Intracranial Regulation
Question 1
A client with a known seizure disorder reports missing several doses of prescribed antiepileptic medication due to vomiting. Which assessment finding is most concerning to the nurse?
Reports sleeping poorly overnight
States, “I feel anxious and something feels off”
Has dry mucous membranes
Question 2
Which nursing action is most appropriate during an active generalized tonic-clonic seizure?
Attempt gentle suctioning once jaw relaxation occurs
Turn the client onto their side and protect the head
Apply soft wrist restraints to prevent injury
Insert a padded oral airway
Question 3
Which nursing action during a seizure places the client at greatest risk for injury?
Timing the seizure
Loosening restrictive clothing
Restraining the client’s extremities
Clearing nearby furniture
Question 4
A client is in the post-ictal phase following a generalized tonic-clonic seizure. Which assessment should the nurse perform first?
Assess pain level and headache severity
Obtain a full set of vital signs and neurologic status
Inspect the oral cavity for tongue trauma
Ask the client to describe the aura experienced
Question 5
Which finding meets the criteria for a medical emergency related to seizure activity?
Two seizures in 24 hours with full recovery between
One seizure lasting longer than 5 minutes
A brief seizure followed by confusion
A seizure triggered by fever in a young child
Question 6
Why is prolonged seizure activity considered life-threatening?
It increases the risk of developing epilepsy
It can result in cerebral hypoxia and metabolic acidosis
It often requires surgical intervention
It leads to permanent memory impairment
Question 7
Which medication does the nurse anticipate administering first for a client with ongoing seizure activity that is not stopping?
Oral carbamazepine
IV lorazepam
IV phenytoin via infusion pump only
Rectal acetaminophen
Question 8
When administering IV benzodiazepines for uncontrolled seizure activity, which nursing assessment is most critical?
Blood pressure trends
Level of sedation
Respiratory rate and airway patency
Cardiac rhythm
Question 9
Which statement by a client with epilepsy indicates a need for further teaching?
“I should notify my provider if I can’t keep my medication down.”
“I will avoid driving until I understand my state’s regulations.”
“If I miss one dose, I’ll double the next dose.”
“I should try to manage stress and get enough sleep.”
Question 10
Which situation places a client at the highest risk for recurrent or prolonged seizure activity?
Missed meals and mild dehydration
Febrile illness with a temperature of 101°F
Abrupt discontinuation of antiepileptic medication
Increased physical activity