Exam 3: Seizures (NCLEX)
Which drug used in the treatment of seizures requires careful monitoring of renal function? A. Lamotrigine (Lamictal) B. Primidone (Mysoline) C. Carbamazepine (Tegretol) D. Valproic acid (Depakene)
C
The nurse is creating a plan of care for a child who is at risk for seizures. Which interventions apply if the child has a seizure? Select all that apply. 1. Time the seizure. 2. Restrain the child. 3. Stay with the child. 4. Place the child in a prone position. 5. Move furniture away from the child. 6. Insert a padded tongue blade in the child's mouth.
135
A client is having a seizure. Which nursing intervention is of immediate importance? A.Administering medication B.Maintaining the airway C.Placing a padded tongue blade in the client's mouth D.Intubating the client
B
a nurse is completing discharge teaching to a client who has seizures and received a vagal nerves stimulator to decrease seizure activity. which of the following statements should the nurse include in the teaching? A. it is safe to use microwave that are 1200 watts or less B. you should avoid the use of CT scans with contrast C. you should place a magnet over the implantable device when you feel an aura occurring D. it is recommended that you use ultrasound diathermy for pain management
C
A patient taking phenytoin (Dilantin) has started attending college and reports frequently drinking alcohol with friends. What does the nurse monitor for in this patient? A. Clinical manifestations of phenytoin toxicity B. Hyperglycemia C. Hypertension D. Increased seizure activity
D
A client asks the nurse what might trigger a seizure. Which situation should the nurse include in the response? A.Exposure to toxins B.Decreased intracranial pressure C.Low body temperature D.Low blood pressure
A
A patient has been started on lamotrigine (Lamictal). How does the nurse instruct this patient to take the medication to decrease the incidence of gastric irritation? A. With milk or food B. Between meals with a glass of orange juice C. At bedtime D. One hour before meals or 2 hours after meals
A
Which antiepileptic drug is effective for almost all forms of seizures? A. Valproic acid (Depakene) B. Carbamazepine (Tegretol) C. Phenobarbital (Luminal) D. Phenytoin (Dilantin)
A
A 50-year-old client with a newly diagnosed seizure disorder is depressed because they are not allowed to drive and have lost their independence. Which question should the nurse ask to support the client? (Select all that apply.) A."What does being able to drive mean to you?" B."How is not being able to drive affecting you?" C."Who is supporting you during this transition?" D."Do you have someone who can drive you to appointments?" E."What kind of alternate transportation are you using?"
ABCE
The nurse is teaching a client about possible seizure triggers. Which information should the nurse include? (Select all that apply.) A.Specific odors B.Flashing lights C.Menstruation D.Lactose consumption E.Fever
ABCE
During the postictal period of a seizure, you would expect the patient to A. demonstrate minor jerking and eye fluttering. B. sleep for several hours. C. be incontinent of urine and feces. D. require ventilator assistance.
B
The nurse provides information to the caregiver of a 68-year-old man with epilepsy who has tonic-clonic seizures. Which statement, if made by the caregiver, requires further teaching? A. "It is normal for a person to be sleepy after a seizure." B. "I should call 911 if breathing stops during the seizure." C. "The jerking movements may last for 30 to 40 seconds." D. "Objects should not be placed in the mouth during a seizure."
B
Which characteristic of a patient's recent seizure indicates a partial seizure? A. The patient lost consciousness during the seizure. B. The seizure involved lipsmacking and repetitive movements. C. The patient fell to the ground and became stiff for 20 seconds. D. The etiology of the seizure involved both sides of the patient's brain.
B
Which measurement is the best indicator of how well an antiseizure medication is working? A. Serum drug levels B. Frequency and duration of seizures C. Liver enzymes D. Urinary output
B
Which assessment data should the nurse obtain when completing a health history on a client with a seizure disorder? A.Vital signs B.Level of consciousness C.Neurologic exam D.Presence of auras
D
The nurse is providing instructions to a client with a seizure disorder who will be taking phenytoin (Dilantin). Which statement, if made by the client, would indicate an understanding of the information about this medication? 1."I need to perform good oral hygiene, including flossing and brushing my teeth." 2."I should try to avoid alcohol, but if I'm not able to, I can drink alcohol in moderation." 3."I should take my medication before coming to the laboratory to have a blood level drawn." 4."I should monitor for side effects and adjust my medication dose depending on how severe the side effects are."
