A nurse is preparing to administer phenytoin 75 mg PO. Available is phenytoin suspension 25 mg/5 mL. How many mL should the nurse administer? (Round the answer to the nearest whole number.

Use a leading zero if it applies.

Do not use a trailing zero.

Choice A rationale:

1 cup (8oz) plain low-fat yogurt. This is incorrect choice. Yogurt is a high-protein food that can increase nausea and reduce the absorption of levodopa/carbidopa. According to the American Parkinson Disease Association, taking levodopa/carbidopa with a small, low-protein snack can help with nausea symptoms.

Choice B rationale:

1 cup (8oz) of applesauce. This is a correct choice. Applesauce is a low-protein, low-fiber food that can help reduce nausea and improve the absorption of levodopa/carbidopa. According to Drugs.com, taking levodopa/carbidopa with foods that have a high fiber content can delay the drug’s absorption into the body. Applesauce also contains natural sugars that can provide some energy and hydration to the client.

Choice C rationale:

1 cup (8 oz) cooked spinach. This is an incorrect choice. Spinach is a high-protein, high-fiber food that can increase nausea and decrease the absorption of levodopa/carbidopa. According to the Parkinson’s Foundation3, dietary protein can interfere with the absorption of levodopa by competing with the same transporter in the gut and the brain. High-fiber foods can also slow down the gastric emptying and reduce the drug’s availability.

Choice D rationale:

1 oz of cheddar cheese. This is an incorrect choice. Cheese is a high-protein, high-fat food that can increase nausea and decrease the absorption of levodopa/carbidopa. According to the Parkinson’s Foundation, dietary protein can interfere with the absorption of levodopa by competing with the same transporter in the gut and the brain. High-fat foods can also delay the gastric emptying and reduce the drug’s availability.

The correct answer is choice C. Apply gentle pressure with a finger to the tragus of the ear.

Choice A rationale:

Chilling the medication prior to administration is not recommended. Cold ear drops can cause dizziness or discomfort when instilled into the ear. It is generally advised to warm the drops to body temperature by holding the bottle in your hands for a few minutes before administration.

Choice B rationale:

Holding the dropper against the ear canal while instilling the medication is incorrect. The dropper should be held above the ear canal to avoid contamination and injury. Touching the dropper to the ear canal can introduce bacteria and cause infection.

Choice C rationale:

Applying gentle pressure with a finger to the tragus of the ear helps to facilitate the flow of the medication into the ear canal. This action helps to ensure that the medication reaches the affected area effectively.

Choice D rationale:

Straightening the external auditory canal by pulling it down and back is incorrect for adults. For adults, the correct method is to pull the ear up and back to straighten the ear canal. Pulling it down and back is the method used for children.