Neurology HW Qs

Question 1

The nurse is educating a client about newly prescribed alprazolam. Which information should the nurse include in the teaching?

A. Tardive dyskinesia is common early in treatment
B. Administration of paroxetine may be needed to prevent adverse effects
C. The use of grapefruit juice should be avoided
D. Hyperactivity is seen with long-term use

Answer 1

C. The use of grapefruit juice should be avoided

Question 2

A client has been taking alprazolam for 3 days. For which expected effect of the medication should the nurse evaluate the client?

A. The client reports sleeping through the night
B. The client reports feeling less depressed
C. The client denies having auditory hallucinations
D. The client denies having suicidal ideations

Answer 2

A. The client reports sleeping through the night

Question 3

The nurse is providing discharge education to a client who is prescribed alprazolam for a panic disorder. Which concept should the nurse emphasize concerning the drug action?

A. Short-term relief can be expected
B. The medication acts as a stimulant
C. The medication works by suppressing dopamine
D. If you miss a dose, double the next scheduled dose

Answer 3

A. Short-term relief can be expected

Question 4

The nurse is caring for a client who was prescribed alprazolam. When educating the client about the new medications, which intended effect should the nurse include?

A. Reduce anxiety and provide a calming effect
B. Increase coordination and the ability to concentrate
C. Alleviate signs and symptoms of spasticity
D. Reduce symptoms of depression

Answer 4

A. Reduce anxiety and provide a calming effect

Question 5

A client is prescribed the benzodiazepine alprazolam for the management of panic attacks. Which action by the patient makes the nurse confident that the medication information discussed has been understood?

A. The client removes the pepperoni from a pizza
B. The client asks for an extra bottle of flavored water to drink with dinner
C. The client requests a prescription for oral contraceptives before being discharged
D. The client states that chewable antacids may be taken to relieve heartburn

Answer 5

C. The client requests a prescription for oral contraceptives before being discharged

Question 6

Which statement about benzodiazepines requires correction?

A. They are indicated for ethanol withdrawal
B. These medications increase the activity of gamma-aminobutyric acid
C. Benzodiazepines are the first-line medications used in chronic anxiety disorders
D. These medications depress activity in the brainstem

Answer 6

B. These medications increase the activity of gamma-aminobutyric acid

Question 7

Which manifestation is an adverse effect of intravenous lorazepam? Select all that apply. One, some, or all responses may be correct.

A. Amnesia
B. Drowsiness
C. Sleep driving
D. Blurred vision
E. Respiratory depression

Answer 7

A. Amnesia
B. Drowsiness
C. Sleep driving
D. Blurred vision
E. Respiratory depression

Question 8

A primary health care provider prescribes 0.25 mg of alprazolam by mouth three times per day for a client with anxiety and physical symptoms related to work pressures. Which side effects of this medication will the nurse monitor for this client?

A. Drowsiness
B. Bradycardia
C. Agranulocytosis
D. Tardive dyskinesia

Answer 8

A. Drowsiness

Question 9

A client has been robbed, beaten, and sexually assaulted. The primary health care team provider prescribes 0.25mg of alprazolam for agitation. Which event would alert the nurse to administer this medication?

A. The client’s crying increases
B. The client requests something to calm her
C. The nurse determines a need to reduce her anxiety
D. The primary health care provider is getting ready to perform a vaginal examination

Answer 9

B. The client requests something to calm her

Question 10

The nurse provides care for a client with a long history of alcohol abuse. Which medication would the nurse anticipate will be prescribed for the client to prevent symptoms of withdrawal?

A. Lorazepam
B. Phenobarbital
C. Chlorpromazine
D. Disulfiram

Answer 10

A. Lorazepam

Question 11

Which medication is indicated to treat shift-work sleep disorder (SWSD)?

A. Caffeine
B. Modafinil
C. Atomoxetine
D. Methylphenidate

Answer 11

B. Modafinil

Question 12

Which sedative-hypnotics would the nurse identify as being used to treat insomnia associated with a panic disorder? Select all that apply. One, some, or all response may be correct.