1
Medication has been ineffective in controlling a client's seizures. Which treatment option should the nurse suspect will be discussed with the client? A.Surgical resection B.Herbal remedies C.More sleep D.Head massage
A
The nurse is caring for a client with a seizure disorder currently controlled with antiseizure medication. The client states, "A friend recommended an herbal supplement for my depression. Can I take it?" Which response by the nurse is correct? A."St. John's wort has been known to decrease the effectiveness of your antiseizure medication." B."You can take valerian along with your antiseizure medication to help you sleep." C."You should avoid garlic, because it can decrease the effectiveness of your antiseizure medication." D."Essential oils would be a better option with your antiseizure medication."
A
Which action will the nurse take when evaluating a patient who is taking phenytoin (Dilantin) for adverse effects of the medication? a. Inspect the oral mucosa. b. Listen to the lung sounds. c. Auscultate the bowel tones. d. Check pupil reaction to light.
A
You recognize that status epilepticus is a medical emergency because A. seizures continue without a return of consciousness. B. fractures of a limb may occur. C. urinary fecal incontinence may occur. D. heart rate becomes bradycardic.
A
a nurse is caring for a client who just experienced a generalized seizure. which of the following actions should the nurse perform first? A.keep the client in a side lying position B.document the duration of the seizure C.reorient the client to the environment D.provide client hygiene
A
a nurse is assessing a client who has seizure disorder. the client reports he thinks he is out to have a seizure. which of the following actions should the nurse implement (select all that apply) A. provide privacy B. ease the client to the floor if standing C. move furniture away from the client D. loosen the clients clothing E. protect the clients head with padding F. restrain the client
ABCDE
A client reports that they usually have a seizure on the first day of their period. Which response by the nurse is correct? A."Having your period has no relationship to your seizures." B."Menstruation is a common trigger for seizures." C."What makes you think having your period is related?" D."Females who have a lot of menstrual cramps often have seizure activity."
B
The client, age 8, is prescribed valproic acid (Depokene) for treatment of a seizure disorder. The nurse should monitor the client closely for: A.Vitamin B deficiency. B. Restlessness and agitation. C. Hyperthermia. D. Respiratory distress
B
The patient has been receiving scheduled doses of phenytoin (Dilantin) and begins to experience diplopia. You immediately assess the patient for A. an aura. B. nystagmus or confusion. C. abdominal pain or cramping. D. irregular pulse or palpitations
B
The patient is seen in the clinic due to an increase in the frequency of seizure activity. In addition to a thorough health history you should draw blood for A. anemia. B. serum drug levels. C. arterial blood gases. D. electrolytes.
B
When the home health RN is planning care for a patient with a seizure disorder, which nursing action can be delegated to an LPN/LVN? a. Make referrals to appropriate community agencies. b. Place medications in the home medication organizer. c. Teach the patient and family how to manage seizures. d. Assess for use of medications that may precipitate seizures.
B
the nurse is caring for a client who begins to experience seizure activity while in bed. which action by the nurse is contraindicated? A. loosening restrictive clothing B. restraining the clients limbs C. removing the pillow and raising padded side rails D. positioning the client to the side, if possible, with the head flexed forward
B
A nurse is providing discharge instructions to a female client who has a prescription for phenytoin. which of the following information should the nurse include? A.consider taking oral contraceptives when on this medication B.watch for receding gums when taking this medication C.take the medication at the same time everyday D.provide a urine sample to determine therapeutic levels f the medication
C
A patient taking phenytoin (Dilantin) and isoniazid reports feeling lethargic. Nystagmus is noted on physical examination. What problem does this information suggest to the nurse? A. Tubercular reactivation B. Abrupt discontinuation of isoniazid C. Phenytoin toxicity D. Liver damage
C
A patient with diabetes is started on phenytoin (Dilantin) for partial seizures. What does the nurse closely monitor in this individual? A. Blood pressure B. Hypoglycemia C. Hyperglycemia D. Weight loss
C
A client's husband asks, "What should I do if my wife has a seizure to keep her safe?" Which response by the nurse is correct? A."Monitor your wife's blood pressure." B."Restrain your wife." C."Place your wife in the side-lying position." D."Insert a padded tongue blade in your wife's mouth."
