A 25-year-old patient with a history of epilepsy is brought to the emergency department after experiencing a generalized tonic-clonic seizure. Which of the following is the most appropriate initial action by the nurse?

Apply soft restraints to prevent injury during the seizure.

Administer intravenous lorazepam.

Obtain a detailed seizure history from the family.

Ensure the patient's airway is open and position them on their side.

Answer and Explanation

The Correct Answer is D

A.   Applying soft restraints during a seizure could increase the risk of injury and is not recommended.
B.   Administering lorazepam is often necessary in seizures, but the priority during a seizure is ensuring the airway is open and the patient is in a safe position.
C.   Obtaining a seizure history is important but should be done after managing the acute situation.
D.   The priority during a seizure is to ensure the patient's airway is open and to position them on their side to prevent aspiration and facilitate breathing.

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Correct Answer is D

Explanation

A. Documenting the seizure activity is important but should be done after addressing immediate needs.
B. Checking the patient's vital signs is important but is secondary to positioning the patient safely to prevent aspiration.
C. Administering oral antiepileptic medication is necessary but not the first action following a tonic- clonic seizure.
D. Placing the patient in a side-lying position immediately after the seizure ensures that the airway remains open and reduces the risk of aspiration.

A. Troponin level B. Myelogram C. Lumbar puncture D. Brain natriuretic peptide

Correct Answer is C

Explanation

A. A troponin level is used to diagnose cardiac injury, not multiple sclerosis. It does not help in confirming MS.
B. A myelogram is a diagnostic test for spinal cord disorders, but it is not typically used to diagnose multiple sclerosis.
C. A lumbar puncture is commonly performed to help diagnose multiple sclerosis. It can show abnormalities such as oligoclonal bands in the cerebrospinal fluid, which is suggestive of MS.
D. Brain natriuretic peptide (BNP) is a marker for heart failure and is unrelated to the diagnosis of multiple sclerosis.

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A 25-year-old patient with a history of epilepsy is brought to the emergency department after experiencing a generalized tonic-clonic seizure. Which of the following is the most appropriate initial action by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is C

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