Chapter 58, Nursing Management: Chronic Neurologic Problems: Chronic Neurologic Disorders

The nurse should instruct the patient on phenytoin to perform which action to prevent gingival hyperplasia? Visit a dentist annually. Use a firm-bristle toothbrush. Brush the teeth at least twice per day. Rinse with an oral antifungal solution twice per day.

Brush the teeth at least twice per day.

What does the nurse recognize is the highest priority intervention for a patient experiencing status epilepticus? Diazepam IV Phenytoin IV Vecuronium IV Lactated Ringer's IV

Diazepam IV

The caregivers of a patient with acute seizures ask the nurse what they should do if another episode of seizure occurs at home after discharge. What should the nurse tell them? Select all that apply. Ease the patient to the floor. Loosen constrictive clothes. Restrain the patient to a bed. Protect the patient from any injury. Bring the patient to the hospital immediately.

Ease the patient to the floor. Loosen constrictive clothes. Protect the patient from any injury.

A patient is experiencing generalized tonic-clonic seizures due to hypoxia. What should be the immediate nursing interventions provided to the patient? Select all that apply. Administer dextrose Ensure patent airway Administer phenytoin Remove restrictive clothes Force the airway between clenched teeth

Ensure patent airway Remove restrictive clothes

What instructions should a nurse give to a patient who has focal seizures well controlled with phenytoin and who has mild gingival hyperplasia? Select all that apply. The drug should be changed immediately. Regular tooth brushing can limit hyperplasia. Gingival hyperplasia is not related to phenytoin. Surgical repair of gingival tissue will be required. Regular flossing can control gingival tissue growth.

Regular tooth brushing can limit hyperplasia. Regular flossing can control gingival tissue growth.

Which characteristic feature is exclusively seen in a complex focal seizure? Jerking of the limbs Smacking of the lips Loss of consciousness Increased muscle tone

Smacking of the lips

What has been shown to improve mood, sleep, and function in patients with restless leg syndrome? Walking Rocking Yoga Kicking

yoga

A nurse reviews the medical history with a patient and learns that the patient was diagnosed with restless legs syndrome. Based on this fact, which question should the nurse also ask? "Are you able to sleep well and feel rested?" "Do you experience calf pain after walking a block?" "Do you experience episodes where you are unable to move one leg?" "When exposed to cold, do your legs turn pale, then blue, and become painful?"

"Are you able to sleep well and feel rested?"

The nurse is educating a student nurse about how metabolic disturbances cause seizures. Which statements made by the student nurse indicate effective learning? Select all that apply. "Seizures can be caused by a decrease in oxygen levels." "Seizures can be caused by an increase in pH of the blood." "Seizures can be caused by a decrease in pH of the blood." "Seizures can be caused by a decrease in blood glucose levels." "Seizures can be caused by an increase in blood glucose levels."

"Seizures can be caused by a decrease in oxygen levels." "Seizures can be caused by a decrease in pH of the blood." "Seizures can be caused by a decrease in blood glucose levels."

A patient's caregiver asks the nurse how the patient could have developed a tonic-clonic seizure, having no prior history of epilepsy. What would be the nurse's best responses about the precipitating intracranial causes of the tonic-clonic seizure? Select all that apply. "Stroke is an intracranial cause of tonic-clonic seizure." "Septicemia is an intracranial cause of tonic-clonic seizure." "Brain tumor is an intracranial cause of tonic-clonic seizure." "Hypertensive crisis is an intracranial cause of tonic-clonic seizure." "Systemic lupus erythematosus is an intracranial cause of tonic-clonic seizure."

"Stroke is an intracranial cause of tonic-clonic seizure." "Brain tumor is an intracranial cause of tonic-clonic seizure." "Hypertensive crisis is an intracranial cause of tonic-clonic seizure."

A patient developed seizures after a head injury and informs the nurse he or she feels like there has been a loss of control over life since the seizures. Initially, what is the most appropriate response by the nurse? "New treatments come out every year, so don't give up." "Tell me about what you would like to do and how the seizures affect you." "You are young and can still heal from the injury. It has only been a few months." "With medications and your health care provider's assistance, I am sure you will be able to achieve your life goals."

"Tell me about what you would like to do and how the seizures affect you."

