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PREDICTOR exam 2
A nurse knows that which of the following about Lamotrigine is false?
A. Common side effects include dizziness, diplopia, and blurred vision
B. Benefits derive from blocking sodium channels and partly blocking calcium channels
C. Estrogen can lower lamotrigine levels while lamotrigine may lower progesterone levels
D. It has a narrow spectrum of antiseizure activity. - ANS :D. It has a narrow spectrum of
antiseizure activity.
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Lamotrigine has a broad spectrum of antiseizure activity. It treats 1. adjunctive therapy of
partial seizures 2. adjunctive therapy of generalized seizures associated with Lennox-Gastaut
syndrome, 3. adjunctive therapy or generalized tonic-clonic seizures in adults and children
above 2.
The nurse is caring for a patient whose seizures are characterized by a 10- to 30-second loss
of consciousness and mild, symmetric eye blinking. Which seizure type does this most
closely illustrate?
A. Tonic-clonic
B. Absence
C. Atonic
D. Myoclonic - ANS :B. Absence
This scenario accurately describes absence seizures. Tonic-clonic seizures present with
convulsions and muscle rigidity followed by muscle jerks. Patients may experience urinary
incontinence and loss of consciousness. Atonic seizures cause sudden loss of muscle tone.
Myoclonic seizures present with sudden muscle contractions that last but a second.
Which medication should the nurse anticipate administering to a patient in convulsive status
epilepticus to halt seizure activity?
A. Phenytoin [Dilantin] 200 mg IV over 4 minutes
B. Phenobarbital 30 mg IM
C. Lorazepam [Ativan] 0.1 mg/kg IV at a rate of 2 mg/min
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D. Valproic acid [Depacon] 250 mg in 100 mL of normal saline infused IV over 60 minutes -
ANS :C. Lorazepam [Ativan] 0.1 mg/kg IV at a rate of 2 mg/min
Intravenous benzodiazepines, such as lorazepam or diazepam, are used for abrupt
termination of convulsive seizure activity. Lorazepam is preferred over diazepam because of
its longer effects.
The nurse is working with the multidisciplinary healthcare team to optimize the care of a
patient with schizophrenia. Which concepts will guide the nursing care of this patient?
(Select all that apply.)
A. The second-generation antipsychotics generally are more effective than the first-
generation agents.
B. Most antipsychotic agents increase the risk of mortality in elderly patients with dementia.
C. Antipsychotic depot preparations carry a greater risk of neuroleptic malignant syndrome.
D. The lipid levels of patients receiving second-generation antipsychotics should be
monitored.
Schizophrenia is characterized by disordered thinking and loss of touch with reality. - ANS :B,
D, & E
The nurse is caring for a group of patients who have been prescribed sedative-hypnotic
agents. Which agent has the greatest abuse potential?
A. Diazepam [Valium]
B. Triazolam [Halcion]
C. Zolpidem [Ambien]
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D. Phenobarbital [Luminal Sodium] - ANS :D. Phenobarbital [Luminal Sodium]
Phenobarbital is a barbiturate drug that carries a higher abuse potential than the
benzodiazepine or benzodiazepine-like drugs
The nurse is teaching a patient with a new prescription for alprazolam [Xanax]. Which
statement is the most appropriate to include in the teaching plan?
A. "When it is time to discontinue this drug, you will need to taper it off slowly."
B. "Protect your skin from the sun to prevent rash and exaggerated sunburn."
C. "Increase your intake of fluid and high-fiber food to prevent constipation."
D. "Take this medication on an empty stomach at least 2 hours after meals." - ANS :A. "When
it is time to discontinue this drug, you will need to taper it off slowly."
Alprazolam [Xanax] is a benzodiazepine for which abrupt discontinuation can precipitate
withdrawal symptoms. Patients should withdraw the drug gradually over several weeks. The
other statements are not related to alprazolam [Xanax].
The nurse is caring for a patient taking buspirone [BuSpar]. Which statement by the patient
indicates a need for further teaching about this drug?
A. "This medication should not make me feel drowsy, but may make me feel dizzy."
B. "This medication should help me feel less anxious."
C. "I will drink grapefruit juice instead of coffee with breakfast." Grapefruit juice can greatly
increase buspirone levels and should be avoided. The other statements are appropriate.
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