A. Phenelzine
B. Paroxetine
C. Alprazolam
D. Imipramine
E. Clonazepam

Answer 12

C. Alprazolam
E. Clonazepam

Question 13

Which medication would the nurse anticipate developing a teaching plan for when a client reports becoming panicked and having an irrational fear of talking in public?

A. Buspirone
B. Alprazolam
C. Diazepam
D. Lorazepam

Answer 13

B. Alprazolam

Question 14

Which primary reason identifies why oxazepam is given during detoxification?

A. Prevents injury when seizures occur
B. Enables the client to sleep better during periods of agitation
C. Encourages the client to accept treatment for alcoholism
D. Minimizes withdrawal symptoms the client may experience

Answer 14

D. Minimizes withdrawal symptoms the client may experience

Question 15

Diazepam is administered to the client with status epilepticus. In addition to decreasing central neuronal activity, which effect would the nurse anticipate?

A. Relaxing of peripheral muscles
B. Decreased heart rate
C. Dilation of airways
D. Hypertension

Answer 15

A. Relaxing of peripheral muscles

Question 16

The clients wants to know why midazolam will be administered preoperatively. Which reason would the nurse provide?

A. It reduces pain
B. It induces sedation
C. It prevents respiratory depression
D. It limits oral secretion

Answer 16

B. It induces sedation

Question 17

A client has a tonic-clonic seizure. The nurse anticipates the health care provider will prescribe the intravenous administration of which medication?

A. Naloxone
B. Diazepam
C. Epinephrine HCI
D. Atropine

Answer 17

B. Diazepam

Question 18

A client is treated with lorazepam for status epilepticus. Which effect of lorazepam is the reason it is given?

A. Decreases anxiety associated with seizures
B. Promotes rest after the seizure episode
C. Depresses the central nervous system (CNS)
D. Provides amnesia for the convulsive episode

Answer 18

C. Depresses the central nervous system (CNS)

Question 19

For which therapeutic effect will the nurse monitor the client who is prescribed alprazolam?

A. Pain relief
B. Decreased anxiety
C. Reduction in dysrhythmias
D. Reduced blood pressure

Answer 19

B. Decreased anxiety

Question 20

Which concern will the nurse keep in mind when a client has been taking a benzodiazepine?

A. Rebound insomnia may occur if the medication is discontinued abruptly
B. Lifelong treatment is often required
C. Higher dose are needed to accommodate physiological changes during pregnancy
D. These medications have both analgesic and antidepressant properties

Answer 20

A. Rebound insomnia may occur if the medication is discontinued abruptly

Question 21

An 18-month-old toddler is being treated with intravenous diazepam every 4 hours for generalized tetanus. Which response to the medication would the nurse anticipate?

A. Control of hypertonicity and prevention of seizures
B. Control of laryngospasms and neck and jaw rigidity
C. Prevention of excess oxygen and caloric expenditure
D. Prevention of restlessness and resistance to assisted ventilation

Answer 21

A. Control of hypertonicity and prevention of seizures

Question 22

The health care provider prescribes alprazolam 5 mg by mouth three times a day for a client with anxiety. Which intervention will the nurse take before administering this prescription?

A. Assess the apical pulse
B. Check the blood pressure
C. Encourage the ventilation of feelings
D. Clarify the prescription with the health care provider

Answer 22

D. Clarify the prescription with the health care provider

Question 23

In addition to hydration, parental lorazepam is prescribed for a client during alcohol withdrawal delirium. Which primary purpose accurately explains why this medication is given during detoxification?

A. To prevent injury when seizures occur
B. To enable the client to sleep better during periods of agitation
C. To reduce the anxiety tremor state and prevent more serious withdrawal symptoms
D. To calm the client and promote acceptance of the treatment plan

Answer 23

C. To reduce the anxiety tremor state and prevent more serious withdrawal symptoms

Question 24

An antianxiety medication is prescribed for an extremely anxious client. The client states, “I’m afraid to take this medication because I heard it’s addictive. “ Which response by the nurse is most appropriate?

A. “This medication rarely causes dependence when the dosage is controlled”
B. “You may require increases in your dosage; however, it rarely causes dependence”
C. “It usually results in psychological but not physiological dependence”
D. “The medication has the potential for physiological and psychological dependence”

Answer 24

D. “The medication has the potential for physiological and psychological dependence”

Question 25

Which adverse response would a nurse assess for when carbidopa-levodopa is prescribed for a client with Parkinson’s disease? Select all that apply. One, some, or all responses may be correct.