A patient with epilepsy who has been taking oral gabapentin was admitted to the emergency department in an unconscious state. The patient is experiencing seizures that are reoccurring in rapid succession. Which treatment option would be beneficial in alleviating the symptoms of the patient? Administer saline intravenously Administer dextrose intravenously Administer diazepam intravenously Administer gabapentin intravenously

Administer diazepam intravenously

The nurse is managing the care of a patient with status epilepticus. Which assessment would be inappropriate, once the event has subsided? Oxygenation Apical heart rate Oral body temperature Respiratory rate and pattern

Apical heart rate

Which type of seizure is characterized by "drop attacks"? Tonic seizure Clonic seizure Atonic seizure Myoclonic seizure

Atonic

A patient is brought to the emergency department by family members The family states that the patient suddenly fell down and became unconscious and the patient's left leg had jerky movements for a few seconds. Which type of seizure should the nurse suspect? Clonic seizure Atonic seizure Focal seizure Absence seizure

Clonic seizure

A bipolar patient is experiencing a major depressive episode. What factors may be contributing to the depressive episode? Select all that apply. Low-fat diet Darkened room Physical activity Chronic disease Ineffective coping Antiseizure medications

Darkened room Chronic disease Ineffective coping Antiseizure medications

The nurse is reviewing the data of a pediatric patient who is admitted in the hospital. Which findings indicate that the patient is suffering from typical absence seizures? Select all that apply. Birth injury Daydreaming Hyperventilation Loss of consciousness Electroencephalogram (EEG) results

Daydreaming Hyperventilation Electroencephalogram (EEG) results

A client has been receiving scheduled doses of topiramate and is now difficult to arouse. What signs of topiramate toxicity should the nurse report immediately? Palpitations Hypotension Seizure activity Difficult to arouse

Difficult to arouse

What instructions should the nurse give to a patient being treated with carbamazepine for seizures? Select all that apply. Do not stop using the drug abruptly. Do not take the drug with grapefruit juice. Notify the health care provider about any vision problems. Ensure adequate fluid intake. Wear protective clothing while exposed to sunlight. Take the medicine along with food. Notify the health care provider if flu-like symptoms occur.

Do not stop using the drug abruptly. Do not take the drug with grapefruit juice. Notify the health care provider about any vision problems.

patient is prescribed carbamazepine for a new-onset seizure disorder. The nurse is educating the patient about this drug. What teaching comment by the nurse is most accurate? Do not take this medication with grapefruit. This medication is given to treat absence and myloclonic seizures. Don't be concerned if any visual disturbances occur while taking this medication. The goal of this medication is to cure your condition and prevent any more seizures.

Do not take this medication with grapefruit.

A patient with a seizure disorder failed to respond to drug therapy. Resection of epileptogenic tissue is performed. What could be the possible diagnosis? Focal seizures Atonic seizures Myoclonic seizures Tonic-clonic seizures

Focal seizures

The nurse is caring for an elderly patient with a brain tumor. The family reports symptoms of headaches, confusion, and altered level of consciousness. Which drugs would be best for this patient? Select all that apply. Primidone Gabapentin Levetiracetam Oxcarbazepine Carbamazepine

Gabapentin Levetiracetam Oxcarbazepine

A patient displays jerky muscle movements of the extremities and is incontinent of bowel and bladder. With what does the nurse recognize these clinical manifestations to be associated? Aura seizures Postictal seizures Generalized seizures Simple partial seizures

Generalized seizures

Which extracranial disorder can cause seizures? Migraine Meningitis Brain tumor Hypertension

HTN

A patient diagnosed with seizures is advised to take phenytoin. About which common side effects of phenytoin should the nurse inform the patient? Select all that apply. Hirsutism Neuropathy Weight gain Memory loss Gingival hyperplasia

Hirsuitism Gingival hyperplasia

The patient with type 1 diabetes mellitus with hypoglycemia is having a seizure. Which medication should the nurse anticipate administering to stop the seizure? IV diazepam IV phenytoin Oral carbamazepine Intravenous (IV) dextrose solution

Intravenous (IV) dextrose solution

What should be the immediate nursing intervention provided to a patient with hypoglycemia who is suspected to have had a seizure? Intravenous administration of saline Intravenous administration of dextrose Intravenous administration of diazepam Intravenous administration of gabapentin

Intravenous administration of dextrose

An elderly patient with impaired liver function is suspected of having sustained a seizure. Which antiseizure drugs are safe for this patient? Select all that apply. Phenytoin Primidone Lamotrigine Gabapentin Carbamazepine

Lamotrigine Gabapentin

A nurse is educating a group of people in a community center about restless legs syndrome (RLS). Which risk factor included in the presentation would be inappropriate? Pregnancy Liver failure Hypertension Iron deficiency

Liver failure

A patient has been receiving scheduled doses of phenytoin and begins to experience diplopia. For what should the nurse immediately assess the patient? An aura or focal seizure Nystagmus or confusion Abdominal pain or cramping Irregular pulse or palpitations

Nystagmus or confusion

A patient with restless legs syndrome (RLS) failed to respond to gabapentin, which was prescribed earlier. What would be the drug of choice? Carbidopa Oxycodone Pramipexole Phenobarbital

Oxycodone

A patient with a history of epilepsy experienced gingival enlargement. Which drug may be causing it? Phenytoin Gabapentin Clonazepam Valproic acid

Phenytoin

Which is the primary drug of choice for tonic-clonic seizures? Phenytoin Gabapentin Clonazepam Ethosuximide

