ATI LPN
Roach's Introductory Clinical Pharmacology 11th Edition
Chapter 28 Questions
Question 1 of 5
When describing the anticonvulsants to a group of nursing students, the instructor describes which of the following as acting to stabilize the hyperexcitability postsynaptically in the motor cortex of the brain? Select all that apply.
Correct Answer: B,D
Rationale: Hydantoins, like phenytoin (Dilantin) and ethotoin (Peganone), exert their effect by stabilizing the hyperexcitability postsynaptically in the motor cortex of the brain. Ethosuximide depresses the motor cortex, valproic acid increases levels of GABA to stabilize the cell membranes, and topiramate blocks seizure activity instead of raising the threshold.
Question 2 of 5
After reviewing information about anticonvulsants, a nursing student demonstrates understanding of this group of drugs, identifying which of the following as acting to elevate the seizure threshold by decreasing postsynaptic excitation? Select all that apply.
Correct Answer: A,D
Rationale: Benzodiazepines (clonazepam and lorazepam) exert their effect by elevating the seizure threshold by decreasing postsynaptic excitation. Valproic acid increases the levels of GABA, gabapentin is a GABA agonist, and trimethadione decreases the repetitive synaptic transmission of nerve impulses.
Question 3 of 5
A nurse understands that lorazepam (Ativan) is the drug of choice for treating status epilepticus but that its effects last for less than 1 hour. The nurse would expect which of the following to be prescribed along with lorazepam (Ativan) during status epilepticus? Select all that apply.
Correct Answer: B
Rationale: Due to the short effects of lorazepam (Ativan), a longer-acting anticonvulsant, such as phenytoin (Dilantin), is given to continue control of seizure activity.
Question 4 of 5
When reviewing the client's medical record, the nurse understands that which of the following if found would contraindicate administering phenytoin (Dilantin) to a client? Select all that apply.
Correct Answer: A,B
Rationale: The use of phenytoin is contraindicated in clients with known hypersensitivity to the drug, sinus bradycardia, sinoatrial block, Adam-Stokes syndrome, and second- and third-degree atrioventricular block and in clients who are pregnant or lactating.
Question 5 of 5
A nurse is preparing to administer phenytoin to a client. The nurse understands the need to administer this drug cautiously if the client has a history of which of the following? Select all that apply.
Correct Answer: B,E
Rationale: Phenytoin (Dilantin) is used cautiously in clients with hypotension, severe myocardial insufficiency, and hepatic impairment.