A nurse is preparing to administer lorazepam 1 mg PO to an older adult client who has insomnia and who cannot swallow oral tablets.

Available is lorazepam oral solution 2 mg/mL. How many mL should the nurse plan to administer?
(Round to the nearest tenth. Use a leading zero if it applies.)

Choice A rationale:

Asking “Why don’t you want to take the medication?” can help the nurse understand the client’s concerns or fears about the medication. However, it may come across as confrontational.

Choice B rationale:

Saying “I always do what the doctor tells me to do” does not address the client’s concerns and imposes the nurse’s personal beliefs on the client.

Choice C rationale:

Asking “Tell me more about this decision” is an open-ended question that encourages the client to express their feelings and concerns, allowing the nurse to provide appropriate education and support.

Choice D rationale:

Telling the client “You won’t get better unless you take the medication” is a threatening statement that does not respect the client’s autonomy or feelings.

So, the correct answer is C, “Tell me more about this decision.”.

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.