Page 2094 - Saunders Comprehensive Review For NCLEX-RN

Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Planning
Content Area: Pharmacology: Neurological Medications: Opioid analgesics
Health Problem: Adult Health: Neurological: Pain
Priority Concepts: Clinical Judgment; Pain
Reference: Hodgson, Kizior (2018), pp. 277-279.

732. Answer: 2

Rationale: Typical antiseizure medication instructions include taking the
prescribed daily dosage to keep the blood level of the medication constant and
having a sample drawn for serum medication level determination before taking the
morning dose. The client is taught not to stop the medication abruptly, to avoid
alcohol, to check with a primary health care provider before taking over-the-counter
medications, to avoid activities in which alertness and coordination are required
until medication effects are known, to provide good oral hygiene, and to obtain
regular dental care. The client should also wear a MedicAlert bracelet.
Test-Taking Strategy: Focus on the subject, an understanding of medication
instructions for phenytoin. Using knowledge of general principles related to
medication administration will assist you in eliminating options 1 and 3. From the
remaining options, recall that medications generally are not taken just before
determining therapeutic serum levels, because the results would be artificially high.
This leaves oral hygiene as the correct option because of the risk of gingival
hyperplasia.
Level of Cognitive Ability: Evaluating
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Evaluation
Content Area: Pharmacology: Neurological Medications: Anticonvulsants
Health Problem: Adult Health: Neurological Medications: Seizure
disorder/epilepsy
Priority Concepts: Client Education; Safety
Reference: Hodgson, Kizior (2018), pp. 937-938.

733. Answer: 4

Rationale: An edrophonium injection makes the client in cholinergic crisis
temporarily worse. An improvement in the weakness indicates myasthenia crisis.
Muscle spasms are not associated with this test.
Test-Taking Strategy: Focus on the subject, results of an edrophonium test.
Recalling that a cholinergic crisis indicates an overdose of medication, it seems
reasonable that a worsening of the condition will occur when additional medication
is administered.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Analysis
Content Area: Adult Health: Neurological

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