A. Nausea
B. Lethargy
C. Bradycardia
D. Polycythemia
E. Emotional changes

Answer 25

A. Nausea
E. Emotional changes

Question 26

Carbidopa-levodopa is prescribed for a client with Parkinson’s disease. Which instruction will the nurse include when teaching the client about this medication?

A. ‘Take this medication between meals.’
B. ‘Blood levels of the medication should be monitored weekly.’
C. ‘It can cause happy feelings followed by feelings of depression.’
D. ‘You may experience dizziness when moving from sitting to standing.’

Answer 26

D. ‘You may experience dizziness when moving from sitting to standing.’

Question 27

The nurse administers carbidopa-levodopa to a client with Parkinson’s disease. Which activity describes the mechanism of action of this medication?

A. Increase in acetylcholine production
B. Regeneration of injured thalamic cells
C. Improvement in myelination of neurons
D. Replacement of a neurotransmitter in the brain

Answer 27

D. Replacement of a neurotransmitter in the brain

Question 28

A client with Parkinson’s disease is admitted to the hospital. Which medication is prescribed to improve the physical manifestations of Parkinson’s disease?

A. Carbidopa-levodopa
B. Isocarboxazid
C. Dopamine
D. Pyridoxine (vitamin B6)

Answer 28

A. Carbidopa-levodopa

Question 29

Which would the nurse include when teaching a client with Parkinson’s disease about carbidopa-levodopa?

A. Multivitamins should be taken daily.
B. A high-protein diet should be followed.
C. The medication should be taken with meals.
D. Alcohol consumption should be in moderation.

Answer 29

C. The medication should be taken with meals.

Question 30

A client with Parkinson’s disease is taking carbidopa-levodopa (Sinemet). Which observation by the nurse would indicate that the desired outcome of the medication is being achieved?

A. Decreased blood pressure.
B. Lessening of tremors.
C. Increased salivation.
D. Increased attention span.

Answer 30

B. Lessening of tremors.

Question 31

A nurse is providing education on the use of carbidopa-levodopa to a client with Parkinson’s disease. What will the nurse include in the teaching?

A. This medication will stop the progression of your condition
B. Notify your healthcare provider if your urine appears dark
C. Eat plenty of whole-grain foods when taking this medication
D. Avoid eating meals that are high in protein

Answer 31

D. Avoid eating meals that are high in protein

Question 32

The nurse is caring for a client with Parkinson’s disease. Which finding indicates that the client might be experiencing an adverse side effect from the dopamine-enhancing drugs?

A. Urinary retention
B. Hallucinations
C. Kidney failure
D. Hypertensive urgency

Answer 32

B. Hallucinations

Question 33

Which mechanism of action would the nurse identify for levodopa therapy prescribed to a client diagnosed with Parkinson’s disease?

A. Blocks the effects of acetylcholine
B. Increases the production of dopamine
C. Restores the dopamine levels in the brain
D. Promotes the production of acetylcholine

Answer 33

C. Restores the dopamine levels in the brain

Question 34

Which symptom of levodopa toxicity will a client taking levodopa be taught as a reason to contact the primary health care provider?

A. Nausea
B. Dizziness
C. Twitching
D. Constipation

Answer 34

C. Twitching

Question 35

The mother of an infant recently prescribed phenobarbital for seizures calls the pediatric clinic and states that the infant is lethargic and sleeps for long periods. Which response by the nurse is most appropriate?

A. ‘There’s a medication that will prevent this problem.’
B. ‘This means that your baby’s dosage needs to be adjusted.’
C. ‘This is a temporary response to the medication; it usually stops after a few weeks.’
D. ‘Many infants experience the same problem, but your baby needs the medication.’

Answer 35

C. ‘This is a temporary response to the medication; it usually stops after a few weeks.’

Question 36

Two weeks after starting phenobarbital sodium, the client develops new symptoms. Which symptom is probably caused by the medication?

