NR 283: Pathophysiology Core Assessment Midterm Practice Questions and Answers Proven Exam Success Guide: Detailed Concept Review, Extensive Practice Questions, and Comprehensive Test Bank

A client with diabetes reports noticing a distinct smell immediately before experiencing a seizure. Which action should the nurse recommend to reduce the risk of injury? A. Ignore the sensation because it is unrelated to seizures B. Use the sensation as a warning and move to a safe location C. Begin vigorous exercise immediately D. Restrict fluid intake until the sensation disappears Correct Answer: B. Use the sensation as a warning and move to a safe location Rationale: A sensory warning that occurs before a seizure is known as an aura. Recognizing an aura allows the client to move away from hazards, sit or lie down, and notify someone nearby. Ignoring the warning increases the likelihood of injury. Exercise and fluid restriction do not prevent seizure activity and may create additional risks. Question 2 A hospitalized client with no previous history of epilepsy suddenly experiences a generalized seizure. Which finding most strongly suggests an acute symptomatic seizure? A. Family history of epilepsy B. Serum sodium level of 116 mEq/L C. History of occasional tension headaches D. Normal magnetic resonance imaging results Correct Answer: B. Serum sodium level of 116 mEq/L Rationale: Severe hyponatremia can disrupt normal neuronal function and trigger seizures. Acute symptomatic seizures occur in association with reversible conditions such as electrolyte disturbances, hypoglycemia, intoxication, withdrawal, or head trauma. A family history may indicate susceptibility to epilepsy but does not identify an acute cause. Question 3 A client continues to have convulsive seizure activity for more than five minutes without regaining consciousness. What is the most appropriate interpretation and response? A. Postictal confusion; allow uninterrupted sleep B. Status epilepticus; begin emergency seizure management C. Focal seizure; assess for an aura D. Psychogenic episode; delay treatment until testing is completed Correct Answer: B. Status epilepticus; begin emergency seizure management Rationale: Continuous seizure activity lasting longer than five minutes, or recurrent seizures without recovery between episodes, is considered status epilepticus. This medical emergency can result in hypoxia, acidosis, brain injury, and death. Immediate airway support and rapid administration of prescribed antiseizure medications are essential. Question 4 Which finding most clearly differentiates a generalized seizure from a focal seizure? A. Presence of an unusual sensation before the event B. Electrical activity involving both cerebral hemispheres C. Involuntary muscle movements D. Fatigue following the event Correct Answer: B. Electrical activity involving both cerebral hemispheres Rationale: Generalized seizures originate in networks involving both cerebral hemispheres and often result in loss of consciousness and widespread motor involvement. Focal seizures begin in a specific area of the brain. Auras, motor activity, and postictal fatigue may occur with either seizure type. Question 5 A client becomes irritable several hours before a seizure, then smells smoke that is not present immediately before losing consciousness. Rhythmic jerking follows, and afterward the client is sleepy and confused. Which sequence correctly identifies these stages? A. Aura, prodromal, tonic-clonic, recovery B. Prodromal, aura, tonic-clonic, postictal C. Postictal, aura, prodromal, tonic-clonic D. Prodromal, tonic-clonic, aura, postictal Correct Answer: B. Prodromal, aura, tonic-clonic, postictal Rationale: The prodromal phase may involve mood or behavioral changes occurring hours before the seizure. An aura is a specific warning symptom immediately preceding the seizure. The tonic-clonic phase includes muscle stiffening and rhythmic jerking. The postictal phase commonly involves confusion, fatigue, and decreased responsiveness. Question 6 A client experiences recurrent episodes suggestive of seizures, yet a routine electroencephalogram (EEG) is normal. Which explanation is most accurate? A. A normal EEG permanently rules out epilepsy B. EEG abnormalities occur only when the client is unconscious C. Abnormal electrical activity may not occur during the recording period D. EEG is primarily used to assess coronary circulation Correct Answer: C. Abnormal electrical activity may not occur during the recording period Rationale: An EEG records brain activity only while the test is being performed. If seizurerelated electrical abnormalities do not occur during that time, the recording may appear normal. Therefore, a normal EEG does not exclude epilepsy. Extended or video EEG monitoring may be necessary. Question 7 A client begins having a tonic-clonic seizure while sitting in a chair. What should the