Question 1

An order for intravenous phenytoin (Dilantin)has been given to control seizure activity in a client with status epilepticus.What is the maximal injection rate that the nurse should use?&#10;A) 5 mg/min&#10;B) 20 mg/min&#10;C) 50 mg/min&#10;D) 100 mg/min&#10;

Accepted Answer

The maximal injection rate for phenytoin is 50 mg/min. Rapid administration can cause cardiovascular collapse or respiratory arrest.

Question 2

Clients taking carbamazepine (Tegretol)should be taught to report which of the following symptoms?&#10;A) Confusion&#10;B) Increased alertness&#10;C) Easy bruising&#10;D) Improved appetite&#10;

Accepted Answer

Clients taking carbamazepine (Tegretol) should be taught to report confusion as it is a possible side effect of the medication. Increased alertness and improved appetite are not common side effects of carbamazepine, while easy bruising may be a symptom of a different issue and should still be reported, but it is not specifically associated with this medication.

Question 3

Mr.K.complains that his vision is blurry after receiving the intravenous form of phenytoin (Dilantin).The nurse's best response to him at this time would be&#10;A) &#34;You must be having a different type of seizure because of all the anxiety.&#34;&#10;B) &#34;Just relax and take a few deep breaths;surgery will soon be over.&#34;&#10;C) &#34;Let me go call your surgeon immediately,because this may be an allergic reaction and we need to cancel surgery.&#34;&#10;D) &#34;The blurred vision is an adverse effect associated with this drug,and I think your doctor would want to know that you are experiencing this.&#34;&#10;

Accepted Answer

The best response would be to acknowledge the adverse effect associated with phenytoin, which is blurred vision. Informing Mr. K about this would be crucial and he may need further management or adjustment of his medication. Choices A and B are inappropriate responses as they do not address the issue and may cause confusion or anxiety. Choice C is also incorrect as it assumes an allergic reaction without proper assessment and may cause unnecessary cancellation of surgery.

Question 4

The pediatric clinic nurse is working with a 4-year-old client diagnosed with Lennox-Gastaut syndrome.The nurse anticipates that which antiepileptic drug may be indicated for this child?&#10;A) Felbamate (Felbatol)&#10;B) Ethosuximide (Zarontin)&#10;C) Phenytoin (Dilantin)&#10;D) Primidone (Mysoline)&#10;

Accepted Answer

Lennox-Gastaut syndrome is a severe form of epilepsy that is often resistant to traditional antiepileptic drugs. Felbamate has been found to be effective for this condition and is one of the few drugs approved for use in children with Lennox-Gastaut syndrome. Ethosuximide is primarily used for absence seizures, not Lennox-Gastaut syndrome. Phenytoin and Primidone are not typically recommended for treatment of Lennox-Gastaut syndrome.

Question 5

The nurse would give further instructions to the family member of a client beginning therapy with a new antiepileptic drug after hearing the family member make which of the following statements?&#10;A) &#34;This medicine should be kept in the bathroom cabinet along with the other prescriptions.&#34;&#10;B) &#34;Now I won't have to keep a record of seizure activity anymore.&#34;&#10;C) &#34;It will still be important to use the seizure precautions we have been taught.&#34;&#10;D) &#34;It's important not to miss doses so a seizure doesn't occur a few days later.&#34;&#10;

Accepted Answer

The answer of The nurse would give further instructions to...

Question 6

A client with diabetes mellitus has neuropathy in the legs and is in pain.The nurse anticipates that which drug may be ordered for this client?&#10;A) Levetiracetam (Keppra)&#10;B) Gabapentin (Neurontin)&#10;C) Lamotrigine (Lamictal)&#10;D) Primidone (Mysoline)&#10;

Accepted Answer

Gabapentin (Neurontin) is commonly used to treat neuropathic pain, including that caused by diabetic neuropathy. It works by modulating the release of certain neurotransmitters in the brain and spinal cord that are involved in pain processing. Levetiracetam (Keppra) is an antiepileptic drug that is not typically used to treat neuropathic pain. Lamotrigine (Lamictal) is also an antiepileptic drug that may have some efficacy in treating neuropathic pain, but it is not as commonly used as gabapentin. Primidone (Mysoline) is not effective for neuropathic pain and is typically used to control seizures.

Question 7

For a client who is taking oral phenytoin (Dilantin)and who is NPO for surgery,the nurse would be correct to&#10;A) administer the oral phenytoin even though the client is NPO.&#10;B) contact the physician for another dosage form of phenytoin.&#10;C) finish the preoperative teaching and check on the order later.&#10;D) make sure to give the client the phenytoin postoperatively.&#10;

Accepted Answer

The nurse should contact the physician for another dosage form of phenytoin because the client is NPO for surgery and cannot take oral medication. Giving the medication orally could result in aspiration and complications during surgery. Alternative routes of administration or an adjustment in dosage may be necessary.

Question 8

When teaching a client about medications before discharge,the nurse should realize that antiepileptic drug therapy failure is most commonly caused by&#10;A) drug tolerance and chronic administration.&#10;B) mismanagement of medications by the client.&#10;C) inadequate liver metabolism.&#10;D) drug and dietary interactions.&#10;

Accepted Answer

Mismanagement of medications by the client is the most common cause of antiepileptic drug therapy failure, which includes missed doses or taking incorrect doses of medication. Tolerance, chronic administration, inadequate liver metabolism, and drug and dietary interactions can also contribute to therapy failure, but they are not as common as medication mismanagement.