A. Cognitive impairment
B. Frequent urination
C. Abdominal pain
D. Mania

Answer 36

A. Cognitive impairment

Question 37

A client abruptly stops taking a barbiturate. Which withdrawal complication would the nurse anticipate that the client may experience?

A. Ataxia
B. Seizures
C. Diarrhea
D. Urticaria

Answer 37

B. Seizures

Question 38

Which action would the nurse implement for a client who has overdosed on barbiturates? Select all that apply. One, some, or all responses may be correct.

A. Apply ice packs.
B. Maintain airway.
C. Administer naloxone.
D. Give activated charcoal.
E. Give intravenous fluids.

Answer 38

B. Maintain airway.
D. Give activated charcoal.
E. Give intravenous fluids.

Question 39

A client is admitted to the emergency department with multiple fractures and potential internal injuries. The client’s history reveals abuse of multiple medications for the past 8 months. Which medication when withdrawn will cause the most serious life-threatening responses?

A. Heroin
B. Methadone
C. Barbiturates
D. Amphetamines

Answer 39

C. Barbiturates

Question 40

A client is prescribed alprazolam. Which action must the nurse include in the client assessment during the initiation of therapy?

A. Measure the client’s urine output.
B. Examine the client’s pupils daily.
C. Check the client’s blood pressure.
D. Assess the abdomen for distention.

Answer 40

C. Check the client’s blood pressure.

Question 41

Which medication would the nurse expect to administer to actively reverse the overdose sedative effects of benzodiazepines?

A. Lithium
B. Flumazenil
C. Methadone
D. Chlorpromazine

Answer 41

B. Flumazenil

Question 42

Which rationale explains why the nurse would question a benzodiazepine prescription for an individual experiencing acute grief?

A. The depression is magnified, and the risk of suicide increases.
B. Brain activity is suppressed, and the risk of depression increases.
C. Lethargy results, and it prevents a return to interpersonal activity.
D. The period of denial is extended, and the grieving process is suppressed.

Answer 42

D. The period of denial is extended, and the grieving process is suppressed.

Question 43

Which finding would the nurse report to the health care provider when caring for a client prescribed temazepam at bedtime?

A. Anxiety
B. Drowsiness
C. Sleep driving
D. Morning headache

Answer 43

C. Sleep driving

Question 44

A client has completed therapy and requests to discontinue treatment with benzodiazepines. Which information would the nurse provide to prevent injury?

A. Taper dose over several months.
B. Switch to using an antidepressant.
C. Refrain from renewing prescription.
D. Monitor for signs of increased anxiety.

Answer 44

A. Taper dose over several months.

Question 45

Which medication would the nurse instruct a client to avoid while taking alprazolam? Select all that apply. One, some, or all responses may be correct.

A. Opioids
B. Alcohol
C. Barbiturates
D. Antidepressants
E. First-generation antipsychotics

Answer 45

A. Opioids
B. Alcohol
C. Barbiturates

Question 46

Which medication acts as an antidote to benzodiazepine?

A. Zolpidem
B. Temazepam
C. Suvorexant
D. Flumazenil

Answer 46

D. Flumazenil

Question 47

Which class of medication would the nurse anticipate preparing to administer to a client with alcohol dependence admitted to a detoxification unit?

A. Opiate
B. Antipsychotic
C. Antidepressant
D. Benzodiazepine

Answer 47

D. Benzodiazepine

Question 48

Which medication would the nurse identify as commonly used as an adjunct during conscious sedation for minor surgeries?

A. Diazepam
B. Midazolam
C. Lorazepam
D. Clonazepam

Answer 48

B. Midazolam

Question 49

Which administration guidelines would the nurse follow when administering midazolam to an older client?

A. The increments should be smaller, and the rate of injection should be slower.
B. The medication should be given as a rapid intravenous push.
C. It is important to monitor for spikes in blood pressure elevation during administration.
D. During the procedure, the medication should be given as needed for pain management.

Answer 49

A. The increments should be smaller, and the rate of injection should be slower.

Question 50

Which primary anxiolytic medication would the nurse anticipate developing a teaching plan for when a client with social anxiety disorder has a history of exhibiting an intense, irrational fear of being scrutinized by others? Select all that apply. One, some, or all responses may be correct.

