Deck 19: Antiseizure Drugs

Question 1

A patient is diagnosed with epilepsy and asks the nurse what may have caused this condition. The nurse explains that epilepsy is most often:

A) caused by head trauma.
B) of unknown origin.
C) linked to a stroke.
D) related to brain anoxia.

Answer 1

of unknown origin.

Question 2

The nurse is performing a health history on a patient who is ordered to begin therapy with valproic acid (Depakote) to treat epilepsy. Which aspect of the patient's medical history will cause the nurse to be concerned?

A) Chronic obstructive pulmonary disease
B) Gastrointestinal disease
C) Liver disease
D) Renal disease

Answer 2

Liver disease

Question 3

The nurse is preparing to administer phenytoin to an 80-year-old patient and notes the following order: IVP phenytoin 50 mg. The nurse will perform which action?

A) Administer the undiluted drug through a Y-tube over 2 minutes.
B) Contact the provider to question the route and the dose.
C) Dilute the drug in dextrose solution and infuse over 15 to 20 minutes.
D) Request an order to administer the drug intramuscularly.

Answer 3

Administer the undiluted drug through a Y-tube over 2 minutes.

Question 4

A woman who is pregnant is taking an anticonvulsant medication to treat a seizure disorder. The nurse will ensure that the patient takes which dietary supplement toward the end of her pregnancy?

A) Vitamin D
B) Iron
C) Vitamin C
D) Vitamin K

Question 5

A female patient who takes phenytoin for epilepsy becomes pregnant. The nurse will notify the patient's provider and will anticipate that the provider will take which action?

A) Add valproic acid (Depakote) for improved seizure control.
B) Change the medication to phenobarbital (Luminal).
C) Closely monitor this patient's serum phenytoin levels.
D) Discontinue all anticonvulsant medications.

Question 6

A patient has recently begun taking phenytoin (Dilantin) for a seizure disorder. The nurse notes a reddish-brown color to the patient's urine. Which action will the nurse take?

A) Ask the provider to order a serum drug level.
B) Reassure the patient that this is a harmless side effect.
C) Report possible thrombocytopenia to the provider.
D) Request an order for a urinalysis and creatinine clearance.

Question 7

The nurse is preparing to assist with blood collection on a newly admitted patient who has been taking phenytoin for several years. The provider has ordered a complete blood count and liver function tests. Which other blood test will the nurse discuss with the provider?

A) Blood glucose
B) Coagulation studies
C) Renal function tests
D) Serum electrolytes

Question 8

The nurse is preparing to administer phenytoin (Dilantin) to a patient who has a seizure disorder. The nurse notes that the last random serum drug level was 18 mcg/mL. What action will the nurse take?

A) Administer the dose since the patient's labs do not indicate toxic phenytoin levels.
B) Contact the provider to discuss decreasing the phenytoin dose.
C) Give the drug and monitor closely for toxicity.
D) Report drug toxicity to the providers.

Question 9

The nurse provides teaching for a patient who will begin taking phenytoin. Which statement by the patient indicates understanding of the teaching?

A) "If I develop a rash, I should take diphenhydramine to control the itching."
B) "If I experience bleeding gums, I should stop taking the medication immediately."
C) "I may develop diabetes while I am taking this medication."
D) "I should not be alarmed if my urine turns reddish-brown."

Question 10

The nurse is providing teaching to the parents of a 5-year-old child who will begin taking phenytoin (Dilantin). What information will the nurse include when teaching these parents about their child's medication?

A) "Drug interactions are uncommon with phenytoin."
B) "There are very few side effects associated with this drug."
C) "The therapeutic range of phenytoin is between 15 and 30 mcg/mL."
D) "Your child may need a higher dose than is usually used in adults."

Question 11

A 25-year-old female patient will begin taking phenytoin for epilepsy. The patient tells the nurse she is taking oral contraceptives (OCPs). Which response will the nurse give?

A) "Continue taking OCPs because phenytoin is not safe during pregnancy."
B) "You should use a backup method of contraception along with OCPs."
C) "You should stop taking OCPs because of drug-drug interactions with phenytoin."
D) "You should take low-dose aspirin while taking these medications to reduce your risk of stroke."

Question 12

A patient has recently begun taking carbamazepine (Tegretol) as an adjunct medication to treat refractory seizures. The patient has a serum carbamazepine level of 18 mcg/mL. Which of the following would be the most appropriate next step?

A) Ask the patient about usual dietary preferences.
B) Reassure the patient that this is a therapeutic drug level.
C) Report a subtherapeutic drug dose to the provider.
D) Discontinue the carbamazepine.

Question 13

An intubated child is brought to the emergency department while having a seizure that has been progressing for 20 minutes. Which drug will the nurse anticipate administering to this patient first?

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

Question 14

A parent expresses concern that a 5-year-old child may develop epilepsy because the child experienced a febrile seizure at age 18 months. What will the nurse tell this parent?

A) "A child who has had a febrile seizure is considered to have epilepsy."
B) "A small percentage of children who have febrile seizures develop epilepsy."
C) "I recommend discussing prophylactic anticonvulsant drugs with the provider."
D) "Treat fevers aggressively with aspirin and NSAIDs to prevent seizures."

Question 15

A parent of a child who has been taking valproic acid (Depakote) for several years calls the clinic to report a recent recurrence of seizures and states that the child is having three or four seizures per week. The nurse will perform which action first?

A) Ask the parent to describe the child's drug regimen.
B) Request an order for a serum valproic acid level.
C) Suggest that the parent take the child to the emergency department.
D) Tell the parent that the provider will increase the child's dose of Depakote.

Question 16

A patient who takes phenytoin reports regular alcohol consumption. The nurse might expect a serum phenytoin level in this patient to be in which range?

A) 5 to 10 mcg/mL
B) 10 to 20 mcg/mL
C) 20 to 30 mcg/mL
D) 30 to 50 mcg/mL

Question 17

The nurse is caring for a patient who has been diagnosed with absence seizures. The nurse will anticipate teaching this patient about which antiepileptic medication?

A) Carbamazepine (Tegretol)
B) Ethosuximide (Zarontin)
C) Phenobarbital (Luminal)
D) Phenytoin (Dilantin)

Question 18

The nurse is caring for a patient who has a seizure disorder being treated with phenytoin. The nurse notes that the patient has reddened gums that bleed when brushing. The nurse recognizes this finding as:

A) an adverse effect of the phenytoin.
B) likely due to a drug interaction with aspirin.
C) a symptom of hepatotoxicity.
D) a sign of poor self-care.

Question 19

A patient who has epilepsy will begin an anticonvulsant medication. The patient asks the nurse how long the medication will be necessary. How will the nurse respond?

A) "The medication may be necessary for a lifetime."
B) "The medication will be given until you are seizure free."
C) "You will need to take the medication for 3 to 5 years."
D) "You will take the medication as needed for seizure activity."

Question 20

A patient will begin taking the antiepileptic drug ethosuximide (Zarontin). Ethosuximide works by which of the following mechanisms?

A) Suppressing sodium influx
B) Increasing GABA activity
C) Decreasing GABA activity
D) Suppressing calcium influx