The nurse is providing care for a patient in status epilepticus. What nursing intervention takes the highest priority?

Maintain a patent airway

Place an intravenous catheter (IV)

Administer diazepam, per order

Insert a nasogastric tube (NG)

Answer and Explanation

The Correct Answer is A

Choice A rationale
Maintaining a patent airway is the highest priority when providing care for a patient in status epilepticus. Status epilepticus is a medical emergency characterized by prolonged or recurrent seizures. It can lead to severe complications, including respiratory distress and hypoxia.
Therefore, ensuring a patent airway is crucial to prevent hypoxia and further brain damage. This involves positioning the patient to prevent aspiration, potentially suctioning the airway, and providing supplemental oxygen as needed.
Choice B rationale
While placing an intravenous catheter (IV) is an important intervention, it is not the highest priority. An IV allows for the administration of medications and fluids, which are necessary in the management of status epilepticus. However, it is secondary to maintaining a patent airway.
Choice C rationale
Administering diazepam or other antiepileptic drugs is a key intervention in managing status epilepticus. These medications help to stop the seizures. However, medication administration should only occur after a patent airway has been established.
Choice D rationale
Inserting a nasogastric tube (NG) may be necessary in some cases to protect the airway or for administering medications or nutrition. However, this is not the highest priority intervention. The first step in managing status epilepticus is always to ensure a patent airway.

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Correct Answer is ["B","C","D","F"]

Explanation

Choice A rationale
It is a common misconception that something should be placed in the mouth of someone having a seizure to prevent them from biting their tongue. However, this can cause more harm than good, including injury to the person’s mouth or the rescuer’s fingers.
Choice B rationale
Moving furniture away from the person having a seizure can help prevent injury. During a seizure, a person may move uncontrollably, and removing nearby objects can reduce the risk of harm.
Choice C rationale
Loosening constrictive clothing can help the person breathe more easily during and after a seizure.
Choice D rationale
Providing privacy can help maintain the person’s dignity and reduce embarrassment after a seizure.
Choice E rationale
It is not recommended to restrain a person during a seizure. This can result in injury. Instead, the goal is to keep the person safe until the seizure stops on its own.
Choice F rationale

Positioning the person on their side with their head flexed forward can help prevent aspiration, which can occur if the person vomits during or after a seizure.

A. Antibiotic therapy B. Antiemetics C. Analgesics D. Antiviral therapy

Correct Answer is A

Explanation

Choice A rationale
If a patient is suspected of having meningitis, the provider will likely prescribe antibiotic therapy after reviewing the lab results. Meningitis is often caused by a bacterial infection, and antibiotics are the primary treatment. The specific antibiotic prescribed will depend on the type of bacteria causing the infection.
Choice B rationale
Antiemetics are medications that help prevent and treat nausea and vomiting. They are not typically used as the primary treatment for meningitis.
Choice C rationale

Analgesics are medications that relieve pain. While they may be used to help manage symptoms in a patient with meningitis, they are not used to treat the underlying infection.
Choice D rationale
Antiviral therapy may be used if the meningitis is caused by a viral infection. However, most cases of meningitis are caused by bacteria, and antibiotics are the primary treatment.

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The nurse is providing care for a patient in status epilepticus. What nursing intervention takes the highest priority?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

While waiting for an appointment in the doctor’s office, a patient experiences a convulsive seizure. The nurse is immediately notified. What nursing care should be provided at this time? (Select all that apply.)

Correct Answer is ["B","C","D","F"]

Explanation

The nurse is caring for a patient suspected of having meningitis. After reviewing the lab results, which medication does the nurse anticipate the provider will prescribe to treat the meningitis?

Correct Answer is A

Explanation

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