A. Sertraline
B. Paroxetine
C. Alprazolam
D. Venlafaxine
E. Clonazepam

Answer 50

C. Alprazolam
E. Clonazepam

Question 51

The nurse in the neurology office is reviewing information about levetiracetam with a 30-year-old female client with a history of seizures. Which instruction about the medication should the nurse make sure to include?

A. “Call the office immediately if you feel like hurting or killing yourself.”
B. “You should avoid becoming pregnant while taking this medication.”
C. “You should stay away from large crowds and sick children.”
D. “You might experience irregular menses and intermittent bleeding.”

Answer 51

A. “Call the office immediately if you feel like hurting or killing yourself.”

Question 52

Which effect would the nurse assess for in a client with Alzheimer’s disease who has been taking galantamine and is newly prescribed paroxetine for depression?

A. Allergic
B. Dystonic
C. Additive
D. Extrapyramidal

Answer 52

C. Additive

Question 53

A client who has been taking the prescribed dose of zolpidem for 5 days returns to the clinic for a follow-up visit. Which statement by the client indicates the medication has been effective?

A. “I have less pain.”
B. “I have been sleeping better.”
C. “My blood glucose is under control.”
D. “My blood pressure is coming down.”

Answer 53

B. “I have been sleeping better.”

Question 54

An older adult client has been prescribed zolpidem for insomnia. The nurse should monitor the client for which side/adverse effect of this medication?

A. Tachypnea
B. Hypotension
C. Tachycardia
D. Constipation

Answer 54

B. Hypotension

Question 55

A client with insomnia takes a new medication to promote sleep. Two hours later, the client is wide awake and feeling more energized than before the medication was taken. Which type of response is the client demonstrating?

A. Allergic
B. Synergistic
C. Paradoxical
D. Idiosyncratic

Answer 55

C. Paradoxical

Question 56

The daughter of a client with Alzheimer’s disease asks the nurse, “Will the medication my mother is taking cure her dementia?” What is the best response by the nurse?

A. “It will help your mother live independently again.”
B. “It is used to halt the progression of Alzheimer’s disease.”
C. “It will not improve dementia but can help control emotional responses.”
D. “It will provide a steady improvement in memory.”

Answer 56

C. “It will not improve dementia but can help control emotional responses.”

Question 57

The nurse is completing a health history of a client diagnosed with Alzheimer’s disease. The nurse reviews a list of the client’s medications and supplements routinely taken at home. Which treatment should be a cause for concern by the nurse?

A. Donepezil
B. Ginkgo biloba
C. Omega-3 fatty acids
D. Coconut oil

Answer 57

D. Coconut oil

Question 58

Donepezil is prescribed for a client who has mild dementia of the Alzheimer type. Which information would the nurse include when discussing this medication with the client and family?

A. Fluids should be limited to 4 large glasses per day.
B. Constipation should be reported to the primary health care provider immediately.
C. Blood tests that reflect liver function will be performed routinely.
D. The client’s medication dosage may be self-adjusted according to the client’s response.

Answer 58

C. Blood tests that reflect liver function will be performed routinely.

Question 59

A client with a diagnosis of dementia of the Alzheimer type has been taking donepezil 10 mg/day for 3 months. The client’s partner calls the clinic and reports that the client has increasing restlessness and agitation accompanied by nausea. Which advice would the nurse give the partner?

A. Give the medication with food.
B. Administer the medication at bedtime.
C. Omit 1 dose today and start with a lower dose tomorrow.
D. Bring the partner (client) to the clinic for testing and a physical examination.

Answer 59

D. Bring the partner (client) to the clinic for testing and a physical examination.

Question 60

The nurse teaches a client’s family about the administration of donepezil for treatment of dementia of the Alzheimer type. Which side effect identified by the caregiver indicates to the nurse that further teaching is needed?

A. Nausea
B. Dizziness
C. Headache
D. Constipation

Answer 60

D. Constipation

Question 61

The caregiver of a client with Alzheimer’s disease asks the nurse for information about different treatment options that can help with memory or behavior problems. Which of the following responses by the nurse are correct? Select all that apply.