C
The nurse completes a history and physical on a client admitted with exacerbation of a seizure disorder. What datum collected by the nurse requires intervention? A.History of asthma B. History of diabetes mellitus C. Use of herb Ginkgo biloba D. Use of aspirin daily
C
The nurse is conducting a home visit for a 6-year-old client who has myoclonic and absence seizures. The parents are following a ketogenic diet for the child. Which observation requires follow-up by the nurse? A.Parents administer medium-chain-triglyceride (MCT) oil as needed. B.Parents include low carbohydrate foods. C.Parents include low-fat foods for each meal. D.Parents monitor urine ketone levels regularly.
C
Which complementary health approach may be specifically tailored to assist in the identification of the warning signs of seizures? A.Behavior modification B.Massage C.Biofeedback D.Meditation
C
A male client is having a tonic-clonic seizures. What should the nurse do first? a. Elevate the head of the bed. b. Restrain the client's arms and legs. c. Place a tongue blade in the client's mouth. d. Take measures to prevent injury
D
A patient has a tonic-clonic seizure while the nurse is in the patient's room. Which action should the nurse take? a. Insert an oral airway during the seizure to maintain a patent airway. b. Restrain the patient's arms and legs to prevent injury during the seizure. c. Avoid touching the patient to prevent further nervous system stimulation. d. Time and observe and record the details of the seizure and postictal state.
D
An elementary teacher who has just been diagnosed with epilepsy after having a generalized tonic-clonic seizure tells the nurse, "I cannot teach anymore, it will be too upsetting if I have a seizure at work." Which response by the nurse is best? a. "You may want to contact the Epilepsy Foundation for assistance." b. "You might benefit from some psychologic counseling at this time." c. "The Department of Vocational Rehabilitation can help with work retraining." d. "Most patients with epilepsy are well controlled with antiseizure medications."
D
A client's mother asks the nurse if there is anything non-pharmacologic that her daughter can do to help with intractable seizures. Which response by the nurse is correct? A."Taking megadoses of vitamins might be worth a try." B."Eating a vegetarian diet has been proven to be successful." C."Taking in extra sugar on a regular basis could be helpful." D."Eating a ketogenic diet can be helpful."
D
The nurse giving discharge teaching for a client receiving carbamazepine (Tegretol) should include: A. Monitor blood glucose, and report decreased levels. B. Expect a discoloration of the contact lenses. C. Expect an orange discoloration of urine. D. Report unusual bleeding or bruises to the health care provider immediately.
D
Which of these prescribed interventions will the nurse implement first for a hospitalized patient who is experiencing continuous tonic-clonic seizures? a. Give phenytoin (Dilantin) 100 mg IV. b. Monitor level of consciousness (LOC). c. Obtain computed tomography (CT) scan. d. Administer lorazepam (Ativan) 4 mg IV.
D
The nurse is instituting seizure precautions for a client who is being admitted from the emergency department. Which measures should the nurse include in planning for the client's safety? Select all that apply. 1. Padding the side rails of the bed 2. Placing an airway at the bedside 3. Placing the bed in the high position 4. Putting a padded tongue blade at the head of the bed 5. Placing oxygen and suction equipment at the bedside 6. Flushing the intravenous catheter to ensure that the site is patent
1256
The nurse is caring for a client who begins to experience seizure activity while in bed. Which actions should the nurse take?Select all that apply. 1. Loosening restrictive clothing 2. Restraining the client's limbs 3. Removing the pillow and raising padded side rails 4. Positioning the client to the side, if possible, with the head flexed forward 5. Keeping the curtain around the client and the room door open so when help arrives they can quickly enter to assist
134
The nurse is caring for a child who had a seizure 15 minutes after sustaining a head injury. After assuring a patent airway, which of the following is the priority intervention? 1 Assess fluid and electrolyte status 2 Administer prescribed benzodiazepine 3 Monitor for postconcussive syndrome 4 Observe for signs of increased intracranial pressure
2
The nurse is planning discharge teaching for a 30-year-old female client who was newly diagnosed with tonic-clonic seizures. Which information should the nurse include in this teaching plan? (Select all that apply.) A.Wearing a bracelet that provides health information B.Avoiding driving while taking antiseizure medication C.Keeping a padded tongue blade at home in case of a seizure D.Taking showers rather than tub baths E.Monitoring the menstrual cycle