Question 9

Which of the following statements correctly describes status epilepticus?&#10;A) The duration of seizure activity is longer than 1 hour&#10;B) The client is conscious throughout the seizure activity&#10;C) There is a 10% to 20% mortality rate associated with this condition&#10;D) The client is in respiratory alkalosis caused by hyperventilation&#10;

Accepted Answer

Status epilepticus is a serious condition where seizures follow one another without recovery of consciousness between them, or a single seizure lasts more than 5 minutes. It is associated with significant morbidity and mortality, with estimates of mortality rates ranging from 10% to 20%, depending on the population and specifics of the condition being studied.

Question 10

A client taking carbamazepine (Tegretol)for 6 weeks telephones the health care provider's office and reports a sore throat and low-grade fever that started 5 days ago.Which of the following responses by the nurse is most appropriate?

A) "You should come to the office to be evaluated.Would a morning or an early afternoon appointment work best for you?"
B) "Have you tried taking acetaminophen (Tylenol)to manage those symptoms?"
C) "Let me ask whether the doctor wants you to take an extra dose of carbamazepine to avoid seizure activity because of the fever."
D) "If these symptoms don't start to get better by tomorrow,call again and we will schedule you for a visit."

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Accepted Answer

The symptoms of sore throat and low-grade fever could be indicative of a serious infection, such as strep throat, especially in a patient who has been taking carbamazepine for 6 weeks. Therefore, the nurse should advise the client to come to the office to be evaluated as soon as possible. It's important to schedule an appointment rather than waiting for the client to call back if symptoms persist because of the potential seriousness of the condition.

Question 11

After listening to intershift report,the nurse makes a note to periodically check the patellar reflex of the client receiving which antiepileptic medication?&#10;A) Phenobarbital (Luminal)&#10;B) Oxcarbazepine (Trileptal)&#10;C) Magnesium sulfate&#10;D) Tiagabine (Gabitril)&#10;

Accepted Answer

The answer of After listening to intershift report,the nurse makes...

Question 12

The nurse would question a new drug order for carbamazepine (Tegretol)for a client with which of the following types of seizures?&#10;A) Simple partial seizures&#10;B) Complex partial seizures&#10;C) Absence seizures&#10;D) Generalized tonic-clonic seizures&#10;

Accepted Answer

The answer of The nurse would question a new drug...

Question 13

A client has a scheduled dose of antiepileptic drug by the intravenous route at 0700,1500,and 2300 each day.The physician orders a serum drug level to be drawn.At which of the following times should the nurse schedule the laboratory work to be drawn?

A) 0630
B) 0800
C) 1400
D) 1700

Accepted Answer

The answer of A client has a scheduled dose of...

Question 14

What is the appropriate method of administering an antiepileptic drug?&#10;A) Give the medication every 8 hours&#10;B) Administer the medication during the day&#10;C) Give one dose of the medication and obtain a serum level&#10;D) Establish a drug regimen based on the half-life of the medication&#10;

Accepted Answer

The answer of What is the appropriate method of administering...

Question 15

Women taking phenytoin (Dilantin)for antiepileptic drug therapy need to be taught to report to their physician if they become pregnant because of the associated risk of&#10;A) maternal tachycardia.&#10;B) increased fetal weight.&#10;C) maternal hypertension.&#10;D) teratogenicity.&#10;

Accepted Answer

The answer of Women taking phenytoin (Dilantin)for antiepileptic drug therapy...

Question 16

If a client has a very high serum level of phenytoin (Dilantin)of 35 mg/mL,the nurse would assess for which of the following problems?&#10;A) Tachycardia&#10;B) Hypertension&#10;C) Nystagmus&#10;D) Nightmares&#10;

Accepted Answer

The answer of If a client has a very high...

Question 17

The nurse should assess a client taking valproic acid (Depakene)for which of the following adverse effects?&#10;A) Dyspnea&#10;B) Hepatotoxicity&#10;C) Drowsiness&#10;D) Oliguria&#10;

Accepted Answer

The answer of The nurse should assess a client taking...

Question 18

Which of the following nursing diagnoses would be appropriate for a client with a seizure disorder?&#10;A) Deficient fluid volume&#10;B) Risk for infection&#10;C) Ineffective tissue perfusion&#10;D) Risk for injury&#10;

Accepted Answer

The answer of Which of the following nursing diagnoses would...

Question 19

Phenytoin (Dilantin)works by which of the following mechanisms?&#10;A) Suppressing medullary activity&#10;B) Inhibiting the vasomotor reflex center&#10;C) Depressing neuronal excitability&#10;D) Enhancing nerve cell permeability&#10;

Accepted Answer

The answer of Phenytoin (Dilantin)works by which of the following...

Question 20

A client has a new drug order for oxcarbazepine (Trileptal).Which of the following statements should the nurse include in client teaching about this medication?&#10;A) &#34;This medication may cause the sodium level in your blood to go up.&#34;&#10;B) &#34;The dose may need to be adjusted upward over time because the drug induces its own metabolism.&#34;&#10;C) &#34;This medication will not cause any drowsiness.&#34;&#10;D) &#34;You will not need to have serum drug levels drawn for this medication.&#34;&#10;

Accepted Answer

The answer of A client has a new drug order...

Deck 17: Antiepileptic Drugs