Holland/Adams/Brice, Core Concepts in Pharmacology 5th Edition Test Bank
Chapter 14

Question 1

Type: MCSA

What condition specifically refers to involuntary, violent spasms of the large skeletal muscles of the face, neck, arms, and legs?

1. Seizures
2. Epilepsy
3. Convulsions
4. Anticonvulsant

Cognitive Level: Remembering

Client Need: Health Promotion and Maintenance

Page Number: 204

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 14-1 Compare and contrast the terms epilepsy, seizures, and convulsions.

Question 2

Type: MCSA

What condition is a disturbance of electrical activity in the brain that can affect consciousness, motor activity, and sensation?

1. Convulsion
2. Dystonia
3. Epilepsy
4. Seizure

Cognitive Level: Remembering

Client Need: Health Promotion and Maintenance

Page Number: 204

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 14-1 Compare and contrast the terms epilepsy, seizures, and convulsions.

Question 3

Type: MCMA

Which items are known causative factors for seizures? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Meningitis
2. Ingestion of poison
3. Hypertension
4. Hypoglycemia
5. Depression

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 205

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 14-2 Recognize possible causes of seizures.

Question 4

Type: MCSA

The nurse is admitting a client to the labor and delivery unit. While obtaining the assessment data, the client informs the nurse she has had high blood pressure since week 22 of this pregnancy. Upon assessment, the nurse finds 2+ edema. The client relates that she has an occasional headache. Before the nurse leaves the room, the client begins to have a seizure. What pregnancy disorder is this client experiencing?

1. HELLP
2. Preeclampsia
3. Eclampsia
4. Anemia

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 209

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 14-2 Recognize possible causes of seizures.

Question 5

Type: MCMA

The nurse is caring for a client who has been diagnosed with complex partial seizures. Which symptoms would the client be likely to experience with a complex partial seizure? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. The client stumbles and falls for no apparent reason.
2. A period of brief confusion following the seizure.
3. Seizure is preceded by an aura.
4. The client experiences alternating contraction and relaxation of muscles.
5. A period of brief somnolence following the seizure.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 206

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 14-3 Relate signs and symptoms to specific types of seizures.

Question 6

Type: MCSA

A 5-month-old infant has been brought to the Emergency Department, and the parent states the child had a high fever and rapid jerking motions that lasted for a minute. Based on these symptoms, the nurse anticipates this client will be diagnosed with which type of seizure?

1. Febrile seizures
2. Generalized seizures
3. Myoclonic seizures
4. Atonic seizures

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 207

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 14-3 Relate signs and symptoms to specific types of seizures.

Question 7

Type: MCSA

The nurse is caring for a client with epilepsy. The client informs the nurse that she is pregnant. What condition should the nurse warn this client about?

1. Vitamin C deficiency
2. Anemia
3. Decreased oxygen
4. Folate deficiency

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 209

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 14-4 Explain the importance of safety and patient drug compliance in the pharmacotherapy of epilepsy and seizures.

Question 8

Type: MCSA

The nurse knows that the client with a history of epilepsy might also have what nursing diagnosis?

1. Impaired gas exchange
2. Risk for injury
3. Chronic pain
4. Risk for infection

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 205

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 14-4 Explain the importance of safety and patient drug compliance in the pharmacotherapy of epilepsy and seizures.

Question 9

Type: MCSA

A client on the unit is experiencing tonic-clonic seizures. What drug does the nurse anticipate for this client because it is considered the drug of choice for this type of seizure?

1. Carbamazepine (Tegretol)
2. Valproic acid (Depakote)
3. Zonisamide (Zonegran)
4. Eslicarbazepine (Aptiom)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 213

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 14-5 Describe the pharmacologic management of epilepsy and acute seizures.

Question 10

Type: MCSA

In order to monitor the effectiveness of drug therapy in a client with seizures, what should the nurse teach the client to do? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Attend office visits.
2. Take medications as ordered.
3. Make up skipped doses.
4. Keep a diary of seizure activity.
5. Keep a normal sleep-wake schedule.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 217

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 14-5 Describe the pharmacologic management of epilepsy and acute seizures.

Question 11

Type: MCMA

The nurse is teaching a client about medications for seizures. Which items should be included in this teaching? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. If seizure activity continues, a different medication is added in small-dose increments while the dose of the first drug is slowly reduced.
2. The amount is gradually increased until seizure control is achieved, or until drug adverse effects prevent additional increases in dose.
3. Once a medication is selected, the patient is placed on a low initial dose.
4. Seizure medication will be stopped when the seizures have been gone for a month.
5. Seizure medications will be required for the rest of your life.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 208

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 14-5 Describe the pharmacologic management of epilepsy and acute seizures.

Question 12

Type: MCSA

The choice of drug for epilepsy pharmacology is determined upon assessment of the client. Once a medication is selected, what type of dose is the client placed on?

1. Bolus dose
2. Life dose
3. Maximum dose
4. Low initial dose

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 208

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 14-4 Explain the importance of safety and patient drug compliance in the pharmacotherapy of epilepsy and seizures.

Question 13

Type: MCSA

A client taking phenytoin (Dilantin) chronically for seizures should be encouraged to maintain good oral hygiene and visit the dentist every 6 months. Why is this such an important area of teaching for this client?

1. Cavities
2. Builds up tartar on the teeth
3. Mouth cancers
4. Gingival hyperplasia

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 217

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 14-7 For hydantoin-related drugs and succinimides, identify representative drugs and explain their mechanisms of drug action, primary actions, and important adverse effects.

