Chapter 24: Drugs for Epilepsy

Chapter 24: Drugs for Epilepsy

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient shows loss of consciousness, jaw clenching, contraction and relaxation of muscle groups, and periods of cyanosis. The nurse correctly identifies this as which type of seizure?

a.	Tonic-clonic
b.	Petit mal
c.	Myoclonic
d.	Atonic

 

 

ANS:  A

Tonic-clonic seizures (or grand mal seizures) are considered generalized seizures and are manifested by a loss of consciousness, jaw clenching, muscle relaxation alternating with muscle contractions, and periods of cyanosis. Absence seizures (or petit mal seizures) are characterized by loss of consciousness for a brief period and usually involve eye blinking and staring into space. Myoclonic seizures consist of sudden contractions that may be limited to one limb or may involve the entire body. Atonic seizures are characterized by sudden loss of muscle tone.

 

PTS:   1                    DIF:    Cognitive Level: Comprehension     REF:   pp. 216-217

TOP:   Nursing Process: Assessment

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Physiologic Adaptation

 

2. A nurse is assessing a patient who becomes motionless and seems to stare at the wall and then experiences about 60 seconds of lip smacking and hand wringing. What should the nurse do?

a.	Ask the patient about a history of absence seizures.
b.	Contact the provider to report symptoms of a complex partial seizure.
c.	Notify the provider that the patient has had a grand mal seizure.
d.	Request an order for intravenous diazepam [Valium] to treat status epilepticus.

 

 

ANS:  B

This patient showed signs of a complex partial seizure, characterized by impaired consciousness beginning with a period of motionlessness with a fixed gaze, followed by a period of automatism. The entire episode generally lasts 45 to 90 seconds. Absence seizures are characterized by loss of consciousness for a brief period (about 10 to 30 seconds) and may involve mild, symmetric motor activity or no motor signs. A grand mal seizure is characterized by jaw clenching and rigidity followed by alternating muscle relaxation and contraction and then periods of cyanosis, all with a loss of consciousness. Status epilepticus is a seizure that persists for 30 minutes or longer.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 216-217

TOP:   Nursing Process: Assessment

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Physiologic Adaptation

 

3. A nurse is discussing partial versus generalized seizures with a group of nursing students. Which statement by a student indicates understanding of the teaching?

a.	“Febrile seizures are a type of generalized tonic-clonic seizure.”
b.	“Generalized seizures are characterized by convulsive activity.”
c.	“Partial seizures do not last as long as generalized seizures.”
d.	“Patients having partial seizures do not lose consciousness.”

 

 

ANS:  A

Febrile seizures typically manifest as a tonic-clonic seizure of short duration and are a type of generalized seizure. Generalized seizures may be convulsive or nonconvulsive. Partial seizures may last longer than some types of generalized seizures. Patients with complex partial seizures and secondarily generalized seizures, which are types of partial seizures, may lose consciousness.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   p. 217

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

4. A nurse provides teaching for a patient with a newly diagnosed partial complex seizure disorder who is about to begin therapy with antiepileptic drugs (AEDs). Which statement by the patient indicates understanding of the teaching?

a.	“Even with an accurate diagnosis of my seizures, it may be difficult to find an effective drug.”
b.	“I will soon know that the drugs are effective by being seizure free for several months.”
c.	“Serious side effects may occur, and if they do, I should stop taking the medication.”
d.	“When drug levels are maintained at therapeutic levels, I can expect to be seizure free.”

 

 

ANS:  A

Even with an accurate diagnosis of seizures, many patients have to try more than one AED to find a drug that is effective and well tolerated. Unless patients are being treated for absence seizures, which occur frequently, monitoring of the clinical outcome is not sufficient for determining effectiveness, because patients with convulsive seizures often have long seizure-free periods. Serious side effects may occur, but withdrawing a drug precipitously can induce seizures. Not all patients have seizure control with therapeutic drug levels, because not all medications work for all patients.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 218-219

TOP:   Nursing Process: Planning

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies