Chapter 19: Drugs for Epilepsy
MULTIPLE CHOICE
1. A patient is diagnosed with epilepsy and asks the nurse what may have caused this
condition. The nurse explains that epilepsy is most often a. caused by head trauma.
b. idiopathic in origin.
c. linked to a stroke.
d. related to brain anoxia.
ANS: B
Of all seizure cases, 75% are primary, or idiopathic, with no known cause. The remaining are
secondary and may be related to head trauma, stroke, or anoxic events.
DIF: COGNITIVE LEVEL: Remembering (Knowledge) REF: dm 304
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pathophysiology
2. A patient who has epilepsy will begin an anticonvulsant medication. The patient asks the
nurse how long the medication will be necessary. How will the nurse respond? a. The
medication is usually taken for a lifetime.
b. The medication will be given until you are seizure-free.
c. You will need to take the medication for 3 to 5 years.
d. You will take the medication as needed for seizure activity.
ANS: A
Anticonvulsants are given to prevent seizures and are usually taken throughout the patients
lifetime. Stopping the medication will lead to recurrence of seizures in most patients. Some
patients may attempt to stop taking the medications after 3 to 5 years of no seizure activity.
Anticonvulsants are not given as needed.
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 305
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
3. The nurse is providing teaching to the parents of a 5-year-old child who will begin taking
phenytoin (Dilantin). What information will the nurse include when teaching these parents
about their childs medication?
a. Drug interactions are uncommon with phenytoin.
b. There are very few side effects associated with this drug.
c. The therapeutic range of phenytoin is between 15 and 30 mcg/mL.
d. Your child may need a higher dose than expected.
ANS: D
Drug dosage for phenytoin is age-related and children, who have a rapid metabolism, may
need higher doses than those used for newborns and adults. Phenytoin has many drug
interactions and many side effects. The therapeutic range is 10-20 mcg/mL.
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 306
, TOP: NURSING PROCESS: Planning/Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
4. The nurse is caring for a patient who has a seizure disorder. The nurse notes that the
patient has reddened gums that bleed when oral care is given. The nurse recognizes this
finding as a. an adverse effect of the phenytoin.
b. a drug interaction with aspirin.
c. a symptom of hepatotoxicity.
d. a sign of poor self-care.
ANS: A
Hydantoins commonly cause gingival hyperplasia, which causes overgrowth of reddened gum
tissue that bleeds easily. It is not a sign of a drug interaction or a symptom of hepatotoxicity.
It does not indicate a lack of self-care.
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 306
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
5. The nurse is preparing to administer phenytoin (Dilantin) to a patient who has a seizure
disorder. The patient appears drowsy, and the nurse notes that the last random serum drug
level was 18 mcg/mL. What action will the nurse take?
a. Administer the dose since the patient is not toxic.
b. Contact the provider to discuss decreasing the phenytoin dose.
c. Give the drug and monitor closely for adverse effects.
d. Report drug toxicity to the providers.
ANS: A
Drowsiness is a common side effect of phenytoin and is not cause for alarm. The patients
drug level is normal, since 10-20 mcg/mL is the therapeutic range. The nurse should
administer the dose. It is not necessary to decrease the dose or monitor the patient more
closely than usual.
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 306
TOP: NURSING PROCESS: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
6. The nurse is preparing to administer phenytoin to an 80-year-old patient and notes
the following order: IVP phenytoin 50 mg. The nurse will perform which action? a.
Administer the undiluted drug through a Y-tube over two minutes.
b. Contact the provider to question the route and the dose.
c. Dilute the drug in dextrose solution and infuse over 15 to 20 minutes.
d. Request an order to administer the drug intramuscularly.
ANS: A
Intravenous phenytoin should be administered undiluted through a 3-way stopcock or Y-
tubing. In older patients it should be infused at a rate of 25 mcg/min. The dose and the route
MULTIPLE CHOICE
1. A patient is diagnosed with epilepsy and asks the nurse what may have caused this
condition. The nurse explains that epilepsy is most often a. caused by head trauma.
b. idiopathic in origin.
c. linked to a stroke.
d. related to brain anoxia.
ANS: B
Of all seizure cases, 75% are primary, or idiopathic, with no known cause. The remaining are
secondary and may be related to head trauma, stroke, or anoxic events.
DIF: COGNITIVE LEVEL: Remembering (Knowledge) REF: dm 304
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pathophysiology
2. A patient who has epilepsy will begin an anticonvulsant medication. The patient asks the
nurse how long the medication will be necessary. How will the nurse respond? a. The
medication is usually taken for a lifetime.
b. The medication will be given until you are seizure-free.
c. You will need to take the medication for 3 to 5 years.
d. You will take the medication as needed for seizure activity.
ANS: A
Anticonvulsants are given to prevent seizures and are usually taken throughout the patients
lifetime. Stopping the medication will lead to recurrence of seizures in most patients. Some
patients may attempt to stop taking the medications after 3 to 5 years of no seizure activity.
Anticonvulsants are not given as needed.
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 305
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
3. The nurse is providing teaching to the parents of a 5-year-old child who will begin taking
phenytoin (Dilantin). What information will the nurse include when teaching these parents
about their childs medication?
a. Drug interactions are uncommon with phenytoin.
b. There are very few side effects associated with this drug.
c. The therapeutic range of phenytoin is between 15 and 30 mcg/mL.
d. Your child may need a higher dose than expected.
ANS: D
Drug dosage for phenytoin is age-related and children, who have a rapid metabolism, may
need higher doses than those used for newborns and adults. Phenytoin has many drug
interactions and many side effects. The therapeutic range is 10-20 mcg/mL.
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 306
, TOP: NURSING PROCESS: Planning/Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
4. The nurse is caring for a patient who has a seizure disorder. The nurse notes that the
patient has reddened gums that bleed when oral care is given. The nurse recognizes this
finding as a. an adverse effect of the phenytoin.
b. a drug interaction with aspirin.
c. a symptom of hepatotoxicity.
d. a sign of poor self-care.
ANS: A
Hydantoins commonly cause gingival hyperplasia, which causes overgrowth of reddened gum
tissue that bleeds easily. It is not a sign of a drug interaction or a symptom of hepatotoxicity.
It does not indicate a lack of self-care.
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 306
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
5. The nurse is preparing to administer phenytoin (Dilantin) to a patient who has a seizure
disorder. The patient appears drowsy, and the nurse notes that the last random serum drug
level was 18 mcg/mL. What action will the nurse take?
a. Administer the dose since the patient is not toxic.
b. Contact the provider to discuss decreasing the phenytoin dose.
c. Give the drug and monitor closely for adverse effects.
d. Report drug toxicity to the providers.
ANS: A
Drowsiness is a common side effect of phenytoin and is not cause for alarm. The patients
drug level is normal, since 10-20 mcg/mL is the therapeutic range. The nurse should
administer the dose. It is not necessary to decrease the dose or monitor the patient more
closely than usual.
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 306
TOP: NURSING PROCESS: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
6. The nurse is preparing to administer phenytoin to an 80-year-old patient and notes
the following order: IVP phenytoin 50 mg. The nurse will perform which action? a.
Administer the undiluted drug through a Y-tube over two minutes.
b. Contact the provider to question the route and the dose.
c. Dilute the drug in dextrose solution and infuse over 15 to 20 minutes.
d. Request an order to administer the drug intramuscularly.
ANS: A
Intravenous phenytoin should be administered undiluted through a 3-way stopcock or Y-
tubing. In older patients it should be infused at a rate of 25 mcg/min. The dose and the route
