Question 1

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

Phenobarbital is a central nervous system depressant and may cause respiratory depression. Therefore, frequent monitoring of the client's respiratory rate and depth is essential to ensure adequate oxygenation. While monitoring electrolyte levels, nutritional intake, and fluid balance are important components of general care, they are not the most critical interventions for a client on phenobarbital for seizure control.

Question 2

The health care provider has ordered intravenous (IV)diazepam (Valium)for the client in status epilepticus.During administration,it is most important for the nurse to assess for which result from this drug?

Accepted Answer

Respiratory depression is the most important result to assess for during administration of IV diazepam. Diazepam is a central nervous system depressant that can cause respiratory depression, especially at high doses or in combination with other drugs that also depress the central nervous system. The nurse should closely monitor the client's respiratory rate, depth, and effort during administration of IV diazepam, and be prepared to intervene promptly if respiratory depression occurs. Tachycardia, level of consciousness, and hypotension are also important to monitor, but they are not the most crucial result to assess for during administration of this drug.

Question 3

The client says to the nurse,"My doctor said that I will always have to take medicine to control the seizures from my epilepsy.Is that so?" What is the best response by the nurse?

Accepted Answer

The best response is A, as it is true that continuous medication is typically required to control seizures in epilepsy. The other options are not accurate or realistic, as there is currently no cure for epilepsy and stopping medication without medical supervision can be dangerous.

Question 4

A parent says to the nurse,"The doctor prescribed ethosuximide (Zarontin)for my child,who has absence seizures.What does this mean?" Which response by the nurse is the most appropriate?

Accepted Answer

This response accurately identifies the type of seizure the child is experiencing and explains that ethosuximide (Zarontin) is a suitable medication for this type of seizure. It provides the parent with helpful information and reassurance about the prescribed medication.

Question 5

The nurse is speaking before a group of elementary school teachers on the topic of seizure control medications.Which behaviors should the nurse advise the teachers to watch for in children who are taking levetiracetam (Keppra)?
Select all that apply.

Accepted Answer

The answer of The nurse is speaking before a group...

Question 6

An emergency department (ED)client's wife says,I couldn't wake my husband up this morning.He was snoring so loudly.Why,he was so asleep he urinated in the bed.He has never done anything like this before and he is okay now." Which is the priority for the nurse to ask the client's wife?

Accepted Answer

The symptoms described by the client's wife, such as inability to wake up, loud snoring, and involuntary urination, could indicate a postictal state following a seizure. Asking about a history of seizures is a priority to assess for a potential neurological cause.

Question 7

A preschool-age client is diagnosed with epilepsy.The child's mother is crying as she tells the nurse,I know that this is my fault.I did drugs before I knew I was pregnant." Which response by the nurse is the most appropriate?

Accepted Answer

The nurse should provide support and empathy to the mother, and reassure her that the most important thing now is getting good care for the child. It is not helpful or appropriate to blame or accuse the mother. The nurse should also provide education on epilepsy and the potential causes, but in a non-judgmental and informative way.

Question 8

A parent tells the nurse,The doctor says my son has epilepsy,but he has never had a convulsion.How can that be?" Which response by the nurse to the parent is the most appropriate?

Accepted Answer

Epilepsy is a neurological disorder that can present with a variety of symptoms, not all of which include convulsions. It is possible for someone to have epilepsy without ever experiencing a seizure, and the absence of convulsions does not necessarily mean that a person does not have epilepsy.

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?
Select all that apply.

Accepted Answer

Febrile seizures are common in children, occurring in up to 5% of children. They are usually not dangerous and do not require seizure medications.

Question 10

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

A ketogenic diet is high in fats and low in carbohydrates. Salad with vinegar and oil dressing fits this requirement as it is low in carbohydrates and can be high in fats depending on the oil used.

Question 11

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 teratogenic drug and is contraindicated in pregnancy. The client should speak to their doctor about safer alternatives for controlling their seizures during pregnancy.

Question 12

The nurse is teaching a class for clients who recently have been diagnosed with epilepsy.The nurse determines that learning has occurred when the clients make which statements?
Select all that apply.

Accepted Answer

These statements accurately reflect known causes and risk factors for epilepsy, including head injury, unknown causes, and neurological events such as stroke. The statements regarding stress and eating disorders are not accurate causes or risk factors for epilepsy.

Question 13

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?
Select all that apply.

Accepted Answer

It is important for the client to take the medication at the same time every day to maintain therapeutic levels in the blood. Additionally, kava supplements should be avoided as they can increase the risk of side effects and seizures.

B is incorrect as the missed dose should be taken as soon as possible, without doubling the dose. 
C is incorrect as additional doses should not be taken without consulting with a healthcare provider. 
D is incorrect as skipping doses can disrupt the effectiveness of the medication and should not be done without consulting with a healthcare provider.

