Question 1

An order for intravenous phenytoin (Dilantin)has been given to control seizure activity in a client with status epilepticus.What is the maximal injection rate that the nurse should use?

Accepted Answer

The maximal injection rate for phenytoin is 50 mg/min. Rapid administration can cause cardiovascular collapse or respiratory arrest.

Question 2

Clients taking carbamazepine (Tegretol)should be taught to report which of the following symptoms?

Accepted Answer

Clients taking carbamazepine (Tegretol) should be taught to report confusion as it is a possible side effect of the medication. Increased alertness and improved appetite are not common side effects of carbamazepine, while easy bruising may be a symptom of a different issue and should still be reported, but it is not specifically associated with this medication.

Question 3

Mr.K.complains that his vision is blurry after receiving the intravenous form of phenytoin (Dilantin).The nurse's best response to him at this time would be

Accepted Answer

The best response would be to acknowledge the adverse effect associated with phenytoin, which is blurred vision. Informing Mr. K about this would be crucial and he may need further management or adjustment of his medication. Choices A and B are inappropriate responses as they do not address the issue and may cause confusion or anxiety. Choice C is also incorrect as it assumes an allergic reaction without proper assessment and may cause unnecessary cancellation of surgery.

Question 4

The pediatric clinic nurse is working with a 4-year-old client diagnosed with Lennox-Gastaut syndrome.The nurse anticipates that which antiepileptic drug may be indicated for this child?

Accepted Answer

Lennox-Gastaut syndrome is a severe form of epilepsy that is often resistant to traditional antiepileptic drugs. Felbamate has been found to be effective for this condition and is one of the few drugs approved for use in children with Lennox-Gastaut syndrome. Ethosuximide is primarily used for absence seizures, not Lennox-Gastaut syndrome. Phenytoin and Primidone are not typically recommended for treatment of Lennox-Gastaut syndrome.

Question 5

The nurse would give further instructions to the family member of a client beginning therapy with a new antiepileptic drug after hearing the family member make which of the following statements?

Accepted Answer

The answer of The nurse would give further instructions to...

Question 6

A client with diabetes mellitus has neuropathy in the legs and is in pain.The nurse anticipates that which drug may be ordered for this client?

Accepted Answer

Gabapentin (Neurontin) is commonly used to treat neuropathic pain, including that caused by diabetic neuropathy. It works by modulating the release of certain neurotransmitters in the brain and spinal cord that are involved in pain processing. Levetiracetam (Keppra) is an antiepileptic drug that is not typically used to treat neuropathic pain. Lamotrigine (Lamictal) is also an antiepileptic drug that may have some efficacy in treating neuropathic pain, but it is not as commonly used as gabapentin. Primidone (Mysoline) is not effective for neuropathic pain and is typically used to control seizures.

Question 7

For a client who is taking oral phenytoin (Dilantin)and who is NPO for surgery,the nurse would be correct to

Accepted Answer

The nurse should contact the physician for another dosage form of phenytoin because the client is NPO for surgery and cannot take oral medication. Giving the medication orally could result in aspiration and complications during surgery. Alternative routes of administration or an adjustment in dosage may be necessary.

Question 8

When teaching a client about medications before discharge,the nurse should realize that antiepileptic drug therapy failure is most commonly caused by

Accepted Answer

Mismanagement of medications by the client is the most common cause of antiepileptic drug therapy failure, which includes missed doses or taking incorrect doses of medication. Tolerance, chronic administration, inadequate liver metabolism, and drug and dietary interactions can also contribute to therapy failure, but they are not as common as medication mismanagement.

Question 9

Which of the following statements correctly describes status epilepticus?

Accepted Answer

Status epilepticus is a serious condition where seizures follow one another without recovery of consciousness between them, or a single seizure lasts more than 5 minutes. It is associated with significant morbidity and mortality, with estimates of mortality rates ranging from 10% to 20%, depending on the population and specifics of the condition being studied.

Question 10

A client taking carbamazepine (Tegretol)for 6 weeks telephones the health care provider's office and reports a sore throat and low-grade fever that started 5 days ago.Which of the following responses by the nurse is most appropriate?

Accepted Answer

The symptoms of sore throat and low-grade fever could be indicative of a serious infection, such as strep throat, especially in a patient who has been taking carbamazepine for 6 weeks. Therefore, the nurse should advise the client to come to the office to be evaluated as soon as possible. It's important to schedule an appointment rather than waiting for the client to call back if symptoms persist because of the potential seriousness of the condition.

Question 11

After listening to intershift report,the nurse makes a note to periodically check the patellar reflex of the client receiving which antiepileptic medication?

Accepted Answer

Magnesium sulfate, used in some cases for seizure control, especially in eclampsia, can cause neuromuscular blockade leading to decreased deep tendon reflexes, such as the patellar reflex. Monitoring reflexes is important to assess for signs of magnesium toxicity.

Question 12

The nurse would question a new drug order for carbamazepine (Tegretol)for a client with which of the following types of seizures?

Accepted Answer

Carbamazepine (Tegretol) is not indicated for the treatment of absence seizures. It is used primarily for simple and complex partial seizures and generalized tonic-clonic seizures.

Question 13

A client has a scheduled dose of antiepileptic drug by the intravenous route at 0700,1500,and 2300 each day.The physician orders a serum drug level to be drawn.At which of the following times should the nurse schedule the laboratory work to be drawn?

