A nurse is preparing to administer phenytoin 50 mg IV bolus to a client Who has a seizure disorder. The medication is supplied as a 50 mg/mL vial. Which of the following actions should the nurse take?

Dilute the medication with sterile water before injecting.

Administer the medication over 1 min.

Follow the IV injection with sterile water.

Slow the injection if the medication crystallizes.

Answer and Explanation

The Correct Answer is B

A.   Diluting phenytoin with sterile water before injecting is not recommended, as phenytoin is incompatible with most used diluents. Diluting it can lead to precipitation and potentially cause adverse effects such as tissue irritation and phlebitis.
B.   Administering the medication over 1 min is recommended. Phenytoin should be administered at a rate of 50mg/min.
C.   Following the IV injection with sterile water is unnecessary and not indicated for administering phenytoin.
D. Phenytoin precipitates out of solution when mixed with certain diluents or when administered too quickly. Crystallized phenytoin can cause local irritation, tissue damage, and potentially more serious adverse effects. Therefore, it should not be administered at all.

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Correct Answer is C

Explanation

Montelukast is a leukotriene receptor antagonist used for the long-term control of asthma. Among the side effects, montelukast causes drowsiness and hence should be taken at night before bed to avoid interference with daily activities.
A. Montelukast is an oral preparation that does not require a spacer unlike inhalers such as salbutamol
B. Montelukast is used controller therapy rather than a reliever in acute asthmatic attack
D. Rinsing the mouth is relevant in the use of inhaled corticosteroids to prevent oral thrush but not montelukast.

A. Infuse the medication at 35 mg/min. B. Infuse the medication with an IV pump. C. Administer a test dose first. D. Cover the IV container with dark paper.

Correct Answer is B

Explanation

Theophylline has a narrow therapeutic window which increase the risk of overdose and toxicity. It is also given at very small doses which could be difficult for the nursing staff to accurately titrate the drops and hence requires an infusion pump
A. Infusion of theophylline loading dose should not exceed 25mg/min due to risk of seizures and cardiac arrhythmias
C. Use of a test dose is not necessary as the risk of hypersensitivity with theophylline is very low.
D. Covering the IV container with dark paper is not necessary for the administration of theophylline.

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A nurse is preparing to administer phenytoin 50 mg IV bolus to a client Who has a seizure disorder. The medication is supplied as a 50 mg/mL vial. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is evaluating teaching on a client Who has a new prescription for montelukast to treat asthma. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is C

Explanation

A nurse in an emergency department is preparing to administer theophylline by continuous intravenous (IV) infusion to a client who is experiencing an asthma attack. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

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