Phenytoin has been prescribed for a patient with seizures. The nurse should include which appropriate nursing intervention in the plan of care?

Correct Answer: B

Rationale: The correct answer is B: Monitor complete blood count levels for early detection of blood dyscrasias. This is important because phenytoin can cause blood disorders, so monitoring CBC levels can help detect any abnormalities early. Choice A is incorrect because an phenytoin level of 18 mcg/mL is within therapeutic range. Choice C is incorrect as vigorous tooth brushing can irritate gums due to phenytoin's side effects. Choice D is incorrect as passing pinkish-red or reddish-brown urine is a common side effect of phenytoin and does not necessarily indicate a need to stop the drug immediately.

Correct Answer: B

Rationale: The correct answer is B: Muscle rigidity. In Parkinson's disease, muscle rigidity is a common assessment finding due to the increased muscle tone. This results in stiffness and resistance to passive movement. The other choices are incorrect: A is incorrect because Parkinson's disease typically has a gradual onset, not abrupt. C is incorrect as tremors in Parkinson's disease are typically voluntary and rhythmic, not involuntary. D is incorrect as bradykinesia, or slowness of movement, is also a common finding in Parkinson's disease, but muscle rigidity is more specific to the disease.

Correct Answer: D

Rationale: The correct answer is D because dopaminergics like carbidopa-levodopa are contraindicated in glaucoma due to their potential to raise intraocular pressure, worsening the condition. This is a critical consideration for the nurse to prevent exacerbation of glaucoma symptoms. Choices A and B are incorrect as carbidopa-levodopa typically does not lead to hypertension or excessive salivation. Choice C is also incorrect as drowsiness is a common side effect of dopaminergics but not the most important consideration in this case.

Correct Answer: C

Rationale: The correct answer is C: Gastrointestinal distress is a common side effect. Rivastigmine is a cholinesterase inhibitor used to treat dementia. Gastrointestinal distress, such as nausea, vomiting, and diarrhea, is a common side effect due to increased cholinergic activity in the GI tract. This information is crucial for the patient and family to monitor and manage these symptoms. Rationale for why the other choices are incorrect: A: Hepatotoxicity and jaundice are not common side effects of rivastigmine. These side effects are more commonly associated with other medications. B: The initial dose of rivastigmine is typically lower, starting at 1.5 mg twice a day to minimize side effects. Starting at 6 mg three times a day would increase the risk of adverse effects. D: Increased appetite and weight gain are not typical side effects of rivastigmine. In fact, weight loss is more commonly reported with this medication.

Correct Answer: B

Rationale: The correct answer is B: Inform the patient that perspiration may be dark and may stain clothing. This is because carbidopa-levodopa can cause dark sweat due to its effect on dopamine levels. This information is crucial for patient education to prevent unnecessary concerns or distress. Choice A is incorrect because high-protein intake can interfere with the absorption of levodopa, leading to reduced effectiveness of the medication. Choice C is incorrect because checking glucose levels with urine testing is not relevant for monitoring the effects of carbidopa-levodopa in Parkinson's disease. Blood glucose monitoring would be more appropriate for diabetes management. Choice D is incorrect because the onset of action for carbidopa-levodopa is typically faster, within hours to days, rather than 4 to 5 days. It is important for the patient to be aware of the potential side effects and expected timeline for symptom improvement.