Question 1

A 9-year-old child will be receiving carbamazepine (Tegretol)suspension,200 mL daily.The medication is available in a strength of 100 mg/5 mL.Identify how many milliliters will the nurse give to the patient for each dose._______

Accepted Answer

10 mL

Question 2

A patient is experiencing status epilepticus.The nurse prepares to give which drug of choice for the treatment of this condition?&#10;A) Diazepam (Valium)&#10;B) Midazolam (Versed)&#10;C) Valproic acid (Depakote)&#10;D) Carbamazepine (Tegretol)

Accepted Answer

Diazepam (Valium) is considered by many to be the drugs of choice for status epilepticus. Other drugs that are used are listed in Table 14-3 and do not include the drugs listed in the other options.

Question 3

The nurse has given medication instructions to a patient receiving phenytoin (Dilantin).Which statement by the patient indicates that the patient has an adequate understanding of the instructions?&#10;A) &#34;I will need to take extra care of my teeth and gums while on this medication.&#34;&#10;B) &#34;I can go out for a beer while on this medication.&#34;&#10;C) &#34;I can skip doses if the side effects bother me.&#34;&#10;D) &#34;I will be able to stop taking this drug once the seizures stop.&#34;

Accepted Answer

It is important for patients receiving phenytoin to practice good dental hygiene and visit a dentist regularly, as the medication can cause gum overgrowth and other oral complications. Choice B is incorrect as alcohol can interact with phenytoin and increase the risk of side effects. Choice C is incorrect as skipping doses can lead to breakthrough seizures and decreased effectiveness. Choice D is incorrect as phenytoin is often used as a long-term treatment for epilepsy and seizures, and should not be stopped suddenly without medical guidance.

Question 4

A patient has a 9-year history of a seizure disorder that has been managed well with oral phenytoin (Dilantin)therapy.He is to be NPO (consume nothing by mouth)for surgery in the morning.What will the nurse do about his morning dose of phenytoin?

A) Give the same dose intravenously.
B) Give the morning dose with a small sip of water.
C) Contact the prescriber for another dosage form of the medication.
D) Notify the operating room that the medication has been withheld.

Accepted Answer

As the patient is NPO, they cannot take their oral phenytoin. Instead of giving the same dose intravenously or with a small sip of water, the nurse should contact the prescriber for another dosage form of the medication, such as an IV form. It is important to not withhold the medication completely, as the patient has a history of seizures and their medication regimen has been effective in controlling them.

Question 5

The nurse is giving an intravenous dose of phenytoin (Dilantin).Which action is correct when administering this drug? A) Give the dose as a fast intravenous (IV)bolus. B) Mix the drug with normal saline,and give it as a slow IV push. C) Mix the drug with dextrose (D₅W),and give it as a slow IV push. D) Mix the drug with any available solution as long as the administration rate is correct.

Accepted Answer

Phenytoin should be mixed with normal saline and administered as a slow IV push over 20-30 minutes. It should not be given as a fast IV bolus or mixed with dextrose, as this can cause precipitation of the drug and potentially dangerous adverse effects. It should also not be mixed with any available solution, as the compatibility of other solutions is not guaranteed.

Question 6

A patient is taking gabapentin (Neurontin),and the nurse notes that there is no history of seizures on his medical record.What is the best possible rationale for this medication order?&#10;A) The medication is used for the treatment of neuropathic pain.&#10;B) The medication is helpful for the treatment of multiple sclerosis.&#10;C) The medication is used to reduce the symptoms of Parkinson's disease.&#10;D) The medical record is missing the correct information about the patient's history of seizures.

Accepted Answer

Gabapentin is often prescribed for neuropathic pain, as it works by blocking nerve signals that transmit pain sensations. While it is also used for other conditions such as multiple sclerosis and Parkinson's disease, its primary indication is for the treatment of neuropathic pain.

Question 7

When teaching a patient about taking a newly prescribed antiepileptic drug (AED)at home,the nurse will include which instruction?&#10;A) &#34;Driving is allowed after 2 weeks of therapy.&#34;&#10;B) &#34;If seizures recur,take a double dose of the medication.&#34;&#10;C) &#34;Antacids can be taken with the AED to reduce gastrointestinal adverse effects.&#34;&#10;D) &#34;Regular,consistent dosing is important for successful treatment.&#34;

Accepted Answer

The best choice is D because regular, consistent dosing is important for successful treatment with antiepileptic drugs. Any variation in dosage can result in an increased risk of seizures or adverse reactions. It is important that patients do not alter their dose or discontinue their medication without consulting their healthcare provider. A is incorrect because driving restrictions are dependent on individual patient response to the medication and should be determined by the healthcare provider. B is incorrect because taking a double dose can increase the risk of adverse reactions and should not be done without consulting the healthcare provider. C is incorrect because antacids can interact with AEDs and reduce their effectiveness, so patients should be advised to separate administration by at least 2 hours.

