Practice Question
A nurse was caring for a patient.
Answer Choices:
Rationale:
🔹 A. Stevens-Johnson syndrome:
✔️ Phenytoin is an antiepileptic drug known to cause rare but serious adverse effects, including Stevens-Johnson syndrome (SJS), a life-threatening hypersensitivity reaction.
✔️ The presence of itchy, dry, hyperpigmented patches with scratch marks and dried blood on the arms suggests an evolving cutaneous reaction—a potential early sign of SJS.
✔️ SJS often starts with nonspecific flu-like symptoms followed by a painful rash or mucocutaneous lesions and epidermal detachment, so early skin signs warrant concern.
✔️ The phenytoin level is subtherapeutic (6 mcg/mL; normal range 10–20 mcg/mL), meaning it's ineffective and the child is still at risk for toxic adverse effects like SJS, especially in the early months after starting the drug.
🔹 B. Skin rash:
✔️ The skin rash is a hallmark early indicator of SJS, particularly in children recently started on high-risk medications like phenytoin.
✔️ While the cough and wheeze point to asthma, the rash is more specific to phenytoin's adverse effects.
✔️ Stevens-Johnson syndrome may also present with mucosal involvement or systemic symptoms, so a progressing rash must be evaluated urgently.
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This question is from RN ATI Nur 2708 Pediatrics Final Exam which contains 51 questions.
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Question Details
- Category: RN Nursing Exam(s)
- Subcategory: ATI Exam(s)
- Domain: RN ATI Pediatrics
- Answer Choices: 0