Question 14

The nurse completes education to the parents of a child newly diagnosed with tonic-clonic seizures.Which comments made by the parents would the nurse evaluate as indicating the need for further education?
Select all that apply.

Accepted Answer

The answer of The nurse completes education to the parents...

Question 15

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

It is important for the nurse to educate the client about the dangers of stopping the medication abruptly. Withdrawal seizures can be life-threatening. The nurse should encourage the client to speak with her healthcare provider to address any concerns about side effects and potentially adjust or switch medications if needed.

Question 16

The client is prescribed phenobarbital for seizure control.The client asks the nurse how this little pill can stop seizures.What response by the nurse is the most appropriate?

Accepted Answer

Phenobarbital is a barbiturate that works by enhancing the activity of GABA, an inhibitory neurotransmitter in the brain that suppresses the electrical activity responsible for seizures. This medication does not affect the levels of calcium, glutamate, or sodium in the brain.

Question 17

The health care provider has prescribed 5 mg of intravenous diazepam (Valium)to treat the client in status epilepticus.The client's IV bag is labeled 1,000 mL D5NS with 20,000 units Heparin." Which nursing interventions are necessary to safely administer this diazepam (Valium)?
Select all that apply.

Accepted Answer

Flushing the IV line with saline ensures that the medication is delivered properly and prevents interactions with other medications. Observing the IV tubing for cloudiness helps detect any precipitation or incompatibility between diazepam and the IV solution.

Question 18

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 response by the nurse is the most appropriate?

Accepted Answer

Blood tests are necessary to monitor the therapeutic range of Dilantin since there is a narrow range between a helpful dose and a dose that could make the client feel sicker. It is important to ensure that the client is receiving the correct dose and that there are no adverse effects or toxicities associated with the use of the medication.

Question 19

The client who is prescribed valproic acid (Depakote)for seizure control would like to have a baby.Which statements should the nurse include in a discussion with this client?
Select all that apply.

Accepted Answer

Valproic acid (Depakote) is known to be teratogenic, meaning it can cause birth defects, especially neural tube defects. Therefore, the medication should not be used during pregnancy. The client should be advised to discuss alternative antiepileptic medications with her healthcare provider if she plans to become pregnant. Folic acid supplementation is important for all women of childbearing age, especially those with epilepsy who are at higher risk for neural tube defects in their babies. Statements A and E are not accurate or appropriate for discussing with the client. Statement B may be true for some antiepileptic medications, but it cannot be generalized without knowing which specific medication the client is taking.

Question 20

The nurse is talking with a client who was just prescribed zonisamide (Zonegran).Which client statement should the nurse immediately discuss with the client's health care provider?
Select all that apply.

Accepted Answer

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

Quiz 22: Pharmacotherapy of Seizures

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?

The health care provider has ordered intravenous (IV) diazepam (Valium) for the client in status epilepticus.During administration,it is most important for the nurse to assess for which result from this drug?

The client says to the nurse,"My doctor said that I will always have to take medicine to control the seizures from my epilepsy.Is that so?" What is the best response by the nurse?

A parent says to the nurse,"The doctor prescribed ethosuximide (Zarontin) for my child,who has absence seizures.What does this mean?" Which response by the nurse is the most appropriate?

The nurse is speaking before a group of elementary school teachers on the topic of seizure control medications.Which behaviors should the nurse advise the teachers to watch for in children who are taking levetiracetam (Keppra) ? Select all that apply.

An emergency department (ED) client's wife says,I couldn't wake my husband up this morning.He was snoring so loudly.Why,he was so asleep he urinated in the bed.He has never done anything like this before and he is okay now." Which is the priority for the nurse to ask the client's wife?

A preschool-age client is diagnosed with epilepsy.The child's mother is crying as she tells the nurse,I know that this is my fault.I did drugs before I knew I was pregnant." Which response by the nurse is the most appropriate?

A parent tells the nurse,The doctor says my son has epilepsy,but he has never had a convulsion.How can that be?" Which response by the nurse to the parent is the most appropriate?

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?

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?

The nurse is teaching a class for clients who recently have been diagnosed with epilepsy.The nurse determines that learning has occurred when the clients make which statements? Select all that apply.

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? Select all that apply.

The nurse completes education to the parents of a child newly diagnosed with tonic-clonic seizures.Which comments made by the parents would the nurse evaluate as indicating the need for further education? Select all that apply.

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?

The client is prescribed phenobarbital for seizure control.The client asks the nurse how this little pill can stop seizures.What response by the nurse is the most appropriate?

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 response by the nurse is the most appropriate?

The client who is prescribed valproic acid (Depakote) for seizure control would like to have a baby.Which statements should the nurse include in a discussion with this client? Select all that apply.

The nurse is talking with a client who was just prescribed zonisamide (Zonegran) .Which client statement should the nurse immediately discuss with the client's health care provider? Select all that apply.