The nurse is preparing to administer phenytoin to a patient who has a seizure disorder. The patient appears drowsy, and the nurse notes that the last random serum drug level was 18 mcg/mL. What action will the nurse take?

Administer the dose since the patient is not toxic

Contact the provider to discuss decreasing the phenytoin dose

Give the drug and monitor closely for adverse effects

Report drug toxicity to the providers

Answer and Explanation

The Correct Answer is D

A. Administer the dose since the patient is not toxic.

This is not the appropriate action. With a drowsy patient and a high serum phenytoin level, there is a concern for toxicity. Administering the next dose could worsen the toxicity.

B. Contact the provider to discuss decreasing the phenytoin dose.

While adjusting the dose may be a consideration, the immediate action should be to withhold the next dose and report the elevated level to the healthcare provider. The provider can then determine the appropriate course of action.

C. Give the drug and monitor closely for adverse effects.

Giving the drug without further intervention is not appropriate when there are signs of potential toxicity, such as drowsiness. Monitoring alone is not sufficient in this case.

D. Report drug toxicity to the providers.

This is the correct choice. With a drowsy patient and a serum phenytoin level of 18 mcg/mL, which is considered high, reporting the drug toxicity to the healthcare provider is the immediate and appropriate action. The provider can then determine the next steps, such as adjusting the dose or ordering additional tests.

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Correct Answer is B

Explanation

A. Give the child fluids and proceed to the emergency department.
While giving the child fluids is generally important, proceeding to the emergency department without consulting poison control may not be the most appropriate initial action. Poison control can provide specific guidance based on the substance ingested.

B. Call the poison control center and follow directions.
The safest advice for a toddler who has ingested a small amount of household cleaning fluid is to call the poison control center and follow their directions. Poison control centers are staffed with professionals who can provide specific guidance based on the type and amount of the ingested substance. They can advise on the appropriate steps to take, such as whether immediate medical attention is needed or if monitoring at home is sufficient.

C. Administer syrup of ipecac and monitor for vomiting.
The use of syrup of ipecac is no longer recommended as a routine measure for ingested substances. It can have adverse effects and may not be effective for all substances. Consulting poison control for guidance is considered a more appropriate approach.

D. Have the toddler eat bread to absorb the substance.
The ingestion of certain substances may not be effectively addressed by having the toddler eat bread. The specific advice for management should come from poison control, which can provide evidence-based guidance.

A. blood cultures will need to be drawn. B. a biopsy of the stomach will be done. C. a breath test will be performed. D. computerized scanning will identify if H. pylori is present.

Correct Answer is C

Explanation

A. Blood cultures will need to be drawn.

Blood cultures are not typically used for diagnosing H. pylori infection. Instead, specific blood tests, such as serology or antibody tests, may be employed to detect antibodies against H. pylori.

B. A biopsy of the stomach will be done.

While a biopsy may be taken during an upper endoscopy to examine the stomach lining for ulcers and H. pylori infection, it is not the primary method for detecting the presence of H. pylori. The biopsy may be used for confirming the infection and assessing the severity of damage.

C. A breath test will be performed.

This is the correct choice. The breath test is a common and non-invasive method used to detect the presence of H. pylori. The patient drinks a solution containing a substance that H. pylori can break down, and the detection of carbon dioxide in the patient's breath indicates the presence of the bacteria.

D. Computerized scanning will identify if H. pylori is present.

Computerized scanning, such as computed tomography (CT) scans, is not a primary method for detecting H. pylori. Imaging studies are not typically used for H. pylori diagnosis, and the methods mentioned earlier, like breath tests and endoscopy, are more commonly employed.

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The nurse is preparing to administer phenytoin to a patient who has a seizure disorder. The patient appears drowsy, and the nurse notes that the last random serum drug level was 18 mcg/mL. What action will the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A toddler ingests a small amount of household cleaning fluid. What is the safest advice for the nurse to provide the caregiver?

Correct Answer is B

Explanation

A patient is suspected to have peptic ulcer disease from H. pylori. The patient asks the nurse what kind of testing will be done to determine the cause of the peptic ulcer. What will the nurse tell the client?

Correct Answer is C

Explanation

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