Phenytoin

A patient with head trauma is admitted to the emergency department with continuous muscle contractions and loss of consciousness. Which drugs would be effective for treating this patient? Select all that apply. Phenytoin Zonisamide Clonazepam Ethosuximide Carbamazepine

Phenytoin Carbamazepine

The nurse is managing the care of a patient with a seizure disorder who was admitted for status epilepticus. Which long-acting antiseizure medications would be effective for a patient with status epilepticus? Select all that apply. Phenytoin Diazepam Lorazepam Lamotrigine Phenobarbital

Phenytoin Lamotrigine Phenobarbital

A patient with systemic lupus erythematosus presents to the emergency room with warm skin and pallor. The nurse observes that the patient is lethargic and has an altered level of consciousness. What seizure phase is this patient most likely experiencing? Tonic phase Clonic phase Postictal phase Hypertonic phase

Postictal phase

A patient with focal seizures is prescribed gabapentin. On a follow-up visit, the primary health care provider finds that the medication has been ineffective in controlling the symptoms. The primary health care provider prescribes another antiseizure drug and advises the patient to use it along with gabapentin. What could be the drug prescribed? Tiagabine Pregabalin Topiramate Levetiracetam

Pregabalin

What is the nursing action of highest priority to be taken with a patient who experiences a generalized tonic-clonic seizure? Restraining the arms and legs Controlling head movements Protecting the head and extremities Inserting a tongue blade between the teeth

Protecting the head and extremities

A patient is displaying psychotic behavior related to Alzheimer's disease. What interventions can help the patient cope with this disorder? Select all that apply. Putting the patient to bed Providing a healthy snack Going for a walk in the garden Turning on the patient's favorite music Singing songs and playing musical instruments Redirecting the patient's focus to a different task

Providing a healthy snack Going for a walk in the garden Turning on the patient's favorite music Singing songs and playing musical instruments Redirecting the patient's focus to a different task

A patient with a suspected seizure failed to respond to drug therapy and reports unusual sensations and hallucinations. What could be the effective surgical treatment? Hemispherectomy Vagal nerve stimulation Sectioning of corpus callosum Resection of epileptogenic tissue

Resection of epileptogenic tissue

The nurse is teaching home care measures to the caregiver of a patient with seizures. Which action made by the patient's caregiver during an acute seizure episode indicates the need for additional teaching? Turning the patient to the side Loosening the patient's tight clothing Easing the patient to the floor, if seated Sending the patient to hospital immediately after a single seizure

Sending the patient to hospital immediately after a single seizure

Which type of seizure lasts longer than five minutes and occurs in rapid succession without return to consciousness between seizures? Epilepsy Tonic seizure Absence seizure Status epilepticus

Status epilepticus

A patient was brought to the hospital after a seizure episode. Which characteristic pattern explained by the patient's caregiver would be useful in diagnosing it as tonic-clonic seizure? Stiffening of the body for 20 seconds, followed by jerking of the extremities for 40 seconds Jerking of the extremities for 20 seconds, followed by stiffening of the body for 40 seconds Stiffening of the body for 30 seconds, followed by jerking of the extremities for 10 seconds Jerking of the extremities for 20 seconds, followed by stiffening of the body for 10 seconds

Stiffening of the body for 20 seconds, followed by jerking of the extremities for 40 seconds

A patient with head trauma is being sedated and is on a ventilator in the intensive care unit. What type of seizure might this patient experience? Atonic seizure Myoclonic seizure Subclinical seizure Tonic-clonic seizure

Subclinical seizure

The parent of a child newly diagnosed with a typical absence seizure is concerned. What information should the nurse provide to the parent regarding typical absence seizures? Select all that apply. A seizure is associated with loss of postural tone. The child will usually seem confused after a seizure. The seizures are characterized by brief staring spells. The seizures are usually precipitated by flashing lights. The occurrence of seizures usually subsides during adolescence.

The seizures are characterized by brief staring spells. The seizures are usually precipitated by flashing lights. The occurrence of seizures usually subsides during adolescence.

The nurse admits a young adult patient with epilepsy to the trauma unit following a motor vehicle accident. The patient asks the nurse about the incidence of the condition. What response by the nurse is most appropriate? Females are more likely to develop epilepsy than males. New cases of epilepsy are most common in Hispanic patients. Thirty percent of all epilepsy cases are not attributable to a specific cause. In younger patients, epilepsy is generally caused by some birth injury, infection, trauma, or genetic factor.

Thirty percent of all epilepsy cases are not attributable to a specific cause.

The nurse is caring for a patient who suddenly loses consciousness and then stiffens for about 15 seconds, followed by jerking of the extremities. How does the nurse document this occurrence in the medical record? Focal seizure Tonic-clonic seizure Psychogenic seizure Typical absence seizure

Tonic-clonic seizure

What seizure disorder typically occurs in children and rarely continues beyond adolescence? Focal seizures Tonic-clonic seizures Psychogenic seizures Typical absence seizures

Typical absence seizures