Seizure Multiple Choice Questions, Chapter 58 - Neuro

Seizure Multiple Choice Questions, Chapter 58 - Neuro Problems Leave the first rating Students also studied Terms in this set (47) Science Medicine Save Seizures NCLEX 12 terms murkacatPreview Seizures - NCLEX 20 terms ccrox96Preview Seizure Multiple Choice Questions 11 terms chelsea_braddy Preview CNRN 235 term MM Gabapentin (along with several other anti-seizure

medications) is characterized by:

• High potential for abuse
• High potential for teratogenicity
• High frequency of off-label prescriptions
• High price
• High frequency of off-label prescriptions

In addition to treating seizures, topiramate is FDA- approved for

• Migraine prevention
• Treating shingles pain
• Treating depression
• Antihypertensive therapy
• Treating benign prostate hypertrophy
• Migraine prevention

Levatiracetam (Keppra) is primarily an

• Anti-seizure medication
• Anti-Parkinson's medication
• Anxiolytic / sedative medication
• Antihypertensive medication
• Anti-seizure medication

Phenytoin (along with several other anti-seizure

medications) is characterized by:

• High potential for abuse
• High potential for teratogenicity
• High therapeutic index
• High frequency of off-label prescriptions
• High price
• High potential for teratogenicity

Phenytoin is used primarily to treat

• Asthma
• Anxiety
• Hypertension
• Incontinence
• Parkinson's disease
• Seizures
• Seizures

A nurse is caring for a client who is taking phenytoin (Dilantin) for control of seizures. During data collection, the nurse notes that the client is taking birth control pills.Which of the following information should the nurse provide to the client?

• Pregnancy should be avoided while taking phenytoin

(Dilantin).

• The client may stop taking the phenytoin (Dilantin) if it

is causing severe gastrointestinal effects.

• The potential for decreased effectiveness of the birth

control pills exists while taking phenytoin (Dilantin).

• The increased risk of thrombophlebitis exists while

taking phenytoin (Dilantin) and birth control pills together.1

• Which is not true of maintenance therapy with

antiepileptic drugs?

• Treatment is continued until the patient has been

seizure free for 2-3 years

• Barbiturates, sodium valproate and phenytoin are liver

enzyme inhibitors

• It is important that the person strictly adheres to the

dosage

• Antiepileptic drugs are ideally administered

parenterally

• Barbiturates, sodium valproate and phenytoin are liver enzyme inhibitors.

These drugs are liver enzyme inducers and thus they may be implicated in drug interactions.

Adverse effects of antiepileptic drugs commonly include:

• hyperactivity and aggression
• CNS depression
• cardiovascular and respiratory stimulation
• hepatotoxicity.
• CNS depression

Antiepileptics are by their mechanism of action CNS depressants.How do generalized seizures differ from focal seizures?

• Focal seizures are confined to one side of the brain

and remain focal in nature.

• Generalized seizures result in loss of consciousness

whereas focal seizures do not.

• Generalized seizures result in temporary residual

deficits during the postictal phase.

• Generalized seizures have bilateral synchronous

epileptic discharges affecting the whole brain at onset of the seizure

• Generalized seizures have bilateral synchronous epileptic discharge affecting

the entire brain at onset of the seizure. Loss of consciousness is also characteristic but many focal seizures also include an altered consciousness. Focal seizures begin in one side of the brain but may spread to involve the entire brain. Focal seizures that start with a local focus and spread to the entire brain, causing a secondary generalized seizure, are associated with a transient residual neurologic deficit postictally known as Todd's paralysis.

Which type of seizure occurs in children, is also known as a petit mal seizure, and consists of a staring spell that lasts for a few seconds?

• Atonic
• Simple focal
• Typical absence
• Atypical absence
• The typical absence seizure is also known as petit mal and the child has staring

spells that last for a few seconds. Atonic seizures occur when the patient falls from loss of muscle tone accompanied by brief unconsciousness. Simple focal seizures have focal motor, sensory, or autonomic symptoms related to the area of the brain involved without loss of consciousness. Staring spells in atypical absence seizures last longer than those in typical absence seizures and are accompanied by peculiar behavior during the seizure or confusion after the seizure.The patient is diagnosed with complex focal seizures.Which characteristics are related to complex focal seizures (select all that apply)?