Accepted Answer

The serum drug level should be drawn just before the next dose to measure the trough level, which is the lowest concentration in the patient's bloodstream, ensuring the drug is within the therapeutic range. Drawing at 0630 is just before the 0700 dose.

Question 14

What is the appropriate method of administering an antiepileptic drug?

Accepted Answer

The appropriate method of administering an antiepileptic drug is to establish a drug regimen based on the half-life of the medication. This ensures that the drug remains at therapeutic levels in the body and helps prevent seizures. It is important to follow the prescribed dosing schedule and not skip doses. Blood level monitoring may also be necessary to ensure the drug remains within therapeutic levels.

Question 15

Women taking phenytoin (Dilantin)for antiepileptic drug therapy need to be taught to report to their physician if they become pregnant because of the associated risk of

Accepted Answer

Phenytoin is known to be teratogenic, which means it can cause birth defects in the developing fetus, including physical and mental abnormalities. Therefore, women taking phenytoin need to be closely monitored during pregnancy and may need to switch to a different medication to prevent harm to the fetus. Maternal tachycardia, increased fetal weight, and maternal hypertension are not associated with phenytoin use during pregnancy.

Question 16

If a client has a very high serum level of phenytoin (Dilantin)of 35 mg/mL,the nurse would assess for which of the following problems?

Accepted Answer

A high serum level of phenytoin (Dilantin) can result in nystagmus, which is an involuntary movement of the eyes. Tachycardia (rapid heart rate), hypertension (high blood pressure), and nightmares are not typically associated with high levels of phenytoin.

Question 17

The nurse should assess a client taking valproic acid (Depakene)for which of the following adverse effects?

Accepted Answer

Valproic acid (Depakene) may cause hepatotoxicity, so the nurse should assess the client for signs and symptoms of liver impairment such as abdominal pain, nausea, vomiting, anorexia, jaundice, and fatigue. Dyspnea (A) and oliguria (D) are not common adverse effects of valproic acid. Drowsiness (C) is a common adverse effect, but it would not be the priority assessment as it is a well-known side effect of the medication.

Question 18

Which of the following nursing diagnoses would be appropriate for a client with a seizure disorder?

Accepted Answer

Clients with seizure disorders are at high risk for injury during seizure episodes. Therefore, the nursing diagnosis of Risk for injury is appropriate for this client. The other options may be applicable to some clients with seizure disorders, but they may not be as crucial as the risk for injury.

Question 19

Phenytoin (Dilantin)works by which of the following mechanisms?

Accepted Answer

Phenytoin works by depressing neuronal excitability, particularly in the motor cortex. It achieves this by blocking voltage-gated sodium channels, which reduces the influx of sodium ions into neurons and thus decreases their excitability.

Question 20

A client has a new drug order for oxcarbazepine (Trileptal).Which of the following statements should the nurse include in client teaching about this medication?

Accepted Answer

The answer of A client has a new drug order...

Quiz 17: Antiepileptic Drugs

An order for intravenous phenytoin (Dilantin) has been given to control seizure activity in a client with status epilepticus.What is the maximal injection rate that the nurse should use?

Clients taking carbamazepine (Tegretol) should be taught to report which of the following symptoms?

Mr.K.complains that his vision is blurry after receiving the intravenous form of phenytoin (Dilantin) .The nurse's best response to him at this time would be

The pediatric clinic nurse is working with a 4-year-old client diagnosed with Lennox-Gastaut syndrome.The nurse anticipates that which antiepileptic drug may be indicated for this child?

The nurse would give further instructions to the family member of a client beginning therapy with a new antiepileptic drug after hearing the family member make which of the following statements?

A client with diabetes mellitus has neuropathy in the legs and is in pain.The nurse anticipates that which drug may be ordered for this client?

For a client who is taking oral phenytoin (Dilantin) and who is NPO for surgery,the nurse would be correct to

When teaching a client about medications before discharge,the nurse should realize that antiepileptic drug therapy failure is most commonly caused by

Which of the following statements correctly describes status epilepticus?

A client taking carbamazepine (Tegretol) for 6 weeks telephones the health care provider's office and reports a sore throat and low-grade fever that started 5 days ago.Which of the following responses by the nurse is most appropriate?

After listening to intershift report,the nurse makes a note to periodically check the patellar reflex of the client receiving which antiepileptic medication?

The nurse would question a new drug order for carbamazepine (Tegretol) for a client with which of the following types of seizures?

A client has a scheduled dose of antiepileptic drug by the intravenous route at 0700,1500,and 2300 each day.The physician orders a serum drug level to be drawn.At which of the following times should the nurse schedule the laboratory work to be drawn?

What is the appropriate method of administering an antiepileptic drug?

Women taking phenytoin (Dilantin) for antiepileptic drug therapy need to be taught to report to their physician if they become pregnant because of the associated risk of

If a client has a very high serum level of phenytoin (Dilantin) of 35 mg/mL,the nurse would assess for which of the following problems?

The nurse should assess a client taking valproic acid (Depakene) for which of the following adverse effects?

Which of the following nursing diagnoses would be appropriate for a client with a seizure disorder?

Phenytoin (Dilantin) works by which of the following mechanisms?

A client has a new drug order for oxcarbazepine (Trileptal) .Which of the following statements should the nurse include in client teaching about this medication?