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A 29-year-old female patient in labor has just received epidural anesthesia. Before the procedure
her blood pressure was 120/78 and her pulse was 60 bpm. Now her blood pressure is 100/60 and
her pulse is 80 bpm. She reports a metallic taste in her mouth, hears a ringing in her ears, and
appears confused. What is this patient most likely experiencing? - CORRECT ANSWER ✔✔ -
Systemic toxicity from local anesthesia
CNS (central nervous system) symptoms (such as tinnitus and disorientation) are commonly
present before hemodynamic changes are evidenced when a patient has systemic toxicity.
Systemic toxicity in this case is from a local anesthetic being injected into a blood vessel.
A 77-year-old man with a long history of absence seizures has been treated with ethosuximide
for many years. The man is now in the process of moving to a long-term care facility and a nurse
is creating a plan of care. The nurse understands the potential adverse effects of this drug and
would consequently prioritize which nursing diagnoses? - CORRECT ANSWER ✔✔ -Risk for
Falls
Common adverse effects of ethosuximide are drowsiness, dizziness, and lethargy. Respiration,
urinary function, and skin integrity are not normally affected by the use of ethosuximide.
,A child is experiencing febrile seizures for which phenobarbital is ordered to be given
intravenously. The dose is administered at 10 AM. The nurse understands that a second dose of
the drug may be given at which time? - CORRECT ANSWER ✔✔ -4 PM
When phenobarbital is given to a child intravenously for treatment of a febrile seizure, a second
dose may be repeated in 6 hours, which in this situation would be 4 PM.
A client is receiving lamotrigine as treatment for partial seizures. Which assessment finding
would lead the nurse to stop the drug immediately? - CORRECT ANSWER ✔✔ -Rash
Lamotrigine has been associated with very serious to life-threatening rashes, and the drug should
be discontinued at the first sign of any rash. Somnolence and confusion are typical CNS effects;
anorexia is a common gastrointestinal effect.
A client is to receive ethotoin. The nurse would expect to administer this drug by which route? -
CORRECT ANSWER ✔✔ -Oral
Ethotoin is administered orally.
A client received fentanyl during a surgical procedure. The nurse will have what drug available
to treat any possible respiratory depression associated with the use of fentanyl? - CORRECT
ANSWER ✔✔ -Naloxone
, Fentanyl is an opioid analgesic, and the nurse will have naloxone on hand to reverse the effects
of the opioid that is causing respiratory depression.
A client who is receiving phenytoin has a serum drug level drawn. Which result would the nurse
interpret as within the therapeutic range? - CORRECT ANSWER ✔✔ -12 mcg/mL
The therapeutic serum phenytoin levels range from 10 to 20 mcg/mL. Thus, a level of 12
mcg/mL would fall within this range.
A common cause of seizures for a client in late infancy to early childhood is: - CORRECT
ANSWER ✔✔ -fever.
Epilepsy can be classified as idiopathic or attributable to a secondary cause. Secondary causes in
infancy include developmental defects, metabolic disease, or birth injury. Fever is a common
cause during late infancy and early childhood, and inherited forms usually begin in childhood or
adolescence.
A female client reports that her seizure was preceded by a brief warning, which she describes as
an unusual smell. This is known as a(n): - CORRECT ANSWER ✔✔ -aura.
Tonic-clonic seizures are sometimes preceded by an aura—a brief warning, such as a flash of
light or a specific sound or smell.