The parents of a pediatric client describe occasional episodes where the client seems to experience a temporary loss of awareness and a blank stare. The nurse suspects which of the following disorders?

Focal awareness seizure

Absence seizure

Transient ischemic attack (TIA)

Tonic clonic seizure

Answer and Explanation

The Correct Answer is B

A. Focal awareness seizure:
Focal awareness seizures (formerly known as simple partial seizures) involve abnormal electrical activity in a specific area of the brain. These seizures typically cause motor symptoms (such as jerking or twitching in one part of the body) or sensory disturbances (like tingling or visual changes), but the person remains fully aware during the episode. The client’s presentation of a temporary loss of awareness and blank stare is more consistent with an absence seizure than a focal awareness seizure, as focal seizures do not cause a loss of consciousness.

B. Absence seizure:
Absence seizures are a type of generalized seizure often seen in children. These seizures are characterized by a sudden, brief loss of awareness, typically lasting only a few seconds. During the episode, the child may exhibit a blank stare and seem unresponsive, often without any noticeable physical movements. These seizures are often mistaken for daydreaming or inattention, but they can be diagnosed with an EEG (electroencephalogram) showing characteristic patterns. This description matches the parents’ observations of occasional episodes of loss of awareness and a blank stare.

C. Transient ischemic attack (TIA):
A TIA, also known as a mini-stroke, involves temporary neurological symptoms due to a brief disruption in blood flow to the brain. However, TIAs usually last longer than the brief episodes of loss of awareness described in this case, and they are more likely to cause focal neurological not just a transient loss of awareness. Additionally, TIAs are much less common in children and are usually associated with other risk factors like cardiovascular disease or clotting disorders.

D. Tonic clonic seizure:
Tonic-clonic seizures (formerly known as grand mal seizures) involve generalized shaking or convulsions, loss of consciousness, and can last from 1 to 3 minutes. These seizures are usually much more dramatic and prolonged compared to the brief, absence-like episodes described here. While they do involve a loss of awareness, the physical manifestations (muscle stiffening and jerking) and duration are distinctively different from the blank stare and brief loss of awareness typical of an absence seizure.

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Correct Answer is B

Explanation

A) "Encourage strict bed rest with turning and repositioning every 2 hours":
. For clients with peripheral arterial disease (PAD), strict bed rest is not recommended unless the client is in severe pain or experiencing complications like ulcers or gangrene. In PAD, exercise and mobility are essential for improving blood flow and reducing symptoms. Prolonged immobility could worsen circulation and lead to complications like muscle atrophy. Therefore, encouraging gentle movement and activity, like walking or repositioning, is typically more beneficial than prolonged bed rest.

B) "Have the client 'dangle' their legs several times per day and when pain occurs":
. For clients with PAD, dangling the legs can be helpful in alleviating pain and discomfort. When the client dangles their legs, gravity helps to increase blood flow to the lower extremities, which can provide temporary relief from symptoms like intermittent claudication (pain caused by insufficient blood flow). It is important to balance this with the advice to avoid elevating the legs, as elevating them above the heart level may decrease arterial perfusion, worsening symptoms.

C) "Have the client elevate their legs above heart level when pain occurs":
. Elevating the legs above the heart level in clients with PAD may worsen symptoms. In PAD, blood flow to the legs is already compromised, and elevating the legs above the heart can further reduce arterial blood flow to the lower extremities, increasing pain and discomfort. Instead, dangling the legs or lying flat with the legs at heart level is generally better for improving circulation.

D) "Have the client use ice packs to relieve lower extremity pain":
. Applying ice packs is not recommended for clients with PAD, as cold can cause vasoconstriction, further reducing blood flow to already compromised tissues. Cold therapy may increase pain and lead to tissue damage in individuals with reduced circulation. The nurse should instead focus on strategies that promote blood flow, such as encouraging gentle exercise, dangling the legs, or using warmth (in some cases) to improve circulation.

A. "Following up with your dentist frequently will be important. B. Take an ant acid with the medication if indigestion occurs. C. *Alcoholic beverages should be limited to 1-2 per day while taking phenytoin.* D. "Phenytoin may turn your urine orange

Correct Answer is A

Explanation

A. "Following up with your dentist frequently will be important.":
This is the correct and important advice to give. Phenytoin (Dilantin), an anticonvulsant, can cause gum overgrowth (gingival hyperplasia), which makes it important for the patient to have regular dental check-ups. Poor oral hygiene combined with gingival hyperplasia can increase the risk of infection and other oral health issues. Therefore, advising the patient to follow up frequently with a dentist is essential to manage this side effect.

B. "Take an antacid with the medication if indigestion occurs.":
advice. Taking an antacid with phenytoin can interfere with its absorption. Antacids, especially those containing aluminum or magnesium, can reduce the effectiveness of phenytoin, leading to suboptimal therapeutic levels. It’s important to separate phenytoin from antacids by at least 2 hours to avoid this interaction. Therefore, antacids should not be used with phenytoin to manage indigestion.

C. "Alcoholic beverages should be limited to 1-2 per day while taking phenytoin.":
This is inaccurate advice. Alcohol can significantly affect the metabolism of phenytoin, increasing the risk of both toxicity and reduced effectiveness. Alcohol may lower the seizure threshold and interfere with the therapeutic effect of phenytoin, especially in higher amounts. Therefore, it is generally recommended that patients taking phenytoin avoid alcohol altogether, or at the very least limit consumption significantly and discuss it with their healthcare provider.

D. "Phenytoin may turn your urine orange.":
information. Phenytoin does not cause urine to turn orange. Urine discoloration can occur with some medications (like rifampin, for example), but not with phenytoin. This statement could cause unnecessary confusion for the patient. It is essential to provide accurate information to avoid misconceptions about medication side effects.

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The parents of a pediatric client describe occasional episodes where the client seems to experience a temporary loss of awareness and a blank stare. The nurse suspects which of the following disorders?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client with peripheral arterial disease (PAD). Which of the following interventions should the nurse include in the plan of care?

Correct Answer is B

Explanation

A nurse is providing teaching to a client who has seizures and a new prescription for phenytoin. Which of the following information should the nurse provide?

Correct Answer is A

Explanation

A client who following prescribed multiple medications for recurring urinary tract infections tells the nurse that her urine has turned red-orange. Which of the following prescribed medications does the nurse suspect is responsible for this change?

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