Drugs for Seizures

Understanding Pharmacology Essentials for Medication Safety

Nursing
24
Questions
0
True/False
23
Choices
1
Essay
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Questions

Q1
Free

Which temporary condition is considered a brief but expected response immediately after a person has a seizure?

Multiple Choice
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A) Residual muscle twitches
B) Low blood pressure
C) Unconsciousness
D) Confusion
Answer:
D) Confusion

Explanation:
During seizure activity, especially a generalized seizure, the brain is not well-oxygenated and the person is not aware of his or her surroundings and events. This results in a brief period of confusion once the seizure is over.
Q2
Free

A patient with a seizure disorder tells the nurse about training to participate in a marathon run. What is the most important factor for the nurse to teach the patient at this time?

Multiple Choice
expand_more
A) Your seizure medications prohibit training for this stressful event.
B) During times of increased physical stress you are more likely to have a seizure.
C) Be sure to watch your diet because during training you will need more calories.
D) Start your exercise program slowly and gradually build up your strength.
Answer:
B) During times of increased physical stress you are more likely to have a seizure.

Explanation:
A person with a seizure disorder is more likely to have a seizure during times of increased emotional or physical stress (such as training for a marathon). While watching the diet and pacing the exercise program are important, they are not related to the patients seizure disorder. Most antiseizure drugs do not require the patient to avoid exercise.
Q3
Free

A patient with a seizure disorder asks the nurse why bright spots are always seen before experiencing a seizure. What is the nurses best response?

Multiple Choice
expand_more
A) Some people experience a strange sensation called an aura before each seizure.
B) This is an unusual occurrence. I will notify your prescriber right away.
C) Bright spots before a seizure could indicate pressure in your brain from a tumor.
D) After the seizure do you feel confused, lethargic, and unable to respond to people?
Answer:
A) Some people experience a strange sensation called an aura before each seizure.

Explanation:
Before a seizure, some people experience an aura, which is a strange sensation. It can be an odor, sound, taste, or visual sensation such as bright spots or flashes. It is a common occurrence and not an indicator of tumors or pressure in the brain. Confusion, lethargy, and an inability to respond are common for the postictal phase of a seizure, but asking about these symptoms does not address the patients question.
Q4

Which sign does the nurse expect to see when a patient has an absence seizure?

Multiple Choice
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A) Rigidity of arm and leg muscles
B) Automatisms such as lip smacking
C) Blank staring as if daydreaming
D) One-sided movement of an extremity
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Q5

Which two conditions are possible complications of status epilepticus?

Multiple Choice
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A) Blurred vision and ringing in the ears
B) Muscle paralysis and weakness
C) Brain damage and death
D) Asthma and wheezing
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Q6

Which action is most important for the nurse to perform for a patient during a simple partial seizure?

Multiple Choice
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A) Administering the prescribed antiseizure drug
B) Timing the duration of the seizure
C) Inserting a padded tongue blade
D) Applying oxygen by mask
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Q7

What is the nurses priority intervention for a patient experiencing a tonic-clonic (grand mal) seizure?

Multiple Choice
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A) Place a padded tongue blade in the patients mouth to prevent biting the tongue.
B) Start a saline lock to administer IV anti-seizure medication.
C) Attach pads to the bed side rails to protect the patient from injury.
D) Monitor for and keep the patients airway open.
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Q8

A pediatric patient is prescribed valproic acid (Depacon) 340 mg intravenously. The available drug solution is 500 mg in 5 mL. How many milliliters does the nurse prepare?

Multiple Choice
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A) 1.4
B) 2.4
C) 3.4
D) 4.4
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Q9

A patient who has been prescribed phenytoin (Dilantin) reports gum swelling around the teeth. What is the nurses best action?

Multiple Choice
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A) Tell the patient to document this unexpected change by taking a photograph.
B) Instruct the patient to stop the drug and notify the prescriber immediately.
C) Reassure the patient that this is a common and expected side effect.
D) Remind the patient to brush teeth gently and avoid flossing.
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Q10

A patient who has been taking carbamazepine (Tegretol) for 2 months has all of the following blood laboratory results. Which result does the nurse report to the prescriber immediately?

Multiple Choice
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A) White blood cell (WBC) count 2200/mm3
B) Platelet count 300,000/mm3
C) Potassium 3.6 mEq/L
D) Sodium 132 mEq/L
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Q11

Which question is most important for the nurse to ask a patient who is prescribed phenytoin (Dilantin) before administering the first dose?

Multiple Choice
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A) Do you drink coffee or other caffeinated beverages?
B) Have you ever had high blood pressure?
C) How many seizures do you have daily?
D) What other drugs do you take daily?
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Q12

Which precaution is most important for the nurse to teach a patient who is prescribed any of the first-line drugs for generalized seizures?

Multiple Choice
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A) Avoid drinking alcoholic beverages.
B) Take the drug with food or a snack.
C) Engage in regular exercise daily.
D) See your dentist twice a year.
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Q13

What is the priority safety measure for the nurse to implement when a patient has been started on carbamazepine (Tegretol)?

Multiple Choice
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A) Ask the patient about symptoms of nausea and vomiting.
B) Monitor for and manage seizure activity.
C) Assist the patient when getting out of bed.
D) Always give this drug with food.
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Q14

A female patient with a seizure disorder who is taking birth control pills is prescribed valproic acid (Depakote). What must the nurse be sure to include in this patients teaching plan?

Multiple Choice
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A) Do not drive a car until you know how this drug will affect you.
B) Be sure to change positions slowly when getting out of bed.
C) Avoid consumption of grapefruit or grapefruit juice.
D) Plan to use another form of contraception.
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Q15

A patient who has been prescribed ethosuximide (Zarontin) twice daily (every 12 hours) for absence seizures reports that the morning dose was missed 10 hours ago. What is the nurses best advice?

Multiple Choice
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A) Skip todays second dose as well as the dose you already missed.
B) Take the missed dose now and the regularly scheduled dose in 2 hours.
C) Take the missed dose and the regularly scheduled second dose immediately.
D) Take the regularly scheduled second dose now and forget about the morning dose.
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Q16

A patient who has been prescribed ethosuximide (Zarontin) tells the nurse about experiencing an upset stomach after each dose of the drug. What is the nurses best action?

Multiple Choice
expand_more
A) Administer a dose of an antinausea drug.
B) Instruct the patient to take the drug with a full glass of water.
C) Give the drug with meals or a snack.
D) Elevate the head of the bed to avoid aspiration.
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Q17

What does the nurse plan to teach a patient who is prescribed ethosuximide (Zarontin) about going out of doors?

Multiple Choice
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A) Move slowly to avoid dizziness.
B) Wear dark glasses when the sun is bright.
C) Be sure to wear long sleeves and a broad-brimmed hat.
D) Apply a strong sunscreen whenever you will be exposed to sunlight.
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Q18

Which second-line drug for seizures has a risk for dependence?

Multiple Choice
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A) Clonazepam (Klonopin)
B) Phenobarbital (Luminal)
C) Gabapentin (Neurontin)
D) Lamotrigine (Lamictal)
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Q19

A patient is prescribed lamotrigine for seizure control. The drug received from the pharmacy is Lamisil. What is the nurses best action?

Multiple Choice
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A) Administer the drug as prescribed.
B) Hold the dose and call the pharmacy immediately.
C) Ask the patient whether he or she recognizes the tablet.
D) Notify the prescriber that the usual brand of lamotrigine is not available.
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Q20

Which assessment question is most important for the nurse to ask a patient who is prescribed clonazepam (Klonopin) before administering the first dose?

Multiple Choice
expand_more
A) Do you smoke cigarettes?
B) How many seizures do you have daily?
C) Have you ever had high blood pressure?
D) Do you currently have an open sore or signs of an infection?
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Q21

A patient who has been prescribed primidone (Mysoline) also takes warfarin (Coumadin). Which laboratory blood test results indicate to the nurse a possible drug interaction?

Multiple Choice
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A) Hematocrit 32%
B) Hemoglobin 11.2 g/dL
C) Blood urea nitrogen (BUN) 21 mg/dL
D) International normalized ratio (INR) 0.5
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Q22

A patient who is prescribed gabapentin (Neurontin) for seizures is also taking aluminum hydroxide (Amphojel) for indigestion. What does the nurse caution the patient about taking these two drugs?

Multiple Choice
expand_more
A) Take the gabapentin one hour after the aluminum hydroxide.
B) Schedule at least 2 hours between taking the gabapentin and the aluminum hydroxide.
C) Take these two drugs together for the best action of both drugs to occur.
D) You may need to take a different antacid to avoid affecting the action of gabapentin.
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Q23

A patient who is prescribed gabapentin (Neurontin) is also taking morphine sulfate for severe pain. What dosage adjustment does the nurse expect?

Multiple Choice
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A) Decreased dosage of gabapentin
B) Increased dosage of gabapentin
C) Decreased dosage of morphine
D) Increased dosage of morphine
Answer:

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Q24

[Multiple Response] Which factors are among the most common causes of seizures in adults? (Select all that apply.)
a. Emotional distress
b. Head injury
c. Stroke
d. Tumors
e. Lack of sleep

Essay
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