Nokea
The client is taking phenyton (Dilantin) for seizure control. A sample is drawn to determine the serum drug level, and the nurse reviews the results. Which of the following would indicate a therapeutic serum drug range?
- A. 5 to 10 mcg/ml.
- B. 20 to 30 mcg/ml.
- C. 10 to 20 mcg/ml.
- D. 30 to 40 mcg/ml.
Correct Answer: A
Rationale: The therapeutic serum drug range for phenytoin (Dilantin) is typically considered to be 10 to 20 mcg/ml. However, some sources may cite a broader range of 5 to 20 mcg/ml. Therefore, a serum drug level range of 5 to 10 mcg/ml would fall within the acceptable therapeutic range for phenytoin. Serum levels outside of this range may indicate potential toxicity (above range) or subtherapeutic levels (below range) which could result in inadequate seizure control.
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All the following are true about infant sleep between 2-6 months EXCEPT
- A. total sleep hours are about 14-16 hr/24 hr
- B. sleeps about 9-10 hr concentrated at night
- C. sleeps 2 naps/day
- D. the sleep cycle time is similar to that of adults
Correct Answer: D
Rationale: Infant sleep cycles differ significantly from adult patterns.
The pediatric nurse prepares a patient, who is newly paralyzed, for discharge. The patient will require home care, ancillary therapies, complex medication regimens, and would benefit from a peer support group. To ensure adequate preparation for discharge and transition to home life, the nurse will:
- A. ask the social worker or case manager to organize a care conference.
- B. assess the family for transportation needs.
- C. call the medical supply company to ensure delivery of home care equipment.
- D. contact the patient's school to ensure its readiness to accommodate the patient.
Correct Answer: A
Rationale: Organizing a care conference ensures all aspects of the patient's care are addressed and coordinated effectively.
A 5-year-old girl Hannah is recently diagnosed with Kawasaki disease. Apart from the identified symptoms of the disease, she may also likely develop which of the following?
- A. Sepsis
- B. Meningitis
- C. Mitral valve disease
- D. Aneurysm formation 45
Correct Answer: D
Rationale: Kawasaki disease is an inflammatory condition that primarily affects medium-sized blood vessels, including the coronary arteries. If not promptly and effectively treated, about 25% of untreated cases can lead to the development of coronary artery aneurysms. These aneurysms can increase the risk of serious complications such as myocardial infarction and sudden death. Therefore, it is crucial to closely monitor and manage the cardiovascular complications in patients with Kawasaki disease, particularly the risk of aneurysm formation.
Mrs. Silang, a 52-year old female, is experiencing advanced hepatic cirrhosis now complicated by hepatic encephalopathy. She is confused, restless, and demonstrating asterixis. The nurse has formulated the nursing diagnosis: Altered thought processes related to which of the following?
- A. massive ascites formation
- B. fluid volume excess
- C. increased serum ammonia levels
- D. altered clotting mechanism
Correct Answer: C
Rationale: Hepatic encephalopathy is a neuropsychiatric complication of advanced liver disease, such as cirrhosis, where the liver's ability to metabolize ammonia is impaired. As a result, there is an increase in serum ammonia levels, leading to alterations in brain function and neurotransmission. Symptoms such as confusion, restlessness, and asterixis (flapping tremor) are characteristic of hepatic encephalopathy caused by increased ammonia levels affecting the brain. Therefore, altered thought processes in Mrs. Silang are primarily related to the increased serum ammonia levels rather than other factors like massive ascites formation, fluid volume excess, or altered clotting mechanism.
The physician prescribes glipizide (Glucotrol), an oral antidiabetic agent, for a client with type 2 diabetes mellitus who has been having trouble controlling the blood glucose level through diet and exercise. Which medication instruction should the nurse provide?
- A. "Be sure to take glipizide 30 minutes before meals."
- B. "Glipizide may cause a low serum sodium level, so make sure you have your sodium level checked monthly."
- C. "You won't need to check you blood glucose level after you start taking glipizide."
- D. "Take glipizide after a metal to prevent heartburn."
Correct Answer: A
Rationale: A. "Be sure to take glipizide 30 minutes before meals."