A. “Music therapy has been found to help some clients.”
B. “Ginkgo biloba may help with memory.”
C. “Acupuncture may be very relaxing.”
D. “Donepezil (Aricept) may help slow cognitive decline.”
E. “Garlic may help with this disease.”

Answer 61

A. “Music therapy has been found to help some clients.”
B. “Ginkgo biloba may help with memory.”
D. “Donepezil (Aricept) may help slow cognitive decline.”

Question 62

The nurse has given discharge instructions to a client who suffers from sensory neuropathy due to diabetes. The client was prescribed gabapentin. Which of the following statements indicates that the client understands the nurse’s instructions regarding the medication?

A. “The medication might cause me to have insomnia.”
B. “I can stop taking the medication at any time.”
C. “My doctor prescribed it for the pain in my legs.”
D. “It is safe to take extra doses if my pain becomes worse.”

Answer 62

C. “My doctor prescribed it for the pain in my legs.”

Question 63

A nurse is providing education on the use of pregabalin to a client with a seizure disorder. Which client statement indicates further teaching is required?

A. I will record the number of seizures I experience
B. I will hold the dose if my seizures are controlled
C. I will notify my healthcare provider if I have significant mood changes
D. I will report any weight gain to my healthcare provider

Answer 63

B. I will hold the dose if my seizures are controlled

Question 64

Which adverse effect would the nurse continually assess for in a client receiving valproic acid?

A. Yellow sclerae
B. Motor restlessness
C. Ringing in the ears
D. Torsion of the neck

Answer 64

A. Yellow sclerae

Question 65

The nurse understands which antiepileptic medication would be used as the first-line treatment for absence seizures?

A. Phenytoin
B. Diazepam
C. Valproic acid
D. Acetazolamide

Answer 65

C. Valproic acid

Question 66

A client is diagnosed with trigeminal neuralgia. Which nonanalgesic can decrease the client’s pain?

A. Echinacea
B. Leucovorin
C. Allopurinol
D. Carbamazepine

Answer 66

D. Carbamazepine

Question 67

Which effect would the nurse monitor to evaluate the effectiveness of carbamazepine in the management of a client’s trigeminal neuralgia?

A. Pain intensity
B. Gait
C. Range of motion
D. Seizure activity

Answer 67

A. Pain intensity

Question 68

The nurse teaches the client about effects of carbamazepine that would be reported to the primary health care provider. Which effects would the nurse include? Select all that apply. One, some, or all responses may be correct.

A. Nausea
B. Dizziness
C. Unusual bleeding or bruising
D. Sensitivity to bright light or sun
E. Breast enlargement

Answer 68

A. Nausea
C. Unusual bleeding or bruising

Question 69

A school-age child with a seizure disorder has been on long-term carbamazepine therapy. Which intervention would the nurse incorporate into the plan of care?

A. Assessing the mouth for gingivitis
B. Checking the pupillary reaction to light
C. Keeping an accurate intake and output record
D. Monitoring the child’s complete blood cell counts

Answer 69

D. Monitoring the child’s complete blood cell counts

Question 70

A client is admitted to the emergency department after experiencing a seizure. Which action would the nurse take first?

A. Ask the emergency provider for a prophylactic anticonvulsant.
B. Obtain a history of seizure type and incidence.
C. Ask the client to remove any dentures and eyeglasses.
D. Observe the client for increased restlessness and agitation.

Answer 70

B. Obtain a history of seizure type and incidence.

Question 71

Which statement by the nurse reflects teaching for a client recently initiated on anticonvulsants? Select all that apply. One, some, or all responses may be correct.

A. ‘It is important to take the medication at the same time every day with meals.’
B. ‘It is important to not drink excessive amounts of caffeine-containing beverages or alcohol.’
C. ‘Avoid driving or hazardous activities until any side effects, such as drowsiness, can be determined.’
D. ‘Some anticonvulsants interfere with vitamin and mineral absorption, so you may need a supplement.’
E. ‘Oral hygiene, such as gum massage and tooth brushing, is important to combat the gingival hyperplasia that some anticonvulsant medication can cause.’

Answer 71

A. ‘It is important to take the medication at the same time every day with meals.’
B. ‘It is important to not drink excessive amounts of caffeine-containing beverages or alcohol.’
C. ‘Avoid driving or hazardous activities until any side effects, such as drowsiness, can be determined.’
D. ‘Some anticonvulsants interfere with vitamin and mineral absorption, so you may need a supplement.’
E. ‘Oral hygiene, such as gum massage and tooth brushing, is important to combat the gingival hyperplasia that some anticonvulsant medication can cause.’

Question 72

Status epilepticus develops in an adolescent with a seizure disorder who is taking antiseizure medication. Which reason would the nurse identify as the most common reason for the development of status epilepticus?

A. The provider failed to account for a growth spurt.
B. The amount prescribed is insufficient to cover activities.
C. The prescribed antiseizure medication probably is not taken consistently.
D. The client is prescribed a medication that is ineffective in preventing seizures.

Answer 72

C. The prescribed antiseizure medication probably is not taken consistently.

Question 73

A client has a tonic-clonic seizure caused by an overdose of aspirin. Which action would the nurse take next?

A. Check reflexes every 2 hours.
B. Insert a urinary retention catheter.
C. Monitor vital signs every 15 minutes.
D. Prepare a setup for a central venous pressure (CVP) line.

Answer 73

C. Monitor vital signs every 15 minutes.

Question 74

During the admission process, the client reports heavy alcohol use for at least one year. What effect does the nurse anticipate the hospitalized client will experience when alcohol consumption stops?

A. Bradycardia
B. Somnolence
C. Withdrawal
D. Tachypnea

Answer 74

C. Withdrawal

Question 75

The nurse is preparing to administer newly prescribed intravenous phenytoin to a client. When reviewing the client’s medical record, which prescription should the nurse question?

A. Continuous infusion of dextrose 5% in 0.9% saline
B. NPH insulin 40 units before meals
C. Labetalol 100 mg orally twice per day Your Answer
D. Ketorolac 15 mg IV push as needed for pain

Answer 75

A. Continuous infusion of dextrose 5% in 0.9% saline

Question 76

The nursing is preparing to administer phenytoin IV push to a client. The client has dextrose 5% in water infusing continuously. Which action is appropriate?

A. Pinch the line above the infusion port during the administration
B. Hold the medication and collaborate with the provider prior to administration
C. Stop the infusion and flush the port with normal saline prior to administration
D. Ask the pharmacy to mix the medication into an IV piggyback (IVPB) infusion

Answer 76

C. Stop the infusion and flush the port with normal saline prior to administration

Question 77

A nurse is providing care to a client who takes phenytoin for seizure prevention. The latest laboratory report shows a phenytoin level of 32 mcg/mL. Which action does the nurse take next?

A. Examine the oral cavity
B. Percuss the abdomen
C. Check the skin turgor
D. Assess the pupillary response

Answer 77

D. Assess the pupillary response

Question 78

The nurse is educating a client with seizure disorder about newly prescribed phenytoin. Which statement should the nurse include in the teaching?

A. Blood work will be required if you have a seizure while taking this medication
B. You will need to have routine visits with a dentist when taking this medication
C. It is normal to have a change in your gait when you first start this medication
D. Avoid grapefruit juice when taking this medication

Answer 78

B. You will need to have routine visits with a dentist when taking this medication

Question 79

A newly admitted client reports taking phenytoin for several months. Which assessment should the nurse include in the admission report? Select all that apply.

A. Report of unsteady gait, rash, and diplopia
B. Report of any seizure activity
C. Serum phenytoin levels
D. Report of anorexia, numbness, and tingling of the extremities

Answer 79

A. Report of unsteady gait, rash, and diplopia
B. Report of any seizure activity
C. Serum phenytoin levels

Question 80

A nurse is teaching parents of a child recently prescribed the medication phenytoin for seizure control. Which side effect will the nurse include?

A. Hypertension
B. Insomnia
C. Gingival hyperplasia
D. Increased appetite

Answer 80

C. Gingival hyperplasia

Question 81

The nurse is caring for a child diagnosed with seizures. While teaching the family and the child about the medication phenytoin, which concept should the nurse emphasize?

A. Omit the medication if the child is seizure-free
B. Serve a diet that is high in iron
C. A rash is normal with this medication
D. Maintain good oral hygiene and dental care

Answer 81

D. Maintain good oral hygiene and dental care

Question 82

Which instruction about phenytoin will the nurse provide during discharge teaching to a client with epilepsy who is prescribed phenytoin for seizure control?

A. “Antiseizure medications will probably be continued for life.”
B. “Phenytoin prevents any further occurrence of seizures.”
C. “This medication needs to be taken during periods of emotional stress.”
D. “Your antiseizure medication usually can be stopped after a year’s absence of seizures.”

Answer 82

A. “Antiseizure medications will probably be continued for life.”

Question 83

The nurse teaches the parents of a child prescribed long-term phenytoin therapy about care. Which statement indicates the teaching has been effective?

A. ‘We give the medication between meals.’
B. ‘We’ll call the clinic if her urine turns pink.’
C. ‘She’s eating high-calorie foods, and we encourage fluids, too.’
D. ‘We’ll have her massage her gums and floss her teeth frequently.’

Answer 83

D. ‘We’ll have her massage her gums and floss her teeth frequently.’

Question 84

A school-age child with a seizure disorder is prescribed divalproex/phenytoin. The nurse would include which instruction when teaching the parents about administering this medication?

A. ‘Crush the tablets and mix them with applesauce.’
B. ‘Take the child for regularly scheduled blood tests.’
C. ‘Stop the medication immediately if a rash develops.’
D. ‘Provide oral hygiene, especially gum massage and flossing.’

Answer 84

B. ‘Take the child for regularly scheduled blood tests.’

Question 85

The client with a seizure disorder receives intravenous (IV) phenytoin. The nurse will monitor closely for which condition?

A. Cardiac dysrhythmias
B. Hypoglycemia
C. Polycythemia
D. Paradoxical excitation

Answer 85

A. Cardiac dysrhythmias

Question 86

A client with a seizure disorder will begin taking phenytoin. Which instructions will the nurse give to the client?

A. ‘Take the medication on an empty stomach.’
B. ‘Provide meticulous oral hygiene.’
C. ‘Taper off the medication if seizures are controlled for 3 months.’
D. ‘Stop taking the medication if you become pregnant.’

Answer 86

B. ‘Provide meticulous oral hygiene.’

Question 87

Warfarin is prescribed for the client who takes phenytoin for a seizure disorder. Which medication interaction complicates seizure therapy?

A. Warfarin inhibits the metabolism of phenytoin.
B. Warfarin decreases phenytoin absorption.
C. Phenytoin competes with warfarin for receptor occupation.
D. Warfarin promotes excretion of phenytoin.

Answer 87

A. Warfarin inhibits the metabolism of phenytoin.

Question 88

A client who is receiving phenytoin asks why folic acid was prescribed. Which explanation would the nurse provide?

A. Phenytoin inhibits absorption of folate from foods.
B. Folic acid potentiates the action of phenytoin.
C. Absorption of iron from foods is improved.
D. Neuropathy caused by phenytoin is prevented.

Answer 88

A. Phenytoin inhibits absorption of folate from foods.

Question 89

A client with a seizure disorder is receiving phenytoin and phenobarbital. Which client statement indicates that the instructions regarding the medications are understood?

A. ‘I will not have any seizures with these medications.’
B. ‘These medicines must be continued to prevent falls and injury.’
C. ‘Stopping the medications can cause continuous seizures and I may die.’
D. ‘By my staying on the medicines I will prevent post seizure confusion.’

Answer 89

C. ‘Stopping the medications can cause continuous seizures and I may die.’

Question 90

A client’s phenytoin level is 16 mcg/L. Which action will the nurse take?

A. Hold the medication and notify the health care provider.
B. Administer the next dose of the medication as prescribed.
C. Hold the next dose and then resume administration as prescribed.
D. Call the health care provider to obtain a prescription with an increased dose.

Answer 90

B. Administer the next dose of the medication as prescribed.

Question 91

Which instruction would the nurse provide to parents of a school-age child who has been on long-term phenytoin therapy to prevent side effects?

A. Provide good oral hygiene.
B. Administer the medication between meals.
C. Watch for a reddish-brown discoloration of urine.
D. Supplement the diet with high-calorie foods.

Answer 91

A. Provide good oral hygiene.