4 hours after ingestion indicates
that there is risk for liver damage. Auranofin is a gold preparation that may be used
to treat rheumatoid arthritis. Pentostatin and fludarabine are antineoplastic agents.
Test-Taking Strategy: Eliminate options 1 and 3 first because they are comparable
or alike (antineoplastic agents). Recalling that auranofin is used to treat rheumatoid
arthritis will direct you to the correct option.
Level of Cognitive Ability: Applying

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