Question 8

The U.S.Food and Drug Administration has issued a warning for users of antiepileptic drugs.Based on this report,the nurse will monitor for which potential problems with this class of drugs?&#10;A) Increased risk of suicidal thoughts and behaviors&#10;B) Signs of bone marrow depression&#10;C) Indications of drug addiction and dependency&#10;D) Increased risk of cardiovascular events,such as strokes

Accepted Answer

The warning issued by the FDA specifically mentions an increased risk of suicidal thoughts and behaviors in patients taking antiepileptic drugs. None of the other options are mentioned in the warning.

Question 9

The nurse is reviewing the dosage schedule for several different antiepileptic drugs (AEDs).Which antiepileptic drug allows for once-a-day dosing?&#10;A) Levetiracetam (Keppra)&#10;B) Phenobarbital&#10;C) Valproic acid (Depakote)&#10;D) Gabapentin (Neurontin)

Accepted Answer

Phenobarbital has the longest half-life of all standard AEDs, including those listed in the other options; therefore, it allows for once-a-day dosing.

Question 10

A patient has been taking an AED for several years as part of his treatment for partial seizures.His wife has called because he ran out of medication this morning and wonders if he can go without it for a week until she has a chance to go to the drugstore.What is the nurse's best response?

A) "He is taking another antiepileptic drug,so he can go without the medication for a week."
B) "Stopping this medication abruptly may cause withdrawal seizures.A refill is needed right away."
C) "He can temporarily increase the dosage of his other antiseizure medications until you get the refill."
D) "He can stop all medications because he has been treated for several years now."

Accepted Answer

Stopping antiepileptic medication abruptly can cause withdrawal seizures, which can be dangerous. It is important for the patient to continue taking the medication as prescribed and for the wife to refill the prescription as soon as possible. Option A is incorrect because it assumes that the patient is taking another antiepileptic drug, which may not be the case. Option C is incorrect because adjusting the dosage of other medications should only be done under medical supervision. Option D is incorrect because it is not safe for the patient to stop all medication abruptly.

Question 11

Phenytoin (Dilantin)has a narrow therapeutic index.The nurse recognizes that this characteristic indicates which of these?&#10;A) The safe and the toxic plasma levels of the drug are very close to each other.&#10;B) The phenytoin has a low chance of being effective.&#10;C) There is no difference between safe and toxic plasma levels.&#10;D) A very small dosage can result in the desired therapeutic effect.

Accepted Answer

The answer of Phenytoin (Dilantin)has a narrow therapeutic index.The nurse...

Question 12

During a routine appointment,a patient with a history of seizures is found to have a phenytoin (Dilantin)level of 23 mcg/mL.What concern will the nurse have,if any?&#10;A) The patient is at risk for seizures because the drug level is not at a therapeutic level.&#10;B) The patient's seizures should be under control because this is a therapeutic drug level.&#10;C) The patient's seizures should be under control if she is also taking a second antiepileptic drug.&#10;D) The drug level is at a toxic level,and the dosage needs to be reduced.

Accepted Answer

The answer of During a routine appointment,a patient with a...

Question 13

The nurse is reviewing antiepileptic drug (AED)therapy.Which statements about AED therapy are accurate? (Select all that apply.)&#10;A) AED therapy can be stopped when seizures are stopped.&#10;B) AED therapy is usually lifelong.&#10;C) Consistent dosing is the key to controlling seizures.&#10;D) A dose may be skipped if the patient is experiencing adverse effects.&#10;E) Do not abruptly discontinue AEDs because doing so may cause rebound seizure activity.

Accepted Answer

The answer of The nurse is reviewing antiepileptic drug (AED)therapy.Which...

Question 14

The nurse is monitoring a patient who has been taking carbamazepine (Tegretol)for 2 months.Which effects would indicate that autoinduction has started to occur?&#10;A) The drug levels for carbamazepine are higher than expected.&#10;B) The drug levels for carbamazepine are lower than expected.&#10;C) The patient is experiencing fewer seizures.&#10;D) The patient is experiencing toxic effects from the drug.

Accepted Answer

The answer of The nurse is monitoring a patient who...

Deck 14: Antiepileptic Drugs