A nurse is giving discharge instructions to a client with epilepsy. What should be included in the nurse’s instructions?

Avoid climbing ladders

Do not swim without a partner

Do not drive unless seizure-free for 3 months

Avoid using power tools

Lay the client on the floor during a seizure

Position the client on their back while they recover from a seizure

Answer and Explanation

Correct Answer : A,B,C,D,E

Choice A rationale: Clients with epilepsy are at high risk of injury from falls during seizures due to sudden loss of consciousness or motor control. Climbing ladders increases the risk of severe trauma, including head injuries and fractures, if a seizure occurs at height. The American Epilepsy Society recommends avoiding elevated surfaces without safety measures. Neurological unpredictability in epilepsy necessitates minimizing exposure to high-risk environments to prevent secondary injuries during seizure episodes.

Choice B rationale: Swimming alone is contraindicated for clients with epilepsy due to the risk of drowning if a seizure occurs in water. A partner can provide immediate assistance, ensuring airway patency and preventing submersion. The CDC and Epilepsy Foundation emphasize supervised aquatic activity. Seizures may cause loss of consciousness or muscle control, making it impossible for the individual to self-rescue. Even brief seizures can lead to aspiration or hypoxic injury if not promptly addressed by a nearby observer.

Choice C rationale: Driving restrictions for clients with epilepsy vary by jurisdiction, but most guidelines, including those from ATI and the Epilepsy Foundation, recommend a seizure-free period of 6 to 12 months before resuming driving. This is based on the risk of sudden incapacitation while operating a vehicle, which endangers both the driver and the public. A 3-month seizure-free period is insufficient and not evidence-based. Neurological stability must be demonstrated over a longer duration to ensure safety.

Choice D rationale: Power tools pose a significant hazard to individuals with epilepsy due to the potential for sudden seizure activity during operation. These tools often involve sharp, fast-moving components that can cause severe injury if control is lost. The Occupational Safety and Health Administration (OSHA) advises against unsupervised use of such equipment by individuals with seizure disorders. Seizure unpredictability necessitates avoiding machinery that requires continuous attention and motor coordination to prevent traumatic injuries.

Choice E rationale: During a seizure, especially a generalized tonic-clonic seizure, it is critical to gently guide the client to the floor to prevent injury from falling. This position helps reduce the risk of head trauma and allows for safer seizure progression. The floor provides a stable surface, minimizing the chance of secondary injury. The nurse should also clear the area of sharp objects and cushion the head to protect the client during convulsions, as recommended by seizure first aid protocols.

Choice F rationale: Positioning a client on their back during postictal recovery is contraindicated due to the risk of airway obstruction. Seizures often result in decreased consciousness, increased oral secretions, or vomiting. The supine position can lead to aspiration or hypoxia. Instead, the recovery position—lying on the side—facilitates drainage of secretions and maintains airway patency. The American Red Cross and Epilepsy Foundation recommend side-lying recovery to reduce respiratory complications and promote safe postictal recovery.

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Correct Answer is B

Explanation

Choice A rationale
While the type of work a person does can potentially expose them to risk factors for Parkinson’s disease (such as pesticides or heavy metals), it is not the most important question to ask a newly diagnosed patient. Occupational exposure is only one of many potential risk factors for Parkinson’s disease.
Choice B rationale

Family history is a significant risk factor for Parkinson’s disease. A person with a close relative (such as a parent or sibling) who has Parkinson’s disease is at a higher risk of developing the disease themselves. Therefore, asking about family history can provide important information about the patient’s risk profile.
Choice C rationale
While some studies have suggested that caffeine intake may be associated with a lower risk of Parkinson’s disease, the evidence is not conclusive. Therefore, asking about coffee consumption is not the most important question when assessing a newly diagnosed patient.
Choice D rationale
While regular physical check-ups are important for overall health, asking about the timing of the last physical is not the most important question for a newly diagnosed Parkinson’s patient. The focus should be on understanding the patient’s symptoms, family history, and potential exposure to known risk factors for Parkinson’s disease.

A. Disruption of cellular function and blood vessel damage B. Damage to brain tissue from decreased pressure shock waves C. Increased blood supply and edema to the area of injury D. Increased synaptic connections from pressure .

Correct Answer is A

Explanation

Choice A rationale
A traumatic brain injury (TBI) can indeed disrupt cellular function and cause blood vessel damage. This can lead to a range of potential effects, from temporary changes in brain function to long-term complications or even death.
Choice B rationale
Damage to brain tissue from decreased pressure shock waves is not typically associated with TBI. This type of injury is more commonly associated with blast injuries, such as those caused by explosions.
Choice C rationale
While increased blood supply and edema (swelling) can occur in the area of a brain injury, they are typically responses to the injury rather than direct consequences of the TBI itself. These processes can contribute to further damage and complications.
Choice D rationale
A TBI does not typically lead to increased synaptic connections. In fact, the injury can cause loss of neurons and synapses, which can lead to long-term cognitive and functional impairments.

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A nurse is giving discharge instructions to a client with epilepsy. What should be included in the nurse’s instructions?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client newly diagnosed with Parkinson’s disease. The client states, “I have no idea why I got this.”. What is the most important he nurse should ask this client while performing the assessment?

Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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