Question 1

The client is receiving carbamazepine (Tegretol) for control of seizures. The client tells the nurse she plans to become pregnant. Which response by the nurse is the most appropriate?

Accepted Answer

Carbamazepine is a known teratogen and is contraindicated in pregnancy. The client should speak with her doctor about alternative medications that are safer during pregnancy.

Question 2

The nurse is providing discharge instructions for a client who has experienced pulled muscles in the back after lifting a heavy item at work. Which statement by the client indicates the need for further instruction?

Accepted Answer

Bed rest is not recommended for pulled muscles in the back, as it can prolong recovery time and increase the risk of complications such as blood clots. Instead, the client should stay active with gentle stretching and walking, and avoid heavy lifting and strenuous activities until the muscles have fully healed. Options A, B, and C are appropriate for managing symptoms and promoting healing.

Question 3

The nurse has been instructing the parents of a child with cerebral palsy about the treatment for the spasticity their child is experiencing. Which statements by the parents indicate that the nurse should plan additional teaching sessions? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

A) While surgery may be an option in severe cases, it is not always necessary for treating spasticity in cerebral palsy.
B) This statement is incorrect as medication alone is not always sufficient for controlling spasticity in cerebral palsy.
C) This is incorrect as physical therapy should focus on relaxing and stretching the muscles rather than flexing them.
D) This statement may be correct, as repeating exercises several times with each muscle group can help improve muscle flexibility and reduce spasticity, but it is not indicative of a need for additional teaching sessions. 
E) This statement is incorrect as physical therapy should be done consistently to see improvement, skipping sessions can hinder progress. Therefore, additional teaching sessions may be needed to emphasize the importance of consistent physical therapy.

Question 4

The health care provider has ordered intravenous (IV) diazepam (Valium) for a client in status epilepticus. What adverse effect is a priority for the nurse to monitor during administration?

Accepted Answer

Respiratory depression is a priority adverse effect to monitor during administration of IV diazepam. Diazepam is a central nervous system depressant and can cause respiratory depression, especially in high doses or when given rapidly through IV. It is crucial to monitor the client's respiratory rate and oxygen saturation during administration. Tachycardia, Steven Johnson Syndrome, and hypertension are not common adverse effects of diazepam.

Question 5

A client who suffers from frequent calf muscle cramping asks the nurse about using nonprescription capsaicin for pain relief. What information should the nurse provide this client?

Accepted Answer

The nurse should inform the client that capsaicin is not effective for the treatment of muscle cramps. However, if the client is still interested in using this medication, it is important to use gloves when applying the medication to avoid skin irritation or burns. Using the medication with a full glass of water is not necessary as it is a topical medication rather than an oral medication. The frequency of use can vary depending on the specific product, so the nurse should recommend that the client follow the package instructions or consult with a healthcare provider.

Question 6

The client has been started on medication to control seizures caused by epilepsy. He asks the nurse how long will he have to take the medications. What is the best response by the nurse?

Accepted Answer

Epilepsy is a chronic neurological disorder characterized by recurring seizures. Anticonvulsant medication is effective in controlling the seizures in most patients, but it does not cure epilepsy. Therefore, the patient will need to take the medication on a continuous basis to control the seizures. Discontinuing the medication without consulting with a healthcare provider can increase the risk of seizures and associated complications.

Question 7

The nurse is planning educational sessions for a client regarding the use of a newly prescribed antiepileptic drug (AED). Which topics should be included in these sessions? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

It is important for the client to take the medication at the same time every day to maintain a consistent level of the medication in their system. The client should also avoid using dietary supplements containing kava when on this medication, as they may interact and increase the risk of side effects. Options B, C, and D are incorrect because they provide incorrect information about medication dosage and usage.

Question 8

The nurse is talking with a client who was just prescribed phenytoin. Which client statement should the nurse immediately discuss with the client's health care provider? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

The answer of The nurse is talking with a client...

Question 9

A mother phones the clinic and tells the nurse, "My 5-year-old son had a fever seizure this morning." She adds that this is the child's first seizure experience. The nurse responds by asking the mother to bring the child in to be seen today. What other information should the nurse offer? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

The answer of A mother phones the clinic and tells...

