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Chapter 18 Drugs Used for Seizure Disorders Test

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Chapter 18 Drugs Used for Seizure Disorders Test

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Chapter 18: Drugs Used for Seizure Disorders Test
Bank


MULTIPLE CHOICE

1. Which condition is associated with hydantoin therapy?
a. Postictal state
b. Atonia
c. Seizure threshold reduction
d. Gingival hyperplasia
ANS: D
Encouraging good oral hygiene practices is indicated when a patient is on hydantoin therapy
because its use contributes to gingival hyperplasia. Postictal state is a characteristic of
generalized tonic clonic seizures. Atonia is not associated with hydantoin therapy. Hydantoin
raises the seizure threshold.

DIF: Cognitive Level: Knowledge REF: p. 295 OBJ: 4
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity

2. The nurse is preparing discharge instructions for a patient with a history of diabetes who has
just been diagnosed with seizure disorder. The patient has been prescribed hydantoin
therapy. What will the patient most likely experience?
a. Hunger
b. Hyperglycemia
c. Diarrhea
d. Pupil dilation
ANS: B
Hydantoins may elevate blood sugar levels. Hunger, diarrhea, and pupil dilation are adverse
effects of hydantoin therapy. Constipation and nystagmus are potential adverse effects.

DIF: Cognitive Level: Application REF: p. 294 OBJ: 5
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity

3. What is a guideline for the nurse when administering phenytoin (Dilantin) intravenously? a.
Deliver rapidly.
b. Monitor for signs of tachycardia.
c. Assess for hypertensive crisis.
d. Administer without mixing with other medications.
ANS: D
Phenytoin should not be mixed in the same syringe with other medications or added to other
intravenous (IV) solutions because a precipitate will form. Phenytoin should be administered
slowly at a rate of 25 to 50 mg/min. Patients should be monitored with an ECG closely for
bradycardia. Patients should be monitored for hypotension.

DIF: Cognitive Level: Application REF: p. 292 OBJ: 6
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TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity

4. For which condition may carbamazepine (Tegretol) be used?
a. Tardive dyskinesia
b. Psychotic episodes
c. Trigeminal neuralgia pain
d. Sedation
ANS: C
Carbamazepine has been used successfully to treat pain associated with trigeminal neuralgia
and for bipolar disorders when lithium therapy has not been optimal. Carbamazepine does
not have antidepressant, antipsychotic, or sedative effects.

DIF: Cognitive Level: Knowledge REF: p. 296 OBJ: 4
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Physiological Integrity

5. What is the drug of choice when treating a generalized tonic clonic seizure?
a. Diazepam (Valium)
b. Haloperidol (Haldol)
c. Valproic acid (Depakene)
d. Risperidone (Risperdal)
ANS: C
Anticonvulsant therapy should start with the use of a single agent selected from a group of
first line agents based on the type of seizure. Valproic acid is indicated for generalized tonic
clonic seizures. Diazepam is not the drug of choice for treatment of tonic clonic seizures.
Haloperidol is an antipsychotic medication. Risperidone is an antipsychotic agent.

DIF: Cognitive Level: ComprehensionREF: p. 306 OBJ: 3
TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity

6. Which response by the nurse is accurate when a patient who has been on lamotrigine (
Lamictal) for seizure control reports a skin rash and urticaria?
a. Reassure the patient that this is a common adverse effect of the medication and not to
worry.
b. Instruct the patient to discontinue use of the drug immediately.
c. Instruct the patient to decrease the dosage of the medication until the rash disappears.
d. Advise the patient that this adverse effect usually resolves but should be reported to the
health care provider.
ANS: D
The nurse is not authorized to recommend dosage changes to the patient. The nurse should
not trivialize the patient’s concern about the adverse effect; it is common only in 10% of
patients who take lamotrigine and can lead to more serious adverse effects. The nurse
should not recommend discontinuing the medication without orders from the health care
provider. This is not a common adverse effect and should be monitored. Approximately 10%
of patients receiving lamotrigine develop a skin rash in the first 4 to 6 months of therapy. The
health care provider should be notified promptly because the rash could be an indicator of a
more serious condition.
DIF: Cognitive Level: Analysis REF: p. 300 OBJ: 4
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