A 22-year-old Asian man has been diagnosed with a seizure disorder. Prior to initiating treatment with an anticonvulsant, what should his nurse practitioner consider?
Obtain a complete blood count (CBC), thyroid studies, and HbA1c
Obtain a CSF analysis, urinalysis, electrolyte level, glucose level
Obtain a pharmacogenomic profile to determine if he has one of the HLA alleles that make him more susceptible to Stevens-Johnson syndrome
Refer to a psychiatrist to rule out factitious disorder
The Correct Answer is C
Choice A reason: CBC, thyroid studies, and HbA1c are not standard pre-treatment requirements for anticonvulsants unless indicated by comorbid conditions.
Choice B reason: CSF analysis and urinalysis are typically reserved for diagnostic workup of seizures, not pre-treatment pharmacogenomic risk assessment.
Choice C reason: Certain anticonvulsants, such as carbamazepine, carry a risk of severe cutaneous reactions like Stevens-Johnson syndrome. Individuals of Asian descent may carry HLA alleles (e.g., HLA-B*1502) that increase susceptibility. Screening reduces risk.
Choice D reason: Referral to psychiatry is unnecessary unless there is suspicion of non-epileptic seizures; it is not a standard consideration prior to anticonvulsant initiation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: The frontal lobe primarily governs voluntary motor activity, executive functions, and speech production rather than sensory integration for taste or reading.
Choice B reason: The parietal lobe processes sensory input, integrates information for reading and writing, and contributes to gustatory sensation. The postcentral gyrus of the parietal lobe contains the primary somatosensory cortex critical for these functions.
Choice C reason: The occipital lobe is responsible for visual processing and is not involved in taste or language-related sensory functions.
Choice D reason: The temporal lobe is involved in auditory processing, memory, and language comprehension but does not directly process primary sensory input for taste or writing.
Correct Answer is A
Explanation
Choice A reason: NDI is not caused by a lack of antidiuretic hormone (ADH); that would describe central diabetes insipidus. In NDI, the kidneys are unresponsive to ADH despite normal or elevated hormone levels.
Choice B reason: NDI can be linked to genetic mutations, particularly X-linked forms, which predominantly affect males. This makes this statement correct.
Choice C reason: NDI is characterized by normal or even elevated ADH levels because the kidney fails to respond appropriately, leading to excessive urination.
Choice D reason: A hallmark of NDI is the production of large volumes of dilute urine, which is a direct result of renal insensitivity to ADH.
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