• Formerly known as grand mal seizure
• Often accompanied by incontinence or tongue or

cheek biting

• Psychomotor seizures with repetitive behaviors and lip

smacking

• Altered memory, sexual sensations, and distortions of

visual or auditory sensations

• Loss of consciousness and stiffening of the body with

subsequent jerking of extremities

• Often involves behavioral, emotional, and cognitive

functions with altered consciousness c, d, f. Complex focal seizures are psychomotor seizures with automatisms such as lip smacking. They cause altered consciousness or loss of consciousness producing a dreamlike state and may involve behavioral, emotional, or cognitive experiences without memory of what was done during the seizure. In generalized tonic-clonic seizures (previously known as grand mal seizures) there is loss of consciousness and stiffening of the body with subsequent jerking of extremities.Incontinence or tongue or cheek biting may also occur.Chapter 59: Nursing Management: Chronic Neurologic Problems Chapter 59: Nursing Management: Chronic Neurologic Problems Test Bank

MULTIPLE CHOICE

• The nurse determines that teaching about management

of migraine headaches has been effective when the patient says which of the following?

• "I can take the (Topamax) as soon as a headache

starts."

• "A glass of wine might help me relax and prevent a

headache."

• "I will lie down someplace dark and quiet when the

headaches begin."

• "I should avoid taking aspirin and sumatriptan (Imitrex)

at the same time."

ANS: C

It is recommended that the patient with a migraine rest in a dark, quiet area.Topiramate (Topamax) is used to prevent migraines and must be taken for several months to determine effectiveness. Aspirin or other nonsteroidal antiinflammatory medications can be taken with the triptans. Alcohol may precipitate migraine headaches.DIF: Cognitive Level: Apply (application) REF: 1416 | 1419 TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity

• The nurse will assess a 67-year-old patient who is

experiencing a cluster headache for

• nuchal rigidity.
• unilateral ptosis.
• projectile vomiting.
• throbbing, bilateral facial pain.

ANS: B

Unilateral eye edema, tearing, and ptosis are characteristic of cluster headaches.Nuchal rigidity suggests meningeal irritation, such as occurs with meningitis.Although nausea and vomiting may occur with migraine headaches, projectile vomiting is more consistent with increased intracranial pressure (ICP). Unilateral sharp, stabbing pain, rather than throbbing pain, is characteristic of cluster headaches.DIF: Cognitive Level: Understand (comprehension) REF: 1414 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity

• While the nurse is transporting a patient on a stretcher

to the radiology department, the patient begins having a tonic-clonic seizure. Which action should the nurse take?

• Insert an oral airway during the seizure to maintain a

patent airway.

• Restrain the patient's arms and legs to prevent injury

during the seizure.

• Time and observe and record the details of the seizure

and postictal state.

• Avoid touching the patient to prevent further nervous

system stimulation.

ANS: C

Because the diagnosis and treatment of seizures frequently are based on the description of the seizure, recording the length and details of the seizure is important. Insertion of an oral airway and restraining the patient during the seizure are contraindicated. The nurse may need to move the patient to decrease the risk of injury during the seizure.DIF: Cognitive Level: Apply (application) REF: 1422 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity

• A high school 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?

• "You might benefit from some psychologic counseling."
• "Epilepsy usually can be well controlled with

medications."

• "You will want to contact the Epilepsy Foundation for

assistance."

• "The Department of Vocational Rehabilitation can help

with work retraining."

ANS: B

The nurse should inform the patient that most patients with seizure disorders are controlled with medication. The other information may be necessary if the seizures persist after treatment with antiseizure medications is implemented.DIF: Cognitive Level: Apply (application) REF: 1422 TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

• A patient has been taking phenytoin (Dilantin) for 2

years. Which action will the nurse take when evaluating for adverse effects of the medication?

• Inspect the oral mucosa.
• Listen to the lung sounds.
• Auscultate the bowel tones.
• Check pupil reaction to light.

ANS: A

Phenytoin can cause gingival hyperplasia, but does not affect bowel tones, lung sounds, or pupil reaction to light.DIF: Cognitive Level: Apply (application) REF: 1424 TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity

• A patient reports feeling numbness and tingling of the

left arm before experiencing a tonic-clonic seizure. The nurse determines that this history is consistent with what type of seizure?

• Focal
• Atonic
• Absence
• Myoclonic

ANS: A

The initial symptoms of a focal seizure involve clinical manifestations that are localized to a particular part of the body or brain. Symptoms of an absence seizure are staring and a brief loss of consciousness. In an atonic seizure, the patient loses muscle tone and (typically) falls to the ground. Myoclonic seizures are characterized by a sudden jerk of the body or extremities.DIF: Cognitive Level: Understand (comprehension) REF: 1421 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity

• When obtaining a health history and physical

assessment for a 36-year-old female patient with possible multiple sclerosis (MS), the nurse should

• assess for the presence of chest pain.
• inquire about urinary tract problems.
• inspect the skin for rashes or discoloration.
• ask the patient about any increase in libido.

ANS: B

Urinary tract problems with incontinence or retention are common symptoms of MS. Chest pain and skin rashes are not symptoms of MS. A decrease in libido is common with MS.DIF: Cognitive Level: Apply (application) REF: 1429 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity