Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch)
1. A patient is admitted to the emergency department with severe recurrent
convulsive seizures. What drug would the nurse expect to be ordered for use in
emergency control of status epilepticus?
a. Phenytoin (Dilantin)
b. Diazepam (Valium)
c. Phenobarbital (Luminal)
d. Ethosuximide (Zarontin)
Ans: C
Feedback:
Phenobarbital is used for emergency control of status epilepticus. This barbiturate
inhibits impulse conduction in the ascending reticular activating system (RAS),
depresses the cerebral cortex, alters cerebellar function, and depresses motor nerve
output. Phenobarbital stabilizes nerve membranes throughout the central nervous
system (CNS) directly by influencing ionic channels in the cell membrane, thereby
decreasing excitability and hyperexcitability to stimulation. By decreasing conduction
through nerve pathways, it reduces the tonicclonic, muscular, and emotional
responses to stimulation. Phenobarbital depresses conduction in the lower brainstem
and the cerebral cortex and depresses motor conduction. Phenytoin is used to prevent
status epilepticus but is not used to stop seizures after they have started; diazepam is
used for short-term treatment of status epilepticus. Ethosuximide is used for absence
seizures.
2. The pharmacology instructor is discussing drugs used for the treatment of partial
seizures. What accurately describes the physiological action of carbamazepine?
a. Reduces electrical activity
b. Alters sodium and calcium channels
c. Increases gamma-aminobutyric acid (GABA) activity and blocks sodium
and calcium channels to stop action potentials
d. Depresses conduction in the brainstem and cortex
Ans: C
Feedback:
Carbamazepine increases GABA activity and blocks sodium and calcium channels to
stop action potentials. Succinimides reduce electrical activity. Acetazolamides reduce
electrical activity and alter sodium and calcium channels. Barbiturates depress
conduction in the brainstem and the cortex.
, 3. A 7-year-old girl is brought to the clinic by her mother. The mother states that the
child will be engaged in some activity at home and then will just stop for a few
seconds and then pick up the activity again as if there had been no break in what
she was doing. The nurse suspects the child might be demonstrating what type of
seizure?
a. Tonicclonic seizure
b. Absence seizure
c. Myoclonic seizure
d. Status epilepticus
Ans: B
Feedback:
Absence seizures involve abrupt periods of loss of consciousness lasting 3 to 5
seconds. Tonic-clonic seizures involve dramatic muscle contractions, loss of
consciousness, and a recovery period characterized by confusion and exhaustion.
Myoclonic seizures involve short, sporadic periods of muscle contractions lasting for
several minutes. These types of seizures are rare. Status epilepticus seizures are the
most dangerous and rapidly occur one after another.
4. A patient is brought into the emergency department in status epilepticus. The nurse
administers phenobarbital 320 mg IV according to protocol. Family members ask
the nurse how long it will take to stop the seizures. What is the nurse’s best
response?
a. The onset of action for the medication is 5 minutes.
b. We should see results in about 10 minutes.
c. It will probably take about 30 minutes before the seizures begin to subside.
d. It may be an hour before the seizures stop.
Ans: A
Feedback:
The onset of IV phenobarbital is 5 minutes; however, it is important not to confuse
when the onset of action will occur and when the seizures will stop because additional
interventions may be needed to stop the seizure activity in some cases. For
intramuscular and subcutaneous administration, the onset should be between 10 and
30 minutes. Onset for an oral dose is between 30 and 60 minutes.
5. The nurse evaluates the patient’s serum phenytoin (Dilantin) level and determines
the level is therapeutic when it is within what range?
a. Between 5 and 12 mcg/mL
b. Between 10 and 20 mcg/mL
c. Between 15 and 50 mcg/mL
d. Between 40 and 100 mcg/mL
Ans: B
1. A patient is admitted to the emergency department with severe recurrent
convulsive seizures. What drug would the nurse expect to be ordered for use in
emergency control of status epilepticus?
a. Phenytoin (Dilantin)
b. Diazepam (Valium)
c. Phenobarbital (Luminal)
d. Ethosuximide (Zarontin)
Ans: C
Feedback:
Phenobarbital is used for emergency control of status epilepticus. This barbiturate
inhibits impulse conduction in the ascending reticular activating system (RAS),
depresses the cerebral cortex, alters cerebellar function, and depresses motor nerve
output. Phenobarbital stabilizes nerve membranes throughout the central nervous
system (CNS) directly by influencing ionic channels in the cell membrane, thereby
decreasing excitability and hyperexcitability to stimulation. By decreasing conduction
through nerve pathways, it reduces the tonicclonic, muscular, and emotional
responses to stimulation. Phenobarbital depresses conduction in the lower brainstem
and the cerebral cortex and depresses motor conduction. Phenytoin is used to prevent
status epilepticus but is not used to stop seizures after they have started; diazepam is
used for short-term treatment of status epilepticus. Ethosuximide is used for absence
seizures.
2. The pharmacology instructor is discussing drugs used for the treatment of partial
seizures. What accurately describes the physiological action of carbamazepine?
a. Reduces electrical activity
b. Alters sodium and calcium channels
c. Increases gamma-aminobutyric acid (GABA) activity and blocks sodium
and calcium channels to stop action potentials
d. Depresses conduction in the brainstem and cortex
Ans: C
Feedback:
Carbamazepine increases GABA activity and blocks sodium and calcium channels to
stop action potentials. Succinimides reduce electrical activity. Acetazolamides reduce
electrical activity and alter sodium and calcium channels. Barbiturates depress
conduction in the brainstem and the cortex.
, 3. A 7-year-old girl is brought to the clinic by her mother. The mother states that the
child will be engaged in some activity at home and then will just stop for a few
seconds and then pick up the activity again as if there had been no break in what
she was doing. The nurse suspects the child might be demonstrating what type of
seizure?
a. Tonicclonic seizure
b. Absence seizure
c. Myoclonic seizure
d. Status epilepticus
Ans: B
Feedback:
Absence seizures involve abrupt periods of loss of consciousness lasting 3 to 5
seconds. Tonic-clonic seizures involve dramatic muscle contractions, loss of
consciousness, and a recovery period characterized by confusion and exhaustion.
Myoclonic seizures involve short, sporadic periods of muscle contractions lasting for
several minutes. These types of seizures are rare. Status epilepticus seizures are the
most dangerous and rapidly occur one after another.
4. A patient is brought into the emergency department in status epilepticus. The nurse
administers phenobarbital 320 mg IV according to protocol. Family members ask
the nurse how long it will take to stop the seizures. What is the nurse’s best
response?
a. The onset of action for the medication is 5 minutes.
b. We should see results in about 10 minutes.
c. It will probably take about 30 minutes before the seizures begin to subside.
d. It may be an hour before the seizures stop.
Ans: A
Feedback:
The onset of IV phenobarbital is 5 minutes; however, it is important not to confuse
when the onset of action will occur and when the seizures will stop because additional
interventions may be needed to stop the seizure activity in some cases. For
intramuscular and subcutaneous administration, the onset should be between 10 and
30 minutes. Onset for an oral dose is between 30 and 60 minutes.
5. The nurse evaluates the patient’s serum phenytoin (Dilantin) level and determines
the level is therapeutic when it is within what range?
a. Between 5 and 12 mcg/mL
b. Between 10 and 20 mcg/mL
c. Between 15 and 50 mcg/mL
d. Between 40 and 100 mcg/mL
Ans: B
