This quiz contains NCLEX questions for seizures (epilepsy).
Seizures occur when there is an abnormal discharge of electrical signals in the brain. Some patients can experience epilepsy, which is a condition where a patient has recurrent seizures.
Before taking the quiz, don’t forget to watch the lecture on seizures.
As the nurse, it is important to know how to care for a patient experiencing a seizure, the various types, triggers, medications, and treatments.
This topic is part of a neuro NCLEX review, so be sure to check out the other NCLEX reviews as well.
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Seizures NCLEX Questions
1. Neurons in the brain are tasked with handling and transmitting information. There are different types of neurons, such as excitatory and inhibitory. Excitatory neurons release the neurotransmitter _____________, while inhibitory neurons release the neurotransmitter ________________.
A. GABA, glutamate
B. Norepinephrine, GABA
C. Glutamate, GABA
D. Dopamine, glutamate
The answer is C. Excitatory neurons release glutamate and inhibitory neurons release GABA.
2. You’re assessing your patient load for the patients who are at MOST risk for seizures. Select all the patients below that are at risk:
A. A 32-year-old with a blood glucose of 20 mg/dL.
B. A 63-year-old whose CT scan shows an ischemic stroke.
C. A 72-year-old who is post opt day 5 from open heart surgery.
D. A 16-year-old with bacterial meningitis.
E. A 58-year-old experiencing ETOH withdrawal.
The answers are A, B, D, and E. All the patients are at risk except option C. Remember all the risk factors: illness (especially CNS types like bacterial meningitis), fever, electrolyte/metabolic issues (low blood sugar, acidosis etc), ETOH (alcohol) withdraw, brain injury, STROKE, congenital brain defects, tumors etc.
3. A patient with a history of epilepsy is taking Phenytoin. The patient’s morning labs are back, and the patient’s Phenytoin level is 7 mcg/mL. Based on this finding, the nurse will?
A. Assess the patient for a rash
B. Initiate seizure precautions
C. Hold the next dose of Phenytoin
D. Continue to monitor the patient
The answer is B. A normal Phenytoin level is 10 to 20 mcg/mL. The patient’s level is low; therefore, the patient is at risk for seizures. The nurse should initiate seizure precautions. Remember a patient being under medicated is a trigger for developing a seizure.
4. You’re educating a 25-year-old female about possible triggers for seizures. Which statement requires you to re-educate the patient about the triggers?
A. “I’m at risk for seizure activity during my menstrual cycle.”
B. “I will limit my alcohol intake to 2 glasses of wine per day.”
C. “It’s important I get plenty of sleep.”
D. “I will be sure to stay hydrated, especially during hot weather.”
The answer is B. The patient should avoid all alcohol because it can lead to a seizure. Hormone shifts (menstrual cycle, ovulation, pregnancy) sleep deprivation, and dehydration can lead to a seizure.
5. True or False: A patient who is experiencing a tonic-clonic seizure is experiencing a focal (partial) seizure.
Answer FALSE: A patient who is experiencing a tonic-clonic seizure is experiencing a GENERALIZED seizure. This type of seizure affects both sides of the brain.
6. A 7-year-old male patient is being evaluated for seizures. While in the child’s room talking with the child’s parents, you notice that the child appears to be daydreaming. You time this event to be 10 seconds. After 10 seconds, the child appropriately responds and doesn’t recall the event. This is known as what type of seizure?
A. Focal Impaired Awareness (complex partial)
The answer is D. This is an absence seizure and is most common in children. The hallmark of it is staring that appears to be like a daydreaming state. It is very short and the post ictus stage of this type of seizure is immediate.
7. Your patient has a history of epilepsy. While helping the patient to the restroom, the patient reports having this feeling of déjà vu and seeing spots in their visual field. Your next nursing action is to?
A. Continue assisting the patient to the restroom and let them sit down.
B. Initiate the emergency response system.
C. Lay the patient down on their side with a pillow underneath the head.
D. Assess the patient’s medication history.
The answer is C. The patient is reporting signs and symptoms of an aura (this is a warning sign before a seizure event). Lay the patient down on their side with a pillow underneath the head and remove any restrictive clothing. Also, time the seizure. If the seizure lasts more than 5 minutes or if the patient starts to have seizures back-to-back activate the emergency response system.
8. Keeping the previous question in mind, the patient is now experiencing characteristics of a tonic-clonic seizure. The seizure started at 1402 and it is now 1408, and the patient is still experiencing a seizure. The nurse should?
A. Continue to monitor the patient
B. Suction the patient
C. Initiate the emergency response system
D. Restrain the patient to prevent further injury
The answer is C. Tonic-clonic seizures should last about 1-3 minutes. If the seizure lasts MORE than 5 minutes, the patient needs medical treatment FAST to stop the seizure….this is known as status epilepticus.
9. Your patient has entered the post ictus stage for seizures. The patient’s seizure presented with an aura followed by body stiffening and then recurrent jerking. The patient had incontinence and bleeding in the mouth from injury to the tongue. What is an expected finding in this stage based on the type of seizure this patient experienced?