Question 14

Type: MCSA

A female client taking phenytoin (Dilantin) has notified the nurse that she is pregnant. The nurse knows that phenytoin (Dilantin) belongs to which pregnancy category?

1. A
2. B
3. C
4. D

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 214

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 14-7 For hydantoin-related drugs and succinimides, identify representative drugs and explain their mechanisms of drug action, primary actions, and important adverse effects.

Question 15

Type: MCSA

An accident victim who presented to the Emergency Department 8 hours earlier begins having seizures. Toxicology reports indicate an abnormally high blood alcohol level. Based on this information, what drug does the nurse expect to administer?

1. Valproic acid (Depakote)
2. Levetiracetam (Keppra)
3. Lorazepam (Ativan)
4. Phenytoin (Dilantin)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 211

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 14-6 Explain the mechanisms of action by which barbiturates, benzodiazepines, and other GABA-related drugs control seizure activity.

Question 16

Type: MCSA

A client with a history of seizures is taking phenytoin (Dilantin). Based on this medication prescription, what are adverse effects the nurse should teach the client?

1. Weight gain, back pain, and headaches
2. Hypertension, bradycardia, and vomiting
3. Confusion, slurred speech, and insomnia
4. Constipation, rashes, and seizures

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 214

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 14-7 For hydantoin-related drugs and succinimides, identify representative drugs and explain their mechanisms of drug action, primary actions, and important adverse effects.

Question 17

Type: MCMA

The nurse is preparing a presentation about antiseizure medications. The nurse plans to include the general mechanisms of actions for these medications. Which items would be appropriate to include? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Delaying an influx of sodium ions
2. Stimulating an influx of chloride ions
3. Increasing the neuronal firing in the brain
4. Slowing an influx of calcium ions
5. Reducing an influx of potassium ions

Cognitive Level: Remembering

Client Need: Health Promotion and Maintenance

Page Number: 209

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 14-6 Explain the mechanisms of action by which barbiturates, benzodiazepines, and other GABA-related drugs control seizure activity.

Question 18

Type: MCSA

The client prescribed clonazepam (Klonopin) asks the nurse why the medication dose needs to be adjusted. What is the best response by the nurse?

1. “Tolerance can begin to develop after only a few months of therapy, and seizures can recur unless doses are periodically adjusted.”
2. “Your dose will be decreased every month until you begin to have seizures again.”
3. “Your body stores this drug, and you will need a lower dose of the medication now.”
4. “The physician will not need to adjust your medication dose.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 210

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 14-6 Explain the mechanisms of action by which barbiturates, benzodiazepines, and other GABA-related drugs control seizure activity.

Question 19

Type: MCSA

A client complains of gingival hypertrophy and weight loss. The nurse knows that this patient has a history of absence seizures. What drug is most likely responsible for the client’s pathophysiological process?

1. Phenytoin (Dilantin)
2. Ethosuximide (Zarontin)
3. Phenobarbital (Luminal)
4. Methsuximide (Celontin)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 215

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 14-7 For hydantoin-related drugs and succinimides, identify representative drugs and explain their mechanisms of drug action, primary actions, and important adverse effects.

Question 20

Type: MCSA

A client is taking carbamazepine (Tegretol). What type of seizure activity does the nurse anticipate this client has experienced?

1. Tonic-clonic seizure
2. Absence seizure
3. Simple partial seizure
4. Febrile seizure

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 214

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 14-6 Explain the mechanisms of action by which barbiturates, benzodiazepines, and other GABA-related drugs control seizure activity.

Question 21

Type: MCMA

The nurse is diagnosed with absence seizures. The client tells the nurse that they experienced an adverse effect with Ethosuximide (Zarontin). Which medication would the nurse anticipate the prescriber to treat absence seizures? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Carbamazepine (Tegretol)
2. Lamotrigine (Lamictal)
3. Valproic acid (Depakene)
4. Zonisamide (Zonegran)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 215

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 14-7 For hydantoin-related drugs and succinimides, identify representative drugs and explain their mechanisms of drug action, primary actions, and important adverse effects.

Question 22

Type: MCSA

The client is experiencing status epilepticus. What medication does the nurse anticipate the healthcare provider to order for this client?

1. Tiagabine (Gabitril)
2. Gabapentin (Neurontin)
3. Diazepam (Valium)
4. Pregabalin (Lyrica)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 208

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 14-6 Explain the mechanisms of action by which barbiturates, benzodiazepines, and other GABA-related drugs control seizure activity.

Question 23

Type: MCMA

A client has been prescribed phenobarbital (Luminal). What are the side effects of phenobarbital (Luminal)? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Hypertension
2. Vitamin deficiencies
3. Drowsiness
4. Tachycardia
5. Bradycardia

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 212

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 14-6 Explain the mechanisms of action by which barbiturates, benzodiazepines, and other GABA-related drugs control seizure activity.

Question 24

Type: MCMA

The client taking phenytoin (Dilantin) asks the nurse what the side effects of the drug are. What should the nurse include in the response? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Bradycardia
2. Hyperglycemia
3. Hypotension
4. Hypertension
5. Hypoglycemia
6. Tachycardia

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 214

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 14-7 For hydantoin-related drugs and succinimides, identify representative drugs and explain their mechanisms of drug action, primary actions, and important adverse effects.