A patient is brought to the emergency department experiencing an active seizure. Which medication should the nurse anticipate administering as the first- line treatment to stop the seizure?
Intramuscular Phenobarbital
Intravenous Lorazepam
Oral Phenytoin
Subcutaneous Sumatriptan
The Correct Answer is B
A. Intramuscular Phenobarbital: While effective as an anticonvulsant, phenobarbital has a slower onset of action and is not the preferred first-line treatment for acute seizures. It is more commonly used in refractory cases or for long-term seizure control.
B. Intravenous Lorazepam: Lorazepam is a benzodiazepine and the first-line treatment for active seizures, especially status epilepticus. Given IV, it acts quickly by enhancing GABA activity, which calms neuronal excitability and stops seizure activity efficiently.
C. Oral Phenytoin: Phenytoin is used for long-term seizure prevention but is not effective for terminating ongoing seizures due to its slow onset when taken orally. It may be used after benzodiazepines to prevent seizure recurrence but not as the initial agent.
D. Subcutaneous Sumatriptan: Sumatriptan is used for treating acute migraines and has no role in managing seizures. It acts on serotonin receptors to relieve migraine symptoms, not to control abnormal neuronal discharges.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Cardiotoxicity: While NSAIDs can contribute to cardiovascular risks such as hypertension and fluid retention, nephrotoxicity is the more direct explanation for the elevated kidney function tests and potassium level. Cardiotoxicity typically presents with symptoms like heart failure or arrhythmias rather than kidney-related lab abnormalities.
B. Nephrotoxicity: NSAIDs inhibit prostaglandin synthesis, which plays a key role in maintaining renal blood flow, especially in older adults or those with preexisting renal impairment. Chronic NSAID use can reduce glomerular filtration, leading to elevated creatinine, hyperkalemia, and worsening blood pressure control, all of which are evident in this patient.
C. Neurotoxicity: Neurotoxic effects are not commonly associated with NSAID use. Symptoms of neurotoxicity include confusion or seizures, which are not relevant to the clinical findings in this scenario.
D. Hepatotoxicity: NSAID-induced liver injury is rare and would typically present with elevated liver enzymes (AST, ALT), not elevated creatinine or potassium. The current lab findings and blood pressure changes are more consistent with kidney involvement.
Correct Answer is B
Explanation
A. Apply the drops directly onto the patient's cornea: Eye drops should be instilled into the conjunctival sac, not directly onto the cornea. The cornea is highly sensitive, and direct application can cause discomfort, injury, and decreased patient adherence.
B. Perform punctal occlusion after instilling the drops: Punctal occlusion (gentle pressure on the inner corner of the eye) for 1–2 minutes reduces systemic absorption of the drug via the nasolacrimal duct. This is especially important with beta-blockers like Timolol, which can cause systemic effects such as bradycardia and hypotension.
C. Administer the medication immediately after meals: The timing of Timolol eye drops is not dependent on meals. Food intake has no impact on the efficacy or absorption of ophthalmic medications.
D. Instruct the patient to blink rapidly after instillation: Blinking rapidly can cause the medication to be expelled from the eye, reducing its effectiveness. Patients should be instructed to gently close the eye for a minute or two to enhance absorption.
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