A school-age child is diagnosed with absence seizures. Which behavior, if observed by the school nurse, is a characteristic of this type of seizure?

The child exhibits lip-smacking and repetitive hand movements followed by confusion.

The child cries out, becomes stiff, and then has rhythmic muscle contractions.

The child suddenly falls to the ground and has jerking movements.

The child stares blankly for a few seconds and then continues the previous activity without awareness of the episode.

Answer and Explanation

The Correct Answer is D

Choice A reason: Lip-smacking and repetitive hand movements followed by confusion are characteristic of focal seizures with impaired awareness, involving specific brain regions like the temporal lobe. These seizures often include automatisms and postictal confusion, unlike absence seizures, which are brief, generalized, and lack motor symptoms or confusion, making this an incorrect choice.

Choice B reason: Crying out, becoming stiff, and having rhythmic muscle contractions describe a tonic-clonic seizure, a generalized seizure type involving bilateral motor activity. This results from widespread cortical activation and differs from absence seizures, which are non-motor, brief lapses in consciousness without convulsive movements, ruling out this option.

Choice C reason: Suddenly falling and jerking movements suggest an atonic or myoclonic seizure, where muscle tone is lost or brief muscle jerks occur due to generalized epileptiform activity. Absence seizures, however, involve only brief staring spells without motor involvement or falling, making this behavior inconsistent with the diagnosis.

Choice D reason: Absence seizures, a generalized epilepsy type, are characterized by brief (5-10 seconds) staring spells with unresponsiveness, often unnoticed by the child. Caused by synchronized thalamocortical discharges, they lack motor symptoms or postictal confusion, allowing the child to resume activity immediately, perfectly matching the described behavior and confirming the diagnosis.

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Correct Answer is B

Explanation

Choice A reason: Hypotension is not a sign of increased ICP; hypertension is part of Cushing’s triad. Low blood pressure may indicate shock, not ICP, making this incorrect for monitoring brain injury.

Choice B reason: Decreased level of consciousness is a primary sign of increased ICP, reflecting brain compression. It’s a critical indicator requiring immediate action, making this the correct manifestation to monitor.

Choice C reason: Tachypnea is not typical of ICP; irregular or slow respirations occur in Cushing’s triad. Rapid breathing is unrelated, making this incorrect for increased ICP manifestations.

Choice D reason: Bilateral weakness may occur in neurological conditions but is less specific to ICP than altered consciousness. ICP primarily affects alertness, making this incorrect for monitoring.

A. Ask the client if she has a plan to commit suicide. B. Notify the client’s family and request a visitor to stay with the client until thoughts of suicide are gone. C. Assist the client to her room and allow her to rest before resuming activity. D. Recognize the attempt at manipulation and escort the client back to her activity.

Correct Answer is A

Explanation

Choice A reason: Asking if the client has a suicide plan is the priority, as it assesses the immediacy and specificity of suicidal intent, critical in depression due to serotonin and norepinephrine dysregulation. A specific plan indicates high risk, necessitating immediate safety measures to prevent self-harm driven by impaired emotional regulation.

Choice B reason: Notifying family and requesting a visitor may provide support but does not immediately assess the client’s suicide risk. Depression-related suicidal ideation, linked to prefrontal cortex dysfunction, requires direct evaluation of intent and plan to ensure safety, making this a secondary action after risk assessment.

Choice C reason: Assisting the client to rest in her room dismisses the suicidal statement, risking neglect of a serious threat. Depression’s neurochemical imbalances can amplify hopelessness, and ignoring suicidal ideation may escalate risk, as it fails to address the immediate need for safety and intervention.

Choice D reason: Recognizing the statement as manipulation is inappropriate, as it dismisses genuine suicidal ideation in depression, driven by profound neurochemical despair. This risks underestimating the client’s intent, potentially leading to harm, as suicidal thoughts require serious assessment rather than being attributed to behavioral manipulation.

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A school-age child is diagnosed with absence seizures. Which behavior, if observed by the school nurse, is a characteristic of this type of seizure?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has sustained a traumatic brain injury. The nurse should monitor the client for which of the following manifestations of increased intracranial pressure?

Correct Answer is B

Explanation

A nurse is caring for a client 3 days after admission for treatment of depression. The client leaves her current activity, approaches the nurse, and states, “There’s no reason to go on living. I just want to end it all.” Which of the following actions should the nurse take?

Correct Answer is A

Explanation

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