A. Crying and anxiety
B. Immediate return to baseline behavior
C. Sleepy, headache, and soreness
The answer is C. Based on the findings during the seizure the patient experienced a tonic-clonic seizure. In the post ictus stage (after the seizure) the patient is expected to be sleepy (very tired), have soreness, and a headache. The nurse should let the patient sleep.
10. You’re developing discharge instructions to the parents of a child who experiences atonic seizures. What information below is important to include in the teaching?
A. “This type of seizure is hard to detect because the child may appear like he or she is daydreaming.”
B. “Be sure your child wears a helmet daily.”
C. “It is common for the child to feel extremely tired after experiencing this type of seizure.”
D. “Avoid high fat and low carbohydrate diets.”
The answer is B. This type of seizure leads to a sudden loss of muscle tone. The patient will go limp and fall, which when this happens the head is usually the first part of the body to hit the floor or an object nearby. It is important the child wears a helmet daily to protect their head from injury. Option A is a characteristic of an absence seizure. Option C is a characteristic of a tonic-clonic seizure during the post ictus stage. And option D is wrong because some patients benefit from this type of diet known as the ketogenic diet.
11. You’re assessing a patient who recently experienced a focal type seizure (partial seizure). As the nurse, you know that which statement by the patient indicates the patient may have experienced a focal impaired awareness (complex partial) seizure?
A. “My friend reported that during the seizure I was staring off and rubbing my hands together, but I don’t remember doing this.”
B. “I remember having vision changes, but it didn’t last long.”
C. “I woke up on the floor with my mouth bleeding.”
D. “After the seizure I was very sleepy, and I had a headache for several hours.”
The answer is A. The patient will experience an alternation in consciousness (hence the name focal IMPAIRED awareness) AND will perform an action without knowing they are doing it called automatism like lip-smacking, rubbing the hands together etc. With a focal onset AWARE seizure (also called partial simple seizure) the patient is aware and will remember what happens (like vision changes etc.).
12. You have a patient who has a brain tumor and is at risk for seizures. In the patient’s plan of care you incorporate seizure precautions. Select below all the proper steps to take in initiating seizure precautions:
A. Oxygen and suction at bedside
B. Bed in highest position
C. Remove all pillows from the patient’s head
D. Have restraints on stand-by
E. Padded bed rails
F. Remove restrictive objects or clothing from patient’s body
G. IV access
The answers are A, E, F, and G. The bed needs to be in the LOWEST position possible, a pillow should be underneath the patient’s head to protect it from injury, AVOID using restraints (this can cause musculoskeletal damage).
13. You’re patient is scheduled for an EEG (electroencephalogram). As the nurse you will:
A. Keep the patient nothing by mouth.
B. Hold seizure medications until after the test.
C. Allow the patient to have coffee, milk, and juice only.
D. Wash the patient’s hair prior to the test.
E. Administer a sedative prior to the test.
The answers are B and D. An EEG is a painless procedure that will assess the patient’s brain activity (if a seizure occurs during the test this can allow the physician to determine what type of seizure it is). Therefore, the nurse would hold seizure medications (this can affect the test) and would NOT allow the patient to have caffeine like coffee or stimulant drugs (the patient can eat prior to the test just NO caffeine). The patient’s hair should be cleaned prior to the test so the technician can apply the electrodes and get them to stick to the scalp easily. A sedative is not needed before this test.
14. A patient is taking Phenytoin for treatment of seizures. Which statement by the patient requires you to re-educate the patient about this medication?
A. “Every morning I take this medication with a full glass of milk with my breakfast.”
B. “I know it is important to have my drug levels checked regularly.”
C. “I will report a skin rash immediately to my doctor.”
D. “This medication can lower my body’s ability to clot and fight infection.”
The answer is A. This medication should NOT be taken with milk products or antacids because it affects absorption. All the other options are correct.
15. The nurse is ordered to administer Lorazepam to a patient experiencing status epilepticus. As a precautionary measure, the nurse will also have what reversal agent on standby?
C. Calcium Chloride
The answer is B. Flumazenil is the reversal agent for Lorazepam, which is a benzodiazepine.
16. A patient who is having a tonic-clonic seizure is prescribed Phenobarbital. During administration of this drug, it is important the nurse monitors for:
A. Respiratory depression
C. Disseminated intravascular clotting
The answers are A and D. This medication stimulates the GABA receptors and helps with inhibitory neurotransmission. It can lead to respiratory depression and hypotension, therefore, it is very important the nurse monitors the patient for this.
17. An 8-year-old child, who is not responding to anti-seizure medications, is prescribed to start a ketogenic diet. This diet will include:
A. High carbohydrates and high fat
B. Low fat, high salt, and high carbohydrates
C. High fat and low carbohydrates
D. High glucose, high fat, and low carbohydrates
The answer is C. This is a type of diet used in the pediatric population with epilepsy whose seizures cannot be controlled by medication. It is a high fat and low carb diet.
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