ABDE
the nurse is planning to institute seizure precautions for a client who is being admitted from the emergency department. which measures should the nurse include in planning care for the client's safety? Select all that apply A. padding the side rails of the bed B. placing an airway at the bedside C. placing the bed in the high position D. putting a padded tongue blade at the head of the bed E. placing oxygen and suction equipment at the bed side F. having intravenous equipment ready for insertion of an intravenous catheter
ABEF
The nurse is admitting a client with a history of frequent tonic-clonic seizures. Which information would be most valuable for the nurse to obtain when performing the health history assessment? (Select all that apply.) A.Presence of auras B.Incontinence during seizure C.Triggers for seizures D.Age of seizure onset E.Duration of seizures
ACD
When preparing to admit a patient who has been treated for status epilepticus in the emergency department, which equipment should the nurse have available in the room (select all that apply)? a. Siderail pads b. Tongue blade c. Oxygen mask d. Suction tubing e. Nasogastric tube
ACD
The nurse is administering an oral antiseizure medication to an adult client. Which intervention should the nurse implement when administering this medication? (Select all that apply.) A.Monitoring the client for seizure activity B.Monitoring oxygen levels C.Assessing the client for slurred speech D.Administering antiseizure medication 2 hours after antacids are administered E.Asking the client for a list of home medications
ACE
The nurse creates a plan of care for a child at risk for tonic-clonic seizures. In the plan of care, the nurse identifies seizure precautions and documents that which item(s) need to be placed at the child's bedside? 1. Emergency cart 2. Tracheotomy set 3. Padded tongue blade 4. Suctioning equipment and oxygen
4
The nurse should question the use of barbiturates for the treatment of seizure activity if prescribed for which of the following clients? A. 30-year-old pregnant female B. 24-year-old male with new diagnosis of seizures C. 55-year-old female with history of diabetes mellitus D. 45-year-old male with history of hypertension
A
The nurse witnesses a patient with a seizure disorder as the patient suddenly jerks the arms and legs, falls to the floor, and regains consciousness immediately. It will be most important for the nurse to a. assess the patient for a possible head injury. b. give the scheduled dose of divalproex (Depakote). c. document the timing and description of the seizure. d. notify the patient's health care provider about the seizure.
A
The patient with type 1 diabetes mellitus with hypoglycemia is having a seizure. Which medication should the nurse anticipate administering to stop the seizure? A. IV dextrose solution B. IV diazepam (Valium) C. IV phenytoin (Dilantin) D. Oral carbamazepine (Tegretol)
A
a nurse is reviewing trigger factos that can cause seizures with a client who has na new diagnosis of generalized seizures. which of the following information should the nurse include in this review? (select all that apply) A. avoid overwhelming fatigue B. remove caffeinated products from the diet C. limit looking at flashing lights D. perform aerobic exercise E. limit episodes of hypoventilation F. use of aerosol hairspray is recommended
ABC
Client is having tonic-clonic seizure. Nurse should take which of the following actions? SELECT ALL THAT APPLY A.Restrain client B.Maintain airway. C.Turn client to side. D.Place tongue blade in mouth E.Protect client from injury.
BCE
A client receiving phenytoin (Dilantin) has been experiencing fluctuating serum blood levels of the medication. Development of which symptoms in the client should prompt the nurse to notify the primary health care provider immediately? (Select all that apply.) A. GI cramping and diarrhea B. Migraine headaches and nausea C. Dry skin and constipation D. Double vision and lethargy
BD
In which patient is carbamazepine (Tegretol) contraindicated? A. Patient with new onset of seizures B. Patient with an ulcer C. Patient with chronic hepatitis B D. Patient with diabetes mellitus
C
Treatment of status epilepticus requires initiation of a rapid-acting antiseizure drug that can be given intravenously. You would anticipate which drugs to be administered (select all that apply)? A. phenytoin (Dilantin) B. phenobarbital C. lorazepam (Ativan) D. diazepam (Valium) E. carbemazepine (Tegretol)
CD
A 6-year-old child is seen in the urgent care unit for a history of seizures at home. He begins to have seizures in the urgent care unit that last more than 5 minutes. IV access has not been successful. The nurse caring for this child is knowledgeable that either of these medications may be given to stop the child's seizures: a. IM phenytoin b. Rectal diazepam c. Buccal midazolam d. a and c e. b and c
E
