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","C","E"]

Explanation

A) Aim to keep your HDL cholesterol as low as possible:
High-density lipoprotein (HDL) cholesterol is often referred to as "good" cholesterol because it helps remove excess cholesterol from the bloodstream, thereby reducing the risk of atherosclerosis and coronary artery disease. The goal should be to raise HDL cholesterol levels, not lower them. Higher levels of HDL are associated with a lower risk of heart disease.

B) Controlling your diabetes is an important factor:
Diabetes is a major risk factor for coronary artery disease (CAD). Uncontrolled blood sugar levels can lead to damage of the blood vessels, increase the risk of atherosclerosis, and raise the likelihood of heart disease. Proper management of diabetes through diet, medication, and lifestyle changes is essential to reduce the risk of CAD.

C) Exercising and achieving your goal weight are recommended:
Regular exercise and maintaining a healthy weight are crucial for reducing the risk of coronary artery disease. Exercise helps improve cardiovascular health, lowers blood pressure, increases HDL cholesterol, and helps control body weight and blood sugar. Achieving and maintaining a healthy weight reduces the strain on the heart and lowers the risk of developing CAD.

D) Increase saturated fat intake and limit unsaturated fats:
Saturated fats can raise low-density lipoprotein (LDL) cholesterol, also known as "bad" cholesterol, which contributes to plaque buildup in the arteries and increases the risk of heart disease. Unsaturated fats, found in foods like olive oil, avocados, and fatty fish, are healthier and can help reduce cholesterol levels and improve heart health. The goal should be to limit saturated fats and increase the intake of unsaturated fats.

E) It is important to keep your blood pressure within normal limits:
High blood pressure is a significant risk factor for coronary artery disease. It can lead to the hardening and narrowing of the arteries, increasing the risk of heart attacks, strokes, and other cardiovascular events. Keeping blood pressure within normal limits through lifestyle changes, such as reducing salt intake, managing stress, exercising, and taking medications if needed, is essential for heart health.

A. Patient's refusal to cough, deep breathe, and use their incentive spirometer due to pain B. Urine output of 40 mL/hr and clear yellow after having their Foley catheter removed C. Patient ambulating short distances and performing range of motion exercises alter pain is controlled D. Hypoactive bowel sounds 2 hours post-operative.

Correct Answer is A

Explanation

A) Patient's refusal to cough, deep breathe, and use their incentive spirometer due to pain:
The patient’s refusal to perform these respiratory exercises could lead to serious complications such as atelectasis, pneumonia, and other respiratory issues. Coughing, deep breathing, and using the incentive spirometer are essential to prevent postoperative respiratory complications, especially if the patient is at higher risk for lung issues due to immobility or anesthesia. This needs immediate intervention to ensure the patient understands the importance of these activities and to address the pain issue, potentially with additional pain management or support.

B) Urine output of 40 mL/hr and clear yellow after having their Foley catheter removed:
A urine output of 40 mL/hr is within normal limits for a post-operative patient, and the clear yellow color indicates that the urine is not concentrated or indicative of infection. While monitoring urine output is important postoperatively, this finding suggests adequate renal function and does not indicate an immediate risk for long-term complications.

C) Patient ambulating short distances and performing range of motion exercises after pain is controlled:
Early ambulation and range of motion exercises are encouraged after surgery to promote circulation, prevent blood clots, and support overall recovery. It indicates that the patient is progressing in their recovery and actively participating in post-operative rehabilitation, which is a positive sign and does not need urgent intervention.

D) Hypoactive bowel sounds 2 hours post-operatively:
This is expected immediately after surgery, especially if the patient underwent abdominal surgery or received general anesthesia, which can temporarily reduce bowel motility. Hypoactive bowel sounds within the first few hours post-surgery are a normal response to anesthesia and do not require urgent intervention. The nurse should continue to monitor the patient’s bowel function, but this finding is not a priority in the immediate postoperative period.

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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

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Explanation

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