A nurse is preparing to administer lorazepam 2 mg PO. Available is lorazepam 1 mg tablets.

How many tablets should the nurse administer?
(Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Choice A rationale:

Switching brands of phenytoin can lead to variations in drug absorption and serum drug levels, potentially leading to a loss of seizure control or toxicity. Therefore, this is not a correct instruction.

Choice B rationale:

Altering the phenytoin administration regimen each week can lead to fluctuations in serum drug levels, potentially leading to a loss of seizure control or toxicity. Therefore, this is not a correct instruction.

Choice C rationale:

Phenytoin does not turn urine blue. This is a side effect associated with some other medications, but not phenytoin. Therefore, this is not a correct instruction.

Choice D rationale:

Alcohol can increase serum phenytoin levels, potentially leading to toxicity. Therefore, this is a correct instruction.

So, the correct answer is D. Alcohol increases the chance of phenytoin toxicity.

Choice A rationale:

Pseudoparkinsonism mimics the symptoms of Parkinson’s disease but is not typically characterized by choreiform movements, lip smacking, and spastic facial distortions.

Choice B rationale:

Tardive dyskinesia, a potential side effect of long-term use of chlorpromazine, is characterized by involuntary movements such as lip smacking and facial distortions.

Choice C rationale:

Akathisia is characterized by a sense of restlessness and a compulsion to move, not typically by the symptoms described.

Choice D rationale:

Dystonia involves involuntary muscle contractions and distortions but not typically the specific symptoms described.

So, the correct answer is B.