Question 10

MCMA Nursing students are being tested on their knowledge of epilepsy and the drugs used to treat it. They are asked to identify conditions that may lead to seizures. What answers by a student indicate understanding of the content?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

Water intoxication, head injury, and meningitis are conditions that can lead to seizures. Water intoxication can cause hyponatremia, leading to seizures. Head injuries can cause brain damage, increasing seizure risk. Meningitis can cause inflammation of the brain, leading to seizures.

Question 11

The elderly client is prescribed phenobarbital for seizure control. What is most important intervention for the nurse to add to the client's care plan?

Accepted Answer

For clients taking phenobarbital, close monitoring of respiratory rate and depth is critical as it can cause respiratory depression. While monitoring for electrolyte imbalance, nutritional intake and fluid intake/output are all important interventions, they are not specific to phenobarbital use.

Question 12

A student is preparing to give phenobarbital for seizure control. Her instructor asks her how this medication works to control seizures. What response by the student is the most appropriate?

Accepted Answer

Phenobarbital is a barbiturate medication that enhances the activity of the neurotransmitter GABA (gamma-aminobutyric acid), which is responsible for inhibiting excessive excitability in the brain. This, in turn, reduces the likelihood of seizures occurring. Phenobarbital does not affect calcium or glutamate levels, nor does it decrease sodium significantly enough to control seizures.

Question 13

MCMA A client in the intensive acre unit is experiencing stars epileptics. Which of the following drugs would be appropriate to treat this client?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

Carbamazepine and gabapentin are not appropriate for treating status epilepticus in the intensive care unit because they are not fast-acting enough. IV phenytoin, IV diazepam, and IV phenobarbital are all effective at treating status epilepticus quickly and are commonly used in this setting.

Question 14

The nurse's neighbour says, "My son has been waking up with bad cramps in his calf for the last two nights. He has been working out with his football team in the hot sun." Which additional statement would indicate to the nurse that the neighbour needs more information concerning muscle spasms?

Accepted Answer

Giving muscle relaxers before practice is not an appropriate solution for muscle spasms and may cause harm to the son. The neighbour needs more education on proper prevention and treatment for muscle spasms. The other options show some knowledge on prevention and treatment of muscle spasms.

Question 15

The client is prescribed valproic acid (Depakene) for treatment of seizures. The client has also been taking a daily 81 mg aspirin tablet prophylactically for a cardiac condition. Because of the use of these two drugs, the nurse closely observes the client for which occurrence?

Accepted Answer

Valproic acid can enhance the effects of aspirin by displacing it from protein-binding sites, which can increase the risk of bleeding from the gums and bruising of the skin. The nurse should closely monitor the client for signs of bleeding and report any abnormal bleeding to the healthcare provider. The other options are not related to the use of valproic acid and aspirin together.

Question 16

The parents of a pediatric client diagnosed with epilepsy have decided to try a ketogenic diet to control their child's epilepsy. Which food should the nurse teach these parents to include in their child's diet?

Accepted Answer

The answer of The parents of a pediatric client diagnosed...

Question 17

The client has epilepsy and is prescribed phenytoin (Dilantin). The client has been seizure free and asks the nurse why he still needs blood tests when he is not having seizures. Which is the best response by the nurse?

Accepted Answer

Dilantin is a medication with a narrow therapeutic range, meaning that the difference between a therapeutic dose (the amount needed to control seizures) and a toxic dose is small. Therefore, regular blood tests are necessary to ensure that the client's Dilantin level is therapeutic and not toxic.

Question 18

The client tells the nurse that she has been prescribed phenytoin (Dilantin) for 2 years and is still having too many side effects. She wants to stop taking it. What is the best response by the nurse?

Accepted Answer

The nurse should educate the client about the risks of stopping phenytoin (Dilantin) abruptly, including the potential for withdrawal seizures. It is important for the client to consult with their healthcare provider before making any changes to their medication regimen. Option A suggests adding another medication without assessing the client's need, and option C is inappropriate as the nurse cannot make this decision on their own. Option D minimizes the client's experience of side effects and does not address their concerns.

Question 19

MCMA What client education should the nurse include in her care plan that will help to reduce complications from anti seizure drugs?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

The answer of MCMA What client education should the nurse...

Question 20

A client is seen for muscle spasms in the upper thigh. Which of the following classifications of drugs does the nurse anticipate being used for this client?

Accepted Answer

Muscle spasms are often treated with muscle relaxants to relieve the spasms and NSAIDs to reduce associated pain and inflammation.

Quiz 5: Pharmacology of Alterations in the Central Nervous System