Review Practice Exercise 5

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Practice Exercise 5

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Total Questions : 4

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Question 1:

A patient suddenly begins to have a tonic-clonic seizure while sitting in a chair. Which nursing action is appropriate?

A. Time the duration of the seizure B. Turn the patient onto their side C. Restrain the patient to prevent injury D. Place a tongue blade in the patient's mouth

Answer and Explanation

Choice A:

Timing the seizure is essential because it provides critical information on the seizure’s duration, which helps determine if further intervention (such as pharmacologic treatment for status epilepticus) is needed. Monitoring the time also guides the evaluation of therapeutic response and supports timely communication with the health care team.

Choice B:

Turning the patient onto their side, while helpful for maintaining airway post-seizure, is not the highest priority during the seizure.

Choice C:

Restraining a patient during a tonic-clonic seizure increases the risk of injury to both the patient and the nurse and is not recommended.

Choice D:

Placing a tongue blade in the patient’s mouth is contraindicated as it can cause dental or soft tissue injury and obstruct the airway.

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Question 2:

A nurse is educating a patient about long-term management of their epilepsy with anti-seizure drugs (ASDs). Which of the following statements should the nurse include in the teaching plan? Select all that apply

A. "You should only take your medication when you feel a seizure coming on." B. "It is important to take your medication at the same time every day." C. "You may need to have your blood levels checked regularly to ensure the medication is working safely." D. "You should immediately stop taking your medication if you experience any side effects." E. "Missing a dose can increase your risk of having a breakthrough seizure."

Answer and Explanation

Choice A:

ASDs must be taken consistently regardless of perceived seizure activity; waiting for a prodrome undermines the therapeutic regimen and could lead to uncontrolled seizures.

Choice B:

Taking the medication at the same time every day maintains a consistent therapeutic level in the bloodstream, which is crucial for preventing breakthrough seizures.

Choice C:

Regular blood level monitoring is important to ensure that the drug concentration stays within the therapeutic range and minimizes toxicity.

Choice D:

Stopping the medication abruptly, even in the face of side effects, can precipitate withdrawal seizures and should only be done under medical supervision.

Choice E:

Missing a dose can lower the drug levels, significantly increasing the risk of breakthrough seizures, which is why adherence to the regimen is critical.

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Question 3:

A nurse is providing discharge instructions to a female client who has a prescription for phenytoin (Dilantin). Which of the following information should the nurse include?

A. Consider taking oral contraceptives when on this medication B. Watch for receding gums when taking the medication C. Take the medication at the same time every day D. Provide a urine sample to determine therapeutic levels of the medication

Answer and Explanation

Choice A:

Consider taking oral contraceptives when on this medication: Phenytoin reduces the effectiveness of hormonal contraceptives. Women should be advised to use non-hormonal methods or consult their provider for alternatives.

Choice B:

Watch for receding gums when taking the medication: While gingival hyperplasia is a known side effect of phenytoin, it is not the most critical discharge teaching point. The priority here is medication adherence and timing.

Choice C:

Take the medication at the same time every day: Maintaining a consistent dosing schedule is essential for drugs like phenytoin, which require stable serum levels. Irregular intake can lead to breakthrough seizures or toxicity.

Choice D:

Provide a urine sample to determine therapeutic levels of the medication: Phenytoin levels are monitored through blood tests, not urine. Blood testing ensures the dose remains within the therapeutic range (typically 10–20 mcg/mL).

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Question 4:

A nurse is completing discharge teaching to a client who has seizures and received a vagal nerve stimulator to decrease seizure activity. Which of the following information should the nurse include in the teaching?

A. The use of a microwave to heat food is permitted B. Inform a provider to order only a MRI when a scan is needed C. Place a magnet over the implantable device when an aura occurs D. The use of ultrasound diathermy for pain management is recommended

Answer and Explanation

Choice A:

The use of a microwave to heat food is permitted: While technically not harmful, this is not the most relevant teaching point during discharge about the VNS device. Microwaves do not interfere with VNS function, but this option lacks priority relevance.

Choice B:

Inform a provider to order only a MRI when a scan is needed: MRIs are generally contraindicated or require caution in patients with VNS. If needed, MRI safety protocols must be followed strictly, and not all MRI sites are safe depending on the magnet strength. This makes the statement inaccurate as written.

Choice C:

Place a magnet over the implantable device when an aura occurs: Patients are taught to swipe a magnet (provided by the manufacturer) over the implanted device when they feel a seizure coming. This action stimulates the vagus nerve, potentially interrupting the seizure.

Choice D:

The use of ultrasound diathermy for pain management is recommended: Ultrasound diathermy is contraindicated in clients with implanted electrical devices like a VNS. It may interfere with the stimulator or cause tissue damage, making this answer incorrect and potentially dangerous.

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Total Questions : 4

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Practice Exercise 5

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