Chapter 22: Anticonvulsants

Chapter 22: Anticonvulsants

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

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.	idiopathic in origin.
c.	linked to a stroke.
d.	related to brain anoxia.

 

 

ANS:  B

Of all seizure cases, 75% are primary, or idiopathic, with no known cause. The remaining are secondary and may be related to head trauma, stroke, or anoxic events.

 

DIF:    COGNITIVE LEVEL: Remembering (Knowledge)           REF:   Page 304

TOP:   NURSING PROCESS: Assessment

MSC:  NCLEX: Physiological Integrity: Pathophysiology

 

2. 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 is usually taken 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.”

 

 

ANS:  A

Anticonvulsants are given to prevent seizures and are usually taken throughout the patient’s lifetime. Stopping the medication will lead to recurrence of seizures in most patients. Some patients may attempt to stop taking the medications after 3 to 5 years of no seizure activity. Anticonvulsants are not given as needed.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 305

TOP:   NURSING PROCESS: Nursing Intervention: Patient Teaching

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

3. 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 expected.”

 

 

ANS:  D

Drug dosage for phenytoin is age-related and children, who have a rapid metabolism, may need higher doses than those used for newborns and adults. Phenytoin has many drug interactions and many side effects. The therapeutic range is 10-20 mcg/mL.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 306

TOP:   NURSING PROCESS: Planning/Nursing Intervention: Patient Teaching

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

4. The nurse is caring for a patient who has a seizure disorder. The nurse notes that the patient has reddened gums that bleed when oral care is given. The nurse recognizes this finding as

a.	an adverse effect of the phenytoin.
b.	a drug interaction with aspirin.
c.	a symptom of hepatotoxicity.
d.	a sign of poor self-care.

 

 

ANS:  A

Hydantoins commonly cause gingival hyperplasia, which causes overgrowth of reddened gum tissue that bleeds easily. It is not a sign of a drug interaction or a symptom of hepatotoxicity. It does not indicate a lack of self-care.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 306

TOP:   NURSING PROCESS: Assessment

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

5. The nurse is preparing to administer phenytoin (Dilantin) to a patient who has a seizure disorder. The patient appears drowsy, and 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 is not toxic.
b.	Contact the provider to discuss decreasing the phenytoin dose.
c.	Give the drug and monitor closely for adverse effects.
d.	Report drug toxicity to the providers.

 

 

ANS:  A

Drowsiness is a common side effect of phenytoin and is not cause for alarm. The patient’s drug level is normal, since 10-20 mcg/mL is the therapeutic range. The nurse should administer the dose. It is not necessary to decrease the dose or monitor the patient more closely than usual.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 306

TOP:   NURSING PROCESS: Evaluation

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies