Deck 22: Anticonvulsants

Question 1

A client has been taking phenytoin (Dilantin) for 10 years. This client should be evaluated for:

A) hypoglycemia.
B) hyperglycemia.
C) hypertension.
D) status epilepticus.

Answer 1

hyperglycemia.

Question 2

A client with a known seizure disorder enters the emergency department. The nurse notes that his gums are swollen and bleeding. What is a priority nursing intervention?

A) Draw a bleeding time.
B) Assess the client's dental hygiene.
C) Assess for mucositis.
D) Draw a phenytoin level.

Answer 2

Draw a phenytoin level.

Question 3

Gastric irritation may occur when taking ethosuximide (Zarontin). The nurse suggests taking the drug:

A) before meals.
B) 2 hours after meals.
C) at bedtime.
D) at mealtime or immediately after the meal.

Answer 3

at mealtime or immediately after the meal.

Question 4

A client with a known seizure disorder is treated with several anticonvulsant medications. The client confides in the nurse, stating that he also has a strong belief in complementary medicine and takes several herbal supplements. Which is an appropriate response by the nurse?

A) "Check with your healthcare provider to ensure that there are no harmful drug interactions."
B) "Most herbal supplements are safe medications with anticonvulsants."
C) "No herbal supplements should be taken with prescription medications."
D) "You need to check the herbal labels to make sure that this is okay."

Question 5

Which of the following dietary restrictions is indicated with carbamazepine (Tegretol)?

A) Limit foods high in vitamin K.
B) Restrict acid-ash foods.
C) Maintain a high-fiber diet.
D) Do not drink grapefruit juice.

Question 6

A client taking anticonvulsants for epilepsy should receive which instruction from the nurse?

A) "The medication is usually taken for a lifetime."
B) "The medication is taken until you are seizure-free."
C) "Seizures are unpredictable, and therefore so is the drug regimen."
D) "Seizure disorders may be cured with anticonvulsants."

Question 7

A client with a new seizure disorder is ordered to receive phenobarbital (Luminal) for seizures. The nurse would expect:

A) a high body temperature.
B) hypertension.
C) lethargy.
D) decreased urine output.

Question 8

A child is brought to the healthcare provider's office. The child has been receiving phenytoin (Dilantin) for seizure activity. The family reports that despite the child's previously reported controlled seizures, the child has been seizing two or three times a day. The nurse would anticipate that the:

A) child's medication will be changed.
B) child will be admitted to the hospital.
C) child will be placed on nasogastric medications.
D) child's phenytoin level will be drawn.

Question 9

The client has been started on phenytoin. He reports experiencing reddish-colored urine. What is the nurse's highest priority intervention?

A) Report this symptom to the physician; this is an adverse reaction.
B) Instruct the client to stop the medication; this is a life-threatening reaction.
C) Report this symptom to the physician; this indicates toxicity of the medication.
D) Instruct the client that this is an expected side effect of the medication.

Question 10

A client is ordered to receive an anticonvulsant for seizure activity. Which side effects are most prevalent with clients who take drugs in this class?

A) Drowsiness and lethargy
B) Nausea and vomiting
C) Weight loss and anorexia
D) Hypertension and tachycardia

Question 11

The client with ________ would not be a candidate for treatment with valproic acid (Depakene).

A) a liver disorder
B) cardiac dysfunction
C) a gastrointestinal tract disorder
D) a thyroid dysfunction

Question 12

The client has been started on valproic acid. Her level of the medication is drawn and is found to be 60 mcg/mL. The nurse notes that this is a(n) _____ level.

A) toxic
B) therapeutic
C) subnormal
D) above-normal

Question 13

A client is ordered to receive phenytoin (Dilantin). The client's serum phenytoin level is noted to be 15 mcg/mL. How does the nurse interpret this level?

A) 5 to 10 mcg/mL is subnormal.
B) 8 to 15 mcg/mL is above normal.
C) 10 to 20 mcg/mL is therapeutic.
D) 15 to 30 mcg/mL is toxic.

Question 14

A client with a known seizure disorder is being treated with phenytoin (Dilantin). The client becomes pregnant. Which recommendation would be appropriate for the nurse to make?

A) "Contact your healthcare provider right away; you should not take Dilantin while pregnant."
B) "Make certain that your healthcare provider is aware that you are taking Dilantin through the first trimester."
C) "Antiepileptic agents need to be taken during pregnancy to avoid the effect of seizure activity on the fetus."
D) "Dilantin is safe during pregnancy as long as you maintain adequate hydration."

Question 15

A client has been receiving phenytoin (Dilantin) for 15 years. The nurse implements which diagnostic test to assess for a common adverse reaction to long-term medication use?

A) Fasting blood glucose level
B) Chest x-ray
C) Voiding cystourethrogram
D) BUN and creatinine

Question 16

A client enters the emergency department in status epilepticus. The nurse anticipates the administration of:

A) phenobarbital (Luminal).
B) phenytoin (Dilantin).
C) valproic acid (Depakene).
D) diazepam (Valium).

Question 17

A nurse is teaching a client about her health plan when taking phenytoin (Dilantin). Which instruction would not be included in the teaching plan?

A) "Avoid use of oral contraceptives."
B) "Assess output daily."
C) "Drink alcoholic beverages sparingly."
D) "Obtain a Medic Alert bracelet."

Question 18

A nurse is providing teaching for a client taking phenytoin (Dilantin). Which client statement indicates a good understanding of the teaching?

A) "Concentrated urine means a life-threatening disorder."
B) "Alcohol is contraindicated with Dilantin."
C) "Dilantin should be taken on an empty stomach."
D) "Dilantin may be discontinued because seizure rebound is uncommon."

Question 19

A child enters the emergency department. The paramedics report that the child has been having a seizure that has lasted for 45 minutes. In addition to securing and maintaining an airway, what is a priority intervention on the part of the nurse?

A) Phenobarbital (Luminal)
B) Diazepam (Valium)
C) Phenytoin (Dilantin)
D) Valproic acid (Depakene)

Question 20

A client taking phenytoin (Dilantin) is admitted to the emergency department with a level of 30 mcg/mL. The nurse would evaluate for the severe side effect of:

A) gingival hyperplasia.
B) abdominal distention.
C) abdominal cramps.
D) hypertension.

Question 21

The client has been started on phenytoin and reports to the nurse that he also takes ginkgo. What is the most accurate response from the nurse?

A) "Ginkgo can decrease the effectiveness of phenytoin."
B) "Ginkgo can increase the effectiveness of phenytoin."
C) "Ginkgo can cause an anaphylactic reaction to phenytoin."
D) "Ginkgo can cause phenytoin to reach a toxic level."