seizure basics
A patient suddenly becomes unresponsive and begins rhythmic jerking of both arms and legs. What is happening that is most likely cause of this event?
A. Decreased cerebral blood flow
B. Abnormal electrical discharge in the brain
C. Increased intracranial pressure
D. Infection of brain tissue
answer: B
rationale:
seizures are caused by abnormal electrical activity in the brain.
A is incorrect because that relates to ischemia.
C is incorrect because ICP can cause symptoms but is not the primary cause of seizure activity.
D is incorrect because infection can trigger seizures but is not the definition.
A patient has been seizing continuously for 6 minutes without regaining consciousness. What should the nurse recognize?
A. This is a normal seizure pattern
B. This is status epilepticus
C. This is a postictal phase
D. This does not require intervention
answer: B
rationale:
status epilepticus is treated as an emergency at ≥5 minutes.
A and D are incorrect because this is not normal and requires immediate action.
C is incorrect because postictal occurs after seizure stops.
A patient begins actively seizing in bed. What is the nurse’s first action?
A. Insert oral airway
B. Call the provider
C. Protect the patient’s head
D. Restrain the patient
answer: C
rationale:
immediate safety is priority.
A is incorrect because nothing goes in mouth.
B is not first action.
D is unsafe.
A patient in status epilepticus is prescribed lorazepam. What is the purpose?
A. Prevent future seizures
B. Stop seizure immediately
C. Reduce ICP
D. Improve circulation
answer: B
rationale:
benzodiazepines are first-line to stop seizures quickly.
A patient presents with fever, headache, and neck stiffness. What condition should the nurse suspect?
A. Stroke
B. Meningitis
C. Migraine
D. Seizure disorder
answer: B
rationale:
classic triad of meningitis includes fever and nuchal rigidity.
SATA
A nurse is assessing a patient after a seizure. Which findings should the nurse document?
A. Duration of seizure
B. Type of movements observed
C. Blood pressure after event
D. Level of consciousness
E. Patient’s room temperature
answer: A, B, D
rationale:
important documentation includes duration, characteristics, and LOC.
C may be monitored but is not the priority documentation.
E is irrelevant.
SATA
A patient is in status epilepticus. Which complications are most concerning?
A. Hypoxia
B. Brain injury
C. Metabolic acidosis
D. Increased appetite
E. Cardiac dysrhythmias
answer: A, B, C, E
rationale:
prolonged seizures cause hypoxia, acidosis, brain injury, and cardiac issues.
D is unrelated.
SATA
During a seizure, which actions are appropriate?
A. Turn patient on side
B. Place object in mouth
C. Remove nearby hazards
D. Restrain limbs
E. Support the head
answer: A, C, E
rationale:
these actions promote safety and airway protection.
B and D are unsafe.
Which medications are considered benzodiazepines used in seizures?
A. Ativan
B. Valium
C. Dilantin
D. Cerebyx
E. Phenobarbital
answer: A, B
rationale:
ativan and valium are benzos. others are anticonvulsants.
SATA
Which findings are associated with meningitis?
A. Nuchal rigidity
B. Kernig’s sign
C. Brudzinski’s sign
D. Clear CSF
E. Fever
answer: A, B, C, E
rationale:
meningitis presents with these signs; CSF is cloudy, not clear.
A patient is scheduled for diagnostic testing after multiple seizures. Which test is most useful for detecting electrical brain activity?
A. CT scan
B. MRI
C. EEG
D. Lumbar puncture
answer: C
rationale:
EEG measures electrical activity in the brain.
A and B show structure, not electrical activity.
D evaluates CSF.
A nurse is caring for a patient in status epilepticus. What is the priority action?
A. Start seizure documentation
B. Notify the provider
C. Maintain airway and oxygenation
D. Check lab results
answer: C
rationale:
airway is always the first priority.
A and B are important but not before airway.
D is not immediate priority.
A patient has excessive oral secretions during a seizure. What is the best nursing action?
A. Insert tongue blade
B. Turn patient supine
C. Suction side of mouth
D. Force jaw open
answer: C
rationale:
suction should be applied to side of mouth between cheek and teeth.
A and D are unsafe.
B increases aspiration risk.
A patient continues seizing after receiving a benzodiazepine. What is the next medication?
A. Phenobarbital
B. Diuretic
C. Antibiotic
D. Phenytoin
answer: D
rationale:
phenytoin is given as a loading dose after benzos.
A patient is undergoing a lumbar puncture. What finding supports meningitis?
A. Clear CSF
B. Yellow CSF
C. Cloudy CSF
D. No CSF present
answer: C
rationale:
cloudy CSF indicates infection.
SATA
Which factors can trigger seizures in a patient?
A. Hypoglycemia
B. Infection
C. Head trauma
D. Adequate oxygenation
E. Fever
answer: A, B, C, E
rationale:
low glucose, infection, trauma, and fever can trigger seizures.
D is incorrect because oxygenation prevents, not causes, seizures.
SATA
Which findings indicate a patient is in status epilepticus?
A. Continuous seizure activity
B. Repeated seizures without recovery
C. Seizure lasting more than 5 minutes
D. Single seizure with full recovery
E. Loss of consciousness
answer: A, B, C, E
rationale:
status epilepticus includes prolonged or repeated seizures with no recovery.
D is incorrect because that is not status epilepticus.
SATA
Which interventions indicate proper seizure precautions are in place?
A. Suction equipment available
B. Oxygen setup ready
C. Bed in lowest position
D. Restraints applied
E. Padded side rails
answer: A, B, C, E
rationale:
these promote safety.
D is incorrect because restraints are not used.
SATA
Which statements about phenobarbital are correct?
A. Used for severe seizures
B. Requires close monitoring
C. Patient may require intubation
D. First-line medication
E. Causes CNS depression
answer: A, B, C, E
rationale:
phenobarbital is last-line and suppresses CNS.
D is incorrect because benzos are first-line.
SATA
Which interventions are appropriate for meningitis?
A. Antibiotics
B. Droplet precautions
C. Dim lighting
D. Increased stimulation
E. Monitor ICP
answer: A, B, C, E
rationale:
antibiotics treat infection, droplet precautions prevent spread, dim lighting reduces stimulation, and ICP monitoring prevents complications.
D is incorrect because stimulation worsens symptoms.
A patient has a seizure but quickly returns to baseline with no residual symptoms. What type of seizure pattern is most likely?
A. Status epilepticus
B. Continuous seizure activity
C. Isolated seizure
D. Refractory seizure
answer: C
rationale:
an isolated seizure resolves with full recovery.
A and B involve ongoing seizure activity.
D refers to seizures that do not respond to treatment.
A patient in status epilepticus is not responding to initial medication therapy. What is the next anticipated step?
A. Discontinue treatment
B. Administer long-acting anticonvulsant
C. Allow seizure to resolve naturally
D. Begin rehabilitation
answer: B
rationale:
after benzodiazepines, loading dose anticonvulsants are given.
A and C are unsafe.
D is inappropriate during active seizure.
A nurse witnesses a seizure and ensures the environment is safe. What is the next priority?
A. Document event
B. Check glucose level
C. Assess airway and breathing
D. Administer medication
answer: C
rationale:
after safety, airway and breathing are the next priority.
A and B come after stabilization.
D depends on assessment first.
A patient is placed on continuous sedation for uncontrolled seizures. What is the nurse’s priority concern?
A. Nutrition
B. Mobility
C. Airway protection
D. Skin care
answer: C
rationale:
sedation suppresses breathing, so airway is priority.
A patient with meningitis develops seizures. What is the cause?
A. Decreased blood flow
B. Brain irritation from infection
C. Electrolyte imbalance
D. Medication side effect
answer: B
rationale:
infection causes inflammation and irritation of brain tissue, triggering abnormal electrical activity and seizures.
A is incorrect because decreased blood flow is not the primary cause here.
C is incorrect because while electrolytes can cause seizures, infection is the main cause in meningitis.
D is incorrect because medications are not the primary cause in this scenario.