NR 283: Pathophysiology Core Assessment Final Exam Practice Questions & Answers All-in-One Exam Companion: Comprehensive Study Review, Complete Test Bank, and Realistic Practice Exams

A nurse is teaching a client with a seizure disorder about behaviors that may increase the risk of seizures or seizure-related injuries. Which behaviors should the nurse identify as increasing risk? Select all that apply. A. Poorly managing diabetes and prescribed insulin B. Ignoring a familiar aura and continuing a hazardous activity C. Taking antiseizure medication at the same time each day D. Maintaining a consistent sleep schedule Correct Answer: A. Poorly managing diabetes and prescribed insulin; B. Ignoring a familiar aura and continuing a hazardous activity Rationale: Poor diabetes management can result in severe hypoglycemia or other metabolic disturbances that may trigger seizures. An aura can provide an early warning that a seizure is about to occur, so ignoring it can increase the risk of injury, particularly during hazardous activities such as driving, bathing, or climbing. Taking medication consistently and maintaining regular sleep generally help reduce seizure risk. Question 2 A client with no previous history of epilepsy experiences a seizure in the emergency department. Which condition is most likely to cause an acute symptomatic seizure? A. Mild seasonal allergies B. Severe hyponatremia C. Stable osteoarthritis D. Controlled hyperlipidemia Correct Answer: B. Severe hyponatremia Rationale: Severe hyponatremia can disrupt neuronal function and may lead to confusion, cerebral edema, and seizures. Other causes of acute symptomatic seizures include head trauma, severe hypoglycemia, infection, and alcohol or drug withdrawal. Seasonal allergies, osteoarthritis, and controlled hyperlipidemia do not ordinarily cause sudden seizure activity. Question 3 A client develops a seizure after accidentally receiving an excessive dose of insulin. Which intervention addresses the underlying cause of the seizure? A. Administering glucose to correct hypoglycemia B. Restricting all oral and intravenous fluids C. Beginning lifelong antiseizure therapy immediately D. Encouraging the client to sleep until the seizure resolves Correct Answer: A. Administering glucose to correct hypoglycemia Rationale: An excessive dose of insulin can cause severe hypoglycemia, depriving brain cells of their primary energy source. Correcting the low blood glucose addresses the underlying cause. Additional emergency antiseizure treatment may be necessary if seizure activity continues. Lifelong antiseizure therapy is not automatically indicated for a seizure caused by a reversible metabolic problem. Question 4 A client continues to experience generalized seizure activity for several minutes without regaining consciousness. Which complication should the nurse suspect? A. Stable focal epilepsy B. Status epilepticus C. Postural hypotension D. Chronic neuropathy Correct Answer: B. Status epilepticus Rationale: Status epilepticus involves prolonged or recurrent seizure activity without adequate recovery between seizures. It is a neurological emergency because persistent seizure activity can lead to hypoxia, metabolic acidosis, hyperthermia, aspiration, and permanent neuronal injury. Immediate airway support and appropriate emergency antiseizure treatment are required. Question 5 Which statement by a client with chronic epilepsy demonstrates an accurate understanding of long-term management? A. “I may stop my medication whenever I have been seizure-free for one month.” B. “I should identify my seizure triggers and take my medication consistently.” C. “I should ignore an aura because it cannot help me prevent an injury.” D. “Driving restrictions never apply when seizures are controlled by medication.” Correct Answer: B. “I should identify my seizure triggers and take my medication consistently.” Rationale: Long-term epilepsy management includes taking prescribed antiseizure medications consistently and avoiding known triggers such as sleep deprivation, substance use, stress, and missed doses. Medication should not be stopped abruptly. An aura may provide enough warning for the client to move to a safe location. Driving restrictions vary by jurisdiction and may require a specific seizure-free period. Question 6 A client reports irritability several hours before a seizure, experiences a distinctive smell immediately before losing consciousness, develops alternating muscle stiffening and jerking, and later becomes sleepy and confused. Which sequence correctly identifies these stages? A. Aura, prodromal, postictal, tonic-clonic B. Prodromal, aura, tonic-clonic, postictal C. Tonic-clonic, aura, prodromal, postictal D. Prodromal, tonic-clonic, aura, postictal Correct Answer: B. Prodromal, aura, tonic-clonic, postictal Rationale: The prodromal stage may involve vague mood or behavioral changes occurring hours before the seizure. An aura is a specific sensory warning that occurs immediately before seizure activity. The tonic-clonic phase involves muscle stiffening followed by rhythmic jerking. The postictal phase occurs after the seizure and may include fatigue, confusion, headache, sleepiness, and temporary neurological impairment. Question 7 Which observation most strongly indicates that a client is experiencing a generalized seizure rather than a focal seizure? A. Abnormal movement limited to one hand B. Tingling affecting one side of the face C. Loss of consciousness with whole-body involvement D. Preserved awareness during localized muscle twitching Correct Answer: C. Loss of consciousness with whole-body involvement Rationale: Generalized seizures involve both cerebral hemispheres and commonly affect the entire body, often resulting in loss of consciousness. Focal seizures begin in a limited region of one cerebral hemisphere and may produce localized motor, sensory, autonomic, or behavioral symptoms. Awareness may remain intact during some focal seizures but may be impaired in others. Question 8 A client has recurring episodes that are strongly suspected to be seizures, but a routine electroencephalogram is normal. Which explanation is most appropriate? A. An EEG can detect seizure activity only when the heart rate is elevated. B. A normal EEG permanently excludes epilepsy. C. Abnormal electrical activity may not occur during the brief recording period. D. CT scanning is the only test capable of detecting seizures. Correct Answer: C. Abnormal electrical activity may not occur during the brief recording period. Rationale: An EEG records electrical activity in the brain during the testing period. A routine EEG may be normal if abnormal electrical activity does not occur during the recording. Therefore, a normal routine EEG does not permanently exclude epilepsy. Prolonged or video EEG monitoring may be necessary. CT and MRI can identify structural abnormalities but do not directly record seizure activity. Question 9 Following a tissue injury, several chemical substances are released and contribute to pain and inflammation. Which substances are directly involved? Select all that apply. A. Bradykinin B. Histamine C. Prostaglandins D. Insulin Correct Answer: A. Bradykinin; B. Histamine; C. Prostaglandins Rationale: Bradykinin directly stimulates pain receptors, histamine contributes to vasodilation and inflammation, and prostaglandins sensitize nociceptors to painful stimuli. These inflammatory mediators contribute to tenderness, swelling, and pain following tissue injury. Insulin regulates glucose metabolism and is not a primary inflammatory mediator responsible for activating pain receptors at an injured site. Question 10 A postoperative client describes sudden, sharp pain that can be traced directly to the abdominal incision. How should the nurse classify this pain? A. Chronic pain B. Acute pain C. Neuropathic pain D. Psychogenic pain Correct Answer: B. Acute pain Rationale: Acute pain typically has a sudden onset, is associated with tissue injury or illness, and is often sharp and relatively well localized. It generally improves as healing occurs. Chronic pain persists beyond the expected healing period and may be described as aching, throbbing, or widespread. Neuropathic pain results from nerve damage.