Seizure Practice Questions Test 2, Fall 2020

Seizure Practice Questions (Test #2, Fall 2020) Leave the first rating Students also studied Terms in this set (25) Science MedicineNursing Save

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60 terms madison_heaton7 Preview Parkinson's Disease Practice Questi...29 terms martina_hughes Preview Seizures NCLEX 12 terms murkacatPreview Exam 3 54 terms jayg The nurse sees a client walking in the hallway who begins to have a seizure. The nurse should do which of the following in priority order?

• Maintain a patent airway.
• Record the seizure activity observed.
• Ease the client to the floor.
• Obtain vital signs.

3,1,4,2

Ease the client to the floor.Maintain a patent airway.Obtain vital signs.Record the seizure activity observed.To protect the client from falling, the nurse first should ease the client to the floor.It is important to protect the head and maintain a patent airway since altered breathing and excessive salivation can occur. The assessment of the postictal period should include level of consciousness and vital signs. The nurse should record details of the seizure once the client is stable. The events preceding the seizure, timing with descriptions of each phase, body parts affected and sequence of involvement, and autonomic signs should be recorded.Which of the following is contraindicated for a client with seizure precautions?

1.Encouraging him to perform his own personal hygiene.

2.Allowing him to wear his own clothing.

3.Assessing his oral temperature with a glass thermometer.

4.Encouraging him to be out of bed.

3.Temperatures are not assessed orally with a glass thermometer because the thermometer could break and cause injury if a seizure occurred. The client can perform personal hygiene. There is no clinical reason to discourage the client from wearing his own clothes. As long as there are no other limitations, the client should be encouraged to be out of bed.

It is the night before a client is to have a computed tomography (CT) scan of the head without contrast. The

nurse should tell the client:

1."You must shampoo your hair tonight to remove all oil and dirt." 2."You may drink fluids until midnight, but after that drink nothing until the scan is completed." 3."You will have some hair shaved to attach the small electrode to your scalp." 4."You will need to hold your head very still during the examination." 4.The client will be asked to hold the head very still during the examination, which lasts about 30 to 60 minutes. In some instances, food and fluids may be withheld for 4 to 6 hours before the procedure if a contrast medium is used because the radiopaque substance sometimes causes nausea. There is no special preparation for a CT scan, so a shampoo the night before is not required. The client may drink fluids until 4 hours before the scan is scheduled. Electrodes are not used for a CT scan, nor is the head shaved.The client will have an electroencephalogram (EEG) in the morning. The nurse should instruct the client to have which of the following for breakfast?

1.No food or fluids.

2.Only coffee or tea if needed.

3.A full breakfast as desired without coffee, tea, or energy drinks.

4.A liquid breakfast of fruit juice, oatmeal, or smoothie.3 Beverages containing caffeine, such as coffee, tea, cola, and energy drinks, are withheld before an EEG because of the stimulating effects of the caffeine on the brain waves. A meal should not be omitted before an EEG because low blood sugar could alter brain wave patterns; the client can have the entire meal except for the coffee. The client does not need to be on a liquid diet or NPO.The client is scheduled to receive phenytoin (Dilantin) through a nasogastric tube (NGT) and has a tube-feeding supplement running continuously. The head of the bed is elevated to 30 degrees. Prior to administering the

medication, the nurse should:

1.Elevate the head of the bed to 60 degrees.

2.Draw blood to determine the Dilantin level after giving the morning dose in order to determine if client has toxic blood level.

3.Stop the tube feeding 1 hour before giving Dilantin and hold tube feeding for 1 hour after giving Dilantin.

4.Flush the NGT with 150 mL of water before and after giving the Dilantin" 3.In order for Dilantin to be properly absorbed and provide maximum benefit to the client, nutritional supplements must be stopped before and after delivery. The head of the bed is elevated 30 degrees since this client has a tube feeding infusing; it is not necessary to elevate the bed any further. Blood levels are usually drawn before giving a dose of Dilantin, not after. It is not necessary to flush with such a large amount of water (150 mL) before and after Dilantin.A 22-year-old who hit his head while playing football has a tonic-clonic seizure. Upon awakening from the seizure, the client asks the nurse, "What caused me to have a seizure? I've never had one before." Which cause should the nurse include in the response as a primary cause of tonic-clonic seizures in adults older than age 20?

1.Head trauma.

2.Electrolyte imbalance.

3.Congenital defect.

4.Epilepsy.

1.Trauma is one of the primary causes of brain damage and seizure activity in adults.Other common causes of seizure activity in adults include neoplasms, withdrawal from drugs and alcohol, and vascular disease. Given the history of head injury, electrolyte imbalance is not the cause of the seizure. There is no information to indicate that the seizure is related to a congenital defect. Epilepsy is usually diagnosed in younger clients.Which of the following should the nurse include in the teaching plan for a client with seizures who is going home with a prescription for gabapentin (Neurontin)?

1.Take all the medication until it is gone.

2.Notify the physician if vision changes occur.

3.Store gabapentin in the refrigerator.

4.Take gabapentin with an antacid to protect against ulcers.

2.Gabapentin (Neurontin) may impair vision. Changes in vision, concentration, or coordination should be reported to the physician. Gabapentin should not be stopped abruptly because of the potential for status epilepticus; this is a medication that must be tapered off. Gabapentin is to be stored at room temperature and out of direct light. It should not be taken with antacids.

