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Question 1 of 5

The physician has ordered Dilantin (phenytoin) 100 mg intravenously for a client with generalized tonic clonic seizures. The nurse should administer the medication:

Correct Answer: C

Rationale: Phenytoin must be administered slowly (over 2-3 minutes) to prevent cardiovascular complications like hypotension or arrhythmias. It should not be mixed with dextrose or given rapidly.

Question 2 of 5

During discharge planning, parents of a child with rheumatic fever should be able to identify which of the following as toxic symptoms of sodium salicylate?

Correct Answer: A

Rationale: These are toxic symptoms of sodium salicylate. (B, C,
D) These are not symptoms associated with sodium salicylate.

Question 3 of 5

A 60-year-old woman exhibits forgetfulness, emotional lability, confusion, and decreased concentration. She has been unable to perform activities of daily living without assistance. After a thorough medical evaluation, a diagnosis of Alzheimer's disease was made. An appropriate nursing intervention to decrease the anxiety of this client would include:

Correct Answer: A

Rationale: This answer is correct. The more the client is able to control her daily routine, the less anxiety she will experience. This answer is incorrect. Confrontation tends to increase anxiety. This answer is incorrect. Reality testing is an assessment tool. It does not decrease anxiety. This answer is incorrect. A highly stimulating environment increases distractibility and anxiety.

Question 4 of 5

The surgical nurse is preparing a patient for surgery on the lower abdomen. In which position would the nurse most likely place the client for surgery on this area?

Correct Answer: A

Rationale: The lithotomy position is used for lower abdominal surgeries (e.g., gynecologic procedures) to provide access to the pelvic area. Sim's (
B) is for rectal exams, prone (
C) for back surgeries, and Trendelenburg (
D) for shock or upper abdominal access.

Question 5 of 5

The nurse who is caring for a client with cancer notes a WBC of 500/mm3 on the laboratory results. Which intervention would be most appropriate to include in the client's plan of care?

Correct Answer: B

Rationale: A WBC of 500/mm3 indicates severe neutropenia, increasing infection risk. Avoiding crowds and sick people (
B) is critical. Hypothermia (
A) is not a primary concern, soft toothbrush (
C) prevents bleeding, and bleeding (
D) is for thrombocytopenia.

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