The nurse observes increased eye blinking and lip smacking in a client who has a history of absence seizures.
The nurse is aware these symptoms indicate:

Automatisms associated with this type of seizure.

The client may have been exposed to a neurotoxin.

An electrolyte imbalance, likely hyponatremia.

A reversible adverse effect of anticonvulsant drugs.

Answer and Explanation

The Correct Answer is A

Choice A rationale

Automatisms, such as eye blinking and lip smacking, are repetitive, involuntary movements commonly associated with absence seizures. They occur due to brief interruptions in consciousness during seizure activity without major motor involvement.

Choice B rationale

Neurotoxin exposure typically presents with symptoms like weakness, ataxia, and autonomic dysfunction. Increased eye blinking and lip smacking are not specific to neurotoxin-related neurological damage or poisoning.

Choice C rationale

Hyponatremia causes confusion, lethargy, and muscle cramps due to electrolyte disturbance affecting cellular function, but it does not cause specific automatisms like eye blinking or lip smacking in seizure-related conditions.

Choice D rationale

Reversible adverse effects of anticonvulsants often include sedation or cognitive slowing. Automatisms such as blinking and smacking are not typically linked to the pharmacological effects of anticonvulsants.

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Correct Answer is B

Explanation

Choice A rationale

Applying pressure to prevent drainage could force cerebrospinal fluid (CSF) back into the cranial cavity, increasing infection risk and intracranial pressure, potentially worsening brain injury. CSF leakage requires non-obstructive handling.

Choice B rationale

Allowing fluid to drain onto gauze prevents build-up of intracranial pressure while assessing for halo sign, indicating CSF leakage. Yellow staining reflects glucose presence in CSF, confirming dura mater damage.

Choice C rationale

Intravenous fluids manage hypovolemia but are not prioritized for trauma patient brain injuries. Replacing lost CSF requires specific medical intervention rather than fluid volume adjustments alone.

Choice D rationale

Antibiotics treat infections but are not first priority for confirmed CSF leakage, which demands careful monitoring of drainage to prevent neurological damage. Post-intervention antibiotics may be necessary.

A. My heart rate will no longer be irregular. B. This medication will help lower my blood pressure. C. I will have decreased pain to my legs when I walk. D. Clopidogrel will prevent clots from forming.

Correct Answer is D

Explanation

Choice A rationale

Clopidogrel is an antiplatelet agent that prevents platelet aggregation but does not affect arrhythmias. It reduces clot formation risk, which is critical for patients with a history of TIA or stroke.

Choice B rationale

Clopidogrel does not lower blood pressure. It works by inhibiting platelet aggregation to prevent thrombus formation, not addressing the mechanisms of hypertension or blood pressure control.

Choice C rationale

Clopidogrel does not directly affect peripheral artery disease symptoms, such as leg pain. It is used to reduce the risk of thrombotic events like strokes and heart attacks by preventing platelet aggregation.

Choice D rationale

Clopidogrel inhibits platelet aggregation by blocking the ADP receptor on platelets, reducing the risk of clot formation. This is crucial for preventing ischemic events in patients with a history of TIA.

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The nurse observes increased eye blinking and lip smacking in a client who has a history of absence seizures.The nurse is aware these symptoms indicate:

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The nurse observes increased eye blinking and lip smacking in a client who has a history of absence seizures.
The nurse is aware these symptoms indicate: