Check For Understanding:

1. A client with chronic pain reports to you, the charge nurse, that the nurse have not been responding to
requests for pain medication. What is your initial action?
A. Check the MARs and nurses’ notes for the past several days.
B. Ask the nurse educator to give an in-service about pain management.
C. Perform a complete pain assessment and history on the client.
D. Have a conference with the nurses responsible for the care of this client.
ANSWER: D
RATIO: As nurse, we must evaluate the staff's performance and attitude in respect to this patient as the
charge nurse. It may be required to get further information from the client and the records after gathering
data from the nurses. If there is a difficulty with knowledge or performance, the educator might be able to
help.

2. Family members are encouraging your client to “tough it out” rather than run the risk of becoming
addicted to narcotics. The client is stoically abiding by the family’s wishes. Priority nursing interventions
for this client should target which dimension of pain?
A. Sensory
B. Affective
C. Sociocultural
D. Behavioral
E. Cognitive
ANSWER: C
RATIO: The sociocultural aspect of suffering consists of the family. They must be concerned withinside
the training sessions at the proper use of medicine and the detrimental effects of pain at the healing
system for the reason that they are influencing the client. To help the client and family realize the whole
treatment plan and pain mechanism, the additional aspects must be mentioned.

3. A client with diabetic neuropathy reports a burning, electrical-type in the lower extremities that is not
responding to NSAIDs. You anticipate that the physician will order which adjuvant medication for this
type of pain?
A. Amitriptyline (Elavil)
B. Corticosteroids
C. Methylphenidate (Ritalin)
D. Lorazepam (Ativan)
ANSWER: A
RATIO: For diabetic neuropathy, antidepressants like amitriptyline may be used. Corticosteroids are used
to deal with pain added on by inflammation. If the client is using painkillers, methylphenidate is
administered to prevent sedation.

4. Which client is most likely to receive opioids for extended periods of time?
A. A client with fibromyalgia
B. A client with phantom limb pain
C. A client with progressive pancreatic cancer
D. A client with trigeminal neuralgia
ANSWER: C
RATIO: Opioids are more likely to be given for a prolonged period of time to a patient with pancreatic
cancer that is progressing. Opioid usage is more widespread in cancer patients because pain often gets
worse as the disease progresses.

5. In caring for a young child with pain, which assessment tool is the most useful?
A. Simple description pain intensity scale
B. 0-10 numeric pain scale
C. Faces pain-rating scale
D. McGill-Melzack pain questionnaire
ANSWER: C
RATIO: Faces-pain is a self-report measure of pain severity created for children. Faces-pain is the most
helpful diagnostic tool when caring for young children with pain.

6. In applying the principles of pain treatment, what is the first consideration?

A. Treatment is based on client goals.
B. A multidisciplinary approach is needed.
C. The client must be believed about perceptions of own pain.
D. Drug side effects must be prevented and managed.
ANSWER: C
RATIO: The client must be believed regarding their impressions of their own pain in order for the therapy
to be successful and reach its goal while using the principles of pain treatment. The client must be given
credit for his or her account of experiencing discomfort. The information obtained from client reports may
then be used to build further possibilities for the treatment plan.
7. A client appears upset and tearful, but denies pain and refuses pain medication, because “my sibling is
a drug addict and has ruined out lives.” What is the priority intervention for this client?
A. Encourage expression of fears on past experiences.
B. Provide accurate information about use of pain medication.
C. Explain that addiction is unlikely among acute care clients.
D. Seek family assistance in resolving this problem.
ANSWER: A
RATIO: This client has strong opinions on the subject of sibling addiction. We must first encourage the
patient regarding her prior expressions of anxieties in order to provide the proper therapy and care for the
patient. The client understood that the feelings were sincere and significant. It offers the possibility to
assess one's beliefs and concerns. When necessary, it is acceptable to offer information and facts. Family
involvement is essential. realizing they could relate to the client's views on drug abuse.

8.It is a rare type of seizure that appears sporadically.

A. Febrile seizure
B. Myoclonic seizure
C. Jacksonian seizure
D. Absence seizure
ANSWER: B
RATIO: A muscle or set of muscles will briefly and jerkily spasm during myoclonic seizures. They
frequently accompany atonic seizures, which result in abrupt muscular limpness and are regarded as a rare
form of random seizure.

9. Which antiseizure agents is used to treat absence seizures?

A. Hydantoins
B. Benzodiazepines
C. Barbiturates
D. Succinimides
ANSWER: B
RATIO: The majority of doctors begin treating absence seizures with benzodiazepines since they are
among the most potent medications for the treatment of acute seizures and status epilepticus. This
medication often works well to control seizures.

10.A patient on Dilantin began showing bruises and signs of active infection. The nurse would be right to
anticipate that these manifestations give clue to ________________.
A. Drug underdosage
B. Hypersensitivity reactions
C. Cellular toxicity
D. None of the above
ANSWER: C
RATIO: While on Dilantin, a patient started exhibiting bruises and symptoms of an infection. The nurse
is correct to assume that these symptoms point to cellular toxicity. Significant liver toxicity, bone marrow
suppression, gingival hyperplasia, and a major dermatological response are its defining characteristics.

11. Which barbiturate is also indicated for management of anxiety?

A. mephobarbital
B. primidone
C. phenobarbital
D. mysoline
ANSWER: A
RATIO: Mephobarbital is a prescription drug used to treat the signs and symptoms of epilepsy, anxiety,
tension, and trepidation. Mebaral may be used by alone or with additional drugs. Mephobarbital is a
member of the class of medications known as barbiturates, or barbiturate anticonvulsants. In addition to
being used to treat tonic-clonic and absence seizures, mephobarbital is also used as a hypnotic or
anxiolytic.

12.Benzodiazepines exert their effect primarily on which neurotransmitter?

A. GABA
B. Serotonin
C. Norepinephrine
D. Both A and B
ANSWER: A
RATIO: By attaching to GABA-gated chloride/bicarbonate channels (GABAARs), which are the primary
mediators of transmission at inhibitory synapses in the brain, benzodiazepines help GABA's inhibitory
effects.

13.The client is prescribed phenytoin (Dilantin), an anticonvulsant, for a seizure disorder. Which
statement indicates the client understands the discharge teaching concerning this medication?
A. "I will brush my teeth after every meal."
B. "I will check my Dilantin level daily."
C. "My urine will turn orange while on Dilantin."
D. "I won't have any seizures while on this medication."
ANSWER: A
RATIO: Dilantin is an antiepileptic and anticonvulsant drug. It works by slowing down the brain
impulses that cause seizures. Take Dilantin to stop seizures. Dilantin users frequently have gingival
hyperplasia, which may be avoided or managed by daily flossing, massaging the gums, maintaining a
strict oral hygiene regimen, and visiting the dentist regularly.

14.The client is admitted to the intensive care department (ICD) experiencing status
epilepticus. Which collaborative intervention should the nurse anticipate?
A. Assess the client's neurological status every hour.
B. Monitor the client's heart rhythm via telemetry.
C. Administer an anticonvulsant medication by intravenous push.
D. Prepare to administer a glucocorticosteroid orally.
ANSWER: C
RATIO: A collaborative intervention that the nurse should prepare for is giving an intravenous push of an
anticonvulsant drug to a patient who is in the status epilepticus. An order or consultation with another
member of the healthcare team are required for the nurse to administer an anticonvulsant drug
intravenously.

15.The client has been newly diagnosed with epilepsy. Which discharge instructions should be taught to
the client? Select all that apply.
A. Keep a record of seizure activity.
B. Take tub baths only; do not take showers.
C. Avoid over-the-counter medications.
D. Have anticonvulsant medication serum levels checked regularly.
E. Do not drive alone; have someone in the car.
ANSWER: A, C, D
RATIO: Keeping track of your medication and seizure records can be useful for scheduling follow-up
visits together along with your physician and detecting potential seizure triggers. In some situations,
together with the use of stimulants, over the counter pills may consist of chemicals in order to interact
with anti-seizure medications or, perhaps, trigger a seizure. The majority of anticonvulsant pills have
therapeutic blood levels that need to be maintained, and routine serum level assessments help to make
sure the right dosage is being used.