STUVIA 2024/2025
Chapter 19: Antiseizure Drugs
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. - ✔✔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. of unknown origin.
c. linked to a stroke.
d. related to brain anoxia.
ANS: A
Anticonvulsants are given to prevent seizures and are usually taken throughout the patient's lifetime.
Stopping the medication can 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. - ✔✔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 may be necessary 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: 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 to 20 mcg/mL. - ✔✔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 child's 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 is usually used in adults."
ANS: A
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, STUVIA 2024/2025
Phenytoin commonly causes gingival hyperplasia, which causes overgrowth of reddened gum tissue
that bleeds easily. It is not a sign of a drug interaction (there is no known interaction between
phenytoin and aspirin) or a symptom of hepatotoxicity. It does not indicate a lack of self-care. -
✔✔The nurse is caring for a patient who has a seizure disorder being treated with phenytoin. The
nurse notes that the patient has reddened gums that bleed when brushing. The nurse recognizes this
finding as:
a. an adverse effect of the phenytoin.
b. likely due to a drug interaction with aspirin.
c. a symptom of hepatotoxicity.
d. a sign of poor self-care.
ANS: A
The patient's drug level is considered normal, since 10 to 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. - ✔✔The nurse is preparing to administer phenytoin (Dilantin) to a patient
who has a seizure disorder. 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's labs do not indicate toxic phenytoin levels.
b. Contact the provider to discuss decreasing the phenytoin dose.
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c. Give the drug and monitor closely for toxicity.
d. Report drug toxicity to the providers.
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 are appropriate.
Phenytoin will precipitate in dextrose solution. Intramuscular injection is very irritating to tissues and is
not used. - ✔✔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 2 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
Patients who have taken hydantoins for long periods might have an elevated blood sugar that results
from the drug inhibiting the release of inulin. The nurse should discuss this test with the provider. -
✔✔The nurse is preparing to assist with blood collection on a newly admitted patient who has been
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