Chapter 15 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

Chapter 15 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

The patient says to the nurse, “My doctor said I have epilepsy and need to take medicine for those seizures I had. Do I really need medicine?” What is the best response by the nurse?

1. “Having epilepsy is the same as having a mental illness; the medications are very similar.”
2. “You will need medicine for a little while to cure the seizures.”
3. “You might not need medicine; you may be controlled by a ketogenic diet.”
4. “Yes, you need to take medication on a continual basis to control the seizures.”

Correct Answer: 4

Rationale 1: Epilepsy is not a mental illness, although some of the same medications are used to control symptoms of both disorders.

Rationale 2: Epilepsy and associated seizures are not curable with medications.

Rationale 3: The ketogenic diet is used when seizures cannot be controlled through pharmacotherapy or when there are unacceptable side effects to the medications.

Rationale 4: Epilepsy is a disease where seizures occur on a chronic basis. Once seizures are controlled, patients are continued indefinitely on the antiseizure drug.

Global Rationale: Epilepsy is a disease where seizures occur on a chronic basis. Once seizures are controlled, patients are continued indefinitely on the antiseizure drug. Epilepsy and associated seizures are not curable with medications. The ketogenic diet is used when seizures cannot be controlled through pharmacotherapy or when there are unacceptable side effects to the medications. Epilepsy is not a mental illness, although some of the same medications are used to control symptoms of both disorders.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 15-2 Recognize possible causes of seizures.

MNL Learning Outcome: 3.5.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 181

 

Question 2

Type: MCMA

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

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. “Excessive stress levels cause disruptions in how the brain receives oxygen, leading to epilepsy.”
2. “Epilepsy may be caused by a head injury.”
3. “Eating disorders, like anorexia nervosa, increase the risk for developing epilepsy.”
4. “A stroke, or brain attack, could increase the risk for developing epilepsy.”
5. “With some cases of epilepsy, the cause is never determined.”

Correct Answer: 2,4,5

Rationale 1: Excessive levels of stress cannot disrupt cerebral oxygen to the extent that epilepsy would occur.

Rationale 2: Head trauma is a known cause of seizures.

Rationale 3: There is no known correlation with anorexia nervosa and the development of epilepsy.

Rationale 4: Changes in cerebral perfusion such as hypotension; strokes, or brain attacks; and shock may be causes of seizures.

Rationale 5: In some cases, the exact etiology may not be identified.

Global Rationale: Epilepsy is a disorder where seizures occur on a chronic basis. Head trauma is a known cause of seizures. In some cases, the exact etiology may not be identified. Changes in cerebral perfusion such as hypotension; strokes, or brain attacks; and shock may be causes of seizures. There is no known correlation with anorexia nervosa and the development of epilepsy. Excessive levels of stress cannot disrupt cerebral oxygen to the extent that epilepsy would occur.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 15-2 Recognize possible causes of seizures.

MNL Learning Outcome: 3.5.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 181

 

Question 3

Type: MCSA

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

1. “Absence seizures are basically the same kind of seizures as grand mal, but they are less frequent.”
2. “Your daughter’s seizures manifest as a staring into space for a few seconds. Ethosuximide (Zarontin) is a good medication for this type of seizure.”
3. “Explaining the types of seizure activity is complicated. Have you spoken to your doctor about it?”
4. “Are you sure your doctor prescribed ethosuximide (Zarontin)? Phenobarbital (Luminal) is used much more frequently with children.”

Correct Answer: 2

Rationale 1: Grand mal, or tonic-clonic, seizures are different from absence or petit mal seizures; they are different forms of epilepsy.

Rationale 2: It is the responsibility of the RN to educate the patient, not just refer questions to the physician.

Rationale 3: Ethosuximide (Zarontin), not phenobarbital (Luminal), is the drug of choice for absence seizures.

Rationale 4: Absence seizures, formerly known as petit mal, last a few seconds and are seen most often in children. Ethosuximide (Zarontin) is a drug of choice for this type of seizure disorder.

Global Rationale: Absence seizures, formerly known as petit mal, last a few seconds and are seen most often in children. Ethosuximide (Zarontin) is a drug of choice for this type of seizure disorder. Grand mal, or tonic-clonic, seizures are different from absence or petit mal seizures; they are different forms of epilepsy. Ethosuximide (Zarontin), not phenobarbital (Luminal), is the drug of choice for absence seizures. It is the responsibility of the RN to educate the patient, not just refer questions to the physician.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: IX.1 Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 15-3 Relate signs and symptoms to specific types of seizures.

MNL Learning Outcome: 3.5.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 183

 

Question 4

Type: MCSA

The patient has epilepsy and receives phenytoin (Dilantin). The patient has been seizure-free, and asks the nurse why he still needs blood tests when he is not having seizures. What is the best response by the nurse?

1. “Because phenytoin (Dilantin) has a very narrow range between a therapeutic dose and a toxic dose.”
2. “Because phenytoin (Dilantin) can cause blood-thinning in some patients.”
3. “Because phenytoin (Dilantin) can cause Stevens-Johnson syndrome, which will show up in the blood tests.”
4. “Because phenytoin (Dilantin) can deplete your system of potassium.”

Correct Answer: 1

Rationale 1: Phenytoin (Dilantin) has a very narrow range between a therapeutic dose and a toxic dose; blood levels must be monitored to ensure a therapeutic level and to prevent toxicity.

Rationale 2: Phenytoin (Dilantin) is not an anticoagulant and does not cause thinning of the blood.

Rationale 3: Stevens-Johnson syndrome is a severe skin reaction that can be an adverse outcome with phenytoin (Dilantin), but it is monitored by skin assessment, not blood tests.

Rationale 4: There isn’t any evidence to support that phenytoin (Dilantin) causes potassium depletion.

Global Rationale: Phenytoin (Dilantin) has a very narrow range between a therapeutic dose and a toxic dose; blood levels must be monitored to ensure a therapeutic level and to prevent toxicity. There isn’t any evidence to support that phenytoin (Dilantin) causes potassium depletion. Stevens-Johnson syndrome is a severe skin reaction that can be an adverse outcome with phenytoin (Dilantin), but it is monitored by skin assessment, not blood tests. Phenytoin (Dilantin) is not an anticoagulant and does not cause thinning of the blood.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: VII.5 Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan.

NLN Competencies: Context and Environment: Chronic disease management.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 15-5 Explain the importance of patient drug compliance in the pharmacotherapy of epilepsy and seizures.

MNL Learning Outcome: 3.5.2 Compare the classes of medications used in pharmacologic management.

Page Number: 183