Nokea
A nurse understands that lorazepam (Ativan) is the drug of choice for treating status epilepticus but that its effects last for less than 1 hour. The nurse would expect which of the following to be prescribed along with lorazepam (Ativan) during status epilepticus? Select all that apply.
- A. Ethosuximide (Zarontin)
- B. Phenytoin (Dilantin)
- C. Ethotoin (Peganone)
- D. Zonisamide (Zonegran)
Correct Answer: B
Rationale: Due to the short effects of lorazepam (Ativan), a longer-acting anticonvulsant, such as phenytoin (Dilantin), is given to continue control of seizure activity.
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A nurse administering valproic acid to a client should monitor the client for increased effects of valproic acid when which of the following medications are initiated? Select all that apply.
- A. Cimetidine (Tagamet)
- B. Amitriptyline (Elavil)
- C. Metformin (Glucophage)
- D. Aspirin
- E. Lisinopril (Prinivil)
Correct Answer: A,B,D
Rationale: A nurse administering valproic acid to a client should monitor the client for increased effects of valproic acid when antibiotics, antifungals, salicylates (such as aspirin), tricyclic antidepressants such as amitriptyline, and cimetidine are initiated.
The nurse is assessing a client who is receiving felbamate. The nurse suspects that the client may be developing pancytopenia based on which assessment finding? Select all that apply.
- A. Gingival hyperplasia
- B. Sore throat
- C. Epistaxis
- D. Skin rash
- E. Bruising
Correct Answer: B,C,E
Rationale: Signs of pancytopenia include sore throat, fever, general malaise, bleeding of the mucous membranes, epistaxis (bleeding from the nose), and easy bruising. Gingival hyperplasia and skin rash are examples of adverse reactions, but these are not associated with pancytopenia.
A client with partial seizures has been prescribed a succinimide anticonvulsant. The client complains of GI upset after taking the drug. The nurse would suggest taking the drug in which manner?
- A. Daily at bedtime
- B. Immediately before eating a meal
- C. With some food or milk
- D. First thing in the morning on arising
Correct Answer: C
Rationale: If the client experiences GI upset after succinimide administration, the nurse should instruct the client to take the drug with food or milk. The nurse need not instruct the client to take the drug once only at bedtime, before meals, or immediately on arising in the morning.
When describing the anticonvulsants to a group of nursing students, the instructor describes which of the following as acting to stabilize the hyperexcitability postsynaptically in the motor cortex of the brain? Select all that apply.
- A. Ethosuximide (Zarontin)
- B. Phenytoin (Dilantin)
- C. Valproic acid (Depakote)
- D. Ethotoin (Peganone)
- E. Topiramate (Topamax)
Correct Answer: B,D
Rationale: Hydantoins, like phenytoin (Dilantin) and ethotoin (Peganone), exert their effect by stabilizing the hyperexcitability postsynaptically in the motor cortex of the brain. Ethosuximide depresses the motor cortex, valproic acid increases levels of GABA to stabilize the cell membranes, and topiramate blocks seizure activity instead of raising the threshold.
A nurse at a health care center has been asked to prepare a teaching plan for a client on oxazolidinedione therapy. Which of the following points should the nurse include?
- A. Avoiding exposure to ultraviolet light
- B. Taking the drug 2 hours after a meal
- C. Taking the drug with milk
- D. Avoiding carbonated drinks during therapy
Correct Answer: A
Rationale: The nurse should suggest avoiding exposure to ultraviolet light in the teaching plan of the client on oxazolidinedione therapy because of the risk for photosensitivity. The nurse need not include taking the drug 2 hours after a meal, taking the drug with milk, or avoiding carbonated drinks.