The nurse practitioner is assessing an adult patient with a seizure disorder that is well controlled on phenytoin (Dilantin). What new finding indicates that a phenytoin drug level assessment is needed?

Correct Answer: D

Rationale: The correct answer is D because a flat affect and anxiety can indicate potential phenytoin toxicity, which warrants a drug level assessment. Phenytoin toxicity can manifest as neurological symptoms such as mood changes and cognitive impairment. Options A and B are unrelated to phenytoin levels. Option C indicates normal vital signs and is not a specific indicator of phenytoin toxicity.

Correct Answer: B

Rationale: The correct answer is B because it encourages the patient to consider alternative explanations for their symptoms, which is key in cognitive restructuring. By exploring other possible reasons for the vomiting, the patient is guided to challenge their automatic assumption of having a brain tumor. This approach helps the patient to reevaluate their thoughts and beliefs in a more rational manner. Choices A, C, and D are incorrect: A: This response dismisses the patient's concerns without addressing the underlying irrational belief. It does not promote cognitive restructuring. C: While acknowledging the patient's emotions is important, this response does not actively challenge the patient's irrational belief or encourage critical thinking. D: Changing the subject does not address the patient's cognitive distortions and does not facilitate cognitive restructuring.

Correct Answer: A

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Correct Answer: A

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Correct Answer: D

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.