Which intervention is most effective in minimizing the risk of seizure activity in a client who is undergoing diagnostic studies after having experienced several episodes of seizures?

1.Maintain the client on bed rest.

2.Administer butabarbital sodium 30 mg PO, three times per day.

3.Close the door to the room to minimize stimulation.

4.Administer carbamazepine 200 mg PO, twice per day.

4.Carbamazepine is an anticonvulsant that helps prevent further seizures. Bed rest, sedation (phenobarbital), and providing privacy do not minimize the risk of seizures.When preparing to teach a client about phenytoin sodium (Dilantin) therapy, the nurse should urge the client

not to stop the drug suddenly because:

1.Physical dependency on the drug develops over time.

2.Status epilepticus may develop.

3.A hypoglycemic reaction develops.

4.Heart block is likely to develop.

2.Anticonvulsant drug therapy should never be stopped suddenly; doing so can lead to life-threatening status epilepticus. Phenytoin sodium does not carry a risk of physical dependency or lead to hypoglycemia. Phenytoin has antiarrhythmic properties, and discontinuation does not cause heart block.A client who has had seizures asks the nurse about being able to drive because of the seizures. Which response by the nurse is best?

1.A person with a history of seizures can drive only during daytime hours.

2.A person with evidence that the seizures are under medical control can drive.

3.A person with evidence that seizures occur no more often than every 12 months can drive.

4.A person with a history of seizures can drive if he or she carries a medical identification card.

2.Specific motor vehicle regulations and restrictions for people who experience seizures vary locally. Most commonly, evidence that the seizures are under medical control is required before the person is given permission to drive. Time of day is not a consideration when determining driving restrictions related to seizures. The amount of time a person has been seizure-free is a consideration for lifting driving restrictions; however, the time frame is usually 2 years. It is recommended, not required, that a person who is subject to seizures carry a card or wear an identification bracelet describing the illness to facilitate quick identification in the event of an emergency.The nurse is teaching a client to recognize an aura. The

nurse should instruct the client to note:

1.A postictal state of amnesia.

2.A hallucination that occurs during a seizure.

3.A symptom that occurs just before a seizure.

4.A feeling of relaxation as the seizure begins to subside.

3.An aura is a premonition of an impending seizure. Auras usually are of a sensory nature (eg, an olfactory, visual, gustatory, or auditory sensation); some may be of a psychic nature. Evaluating an aura may help identify the area of the brain from which the seizure originates. Auras occur before a seizure, not during or after (postictal). They are not similar to hallucinations or amnesia or related to relaxation Which clinical manifestation is a typical reaction to long- term phenytoin sodium (Dilantin) therapy?

1.Weight gain.

2.Insomnia.

3.Excessive growth of gum tissue.

4.Deteriorating eyesight.

3.A common adverse effect of long-term phenytoin therapy is an overgrowth of gingival tissues. Problems may be minimized with good oral hygiene, but in some cases, overgrown tissues must be removed surgically. Phenytoin does not cause weight gain, insomnia, or deteriorating eyesight.

A 21-year-old female client takes clonazepam. What should the nurse ask this client about? Select all that apply.

1.Seizure activity.

2.Pregnancy status.

3.Alcohol use.

4.Cigarette smoking.

5.Intake of caffeine and sugary drinks.

1, 2, 3.

The nurse should assess the number and type of seizures the client has experienced since starting clonazepam monotherapy for seizure control. The nurse should also determine if the client might be pregnant because clonazepam crosses the placental barrier. The nurse should also ask about the client's use of alcohol because alcohol potentiates the action of clonazepam. Although the nurse may want to check on the client's diet or use of cigarettes for health maintenance and promotion, such information is not specifically related to clonazepam therapy.The male client is sitting in the chair and his entire body is rigid with his arms and legs contracting and relaxing. The client is not aware of what is going on and is making guttural sounds. Which action should the nurse implement first?

• Push aside any furniture.
• Place the client on his side.
• Assess the client's vital signs.
• Ease the client to the floor.
• The nurse needs to protect the client from injury. Moving furniture would help

ensure that the client would not hit something accidentally, but this is not done first.

• This is done to help keep the airway patent, but it is not the first intervention in

this specific situation.

• Assessment is important but when the client is having a seizure, the nurse

should not touch him

• The client should not remain in the chair during a seizure. He should be

brought safely to the floor so that he will have room to move the extremities.

TEST TAKING HINT: All of the answer options are possible interventions, so the

test taker should go back to the stem of the question and note that the question asks which intervention has priority. "In the chair" is the key to this question because the nurse should always think about safety, and a The occupational health nurse is concerned about preventing occupation-related acquired seizures. Which intervention should the nurse implement?

• Ensure that helmets are worn in appropriate areas.
• Implement daily exercise programs for the staff.
• Provide healthy foods in the cafeteria.
• Encourage employees to wear safety glasses.
• Head injury is one of the main reasons for epilepsy that can be prevented

through occupational safety precautions and highway safety programs.

• Sedentary lifestyle is not a cause of epilepsy.
• Dietary concerns are not a cause of epilepsy.
• Safety glasses will help prevent eye injuries, but such injuries are not a cause of

epilepsy.TEST TAKING HINT: The nurse must be aware of risk factors that cause diseases. If the test taker does not know the correct answer, thinking about which body system the question is asking about may help rule out or rule in some of the answer options. Only options "1" and "4" have anything to do with the head, and only helmets on the head are connected with the neurological system.