NURS 218 Psychotic Bipolar TPN HA Seizures at Baton Rouge General School of Nursing
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Free NURS 218 Psychotic Bipolar TPN HA Seizures at Baton Rouge General School of Nursing Questions
A nurse is speaking with a patient who has schizophrenia when the patient suddenly stops focusing on the nurse's questions and begins looking at the ceiling and talking to themselves. Which action should the nurse take?
- Tell the patient, "You seem to be looking at something on the ceiling. I see something there, too."
- Continue the interview without comment on the patient's behavior.
- Stop the interview at this point and resume later when the patient is better able to concentrate.
- Ask the patient, "Are you seeing something on the ceiling?"
Explanation
Asking the patient directly whether they are seeing something on the ceiling is the safest and most therapeutic action. It assesses for hallucinations without validating or denying the experience. This approach is grounded in therapeutic communication: acknowledge the behavior, gather accurate information, and maintain patient trust. It also helps the nurse determine whether the patient is responding to internal stimuli and whether safety concerns or further interventions are needed.
Correct Answer Is:
D. Ask the patient, "Are you seeing something on the ceiling?"
The nurse is obtaining a health history from a patient who is being evaluated for the cause of frequent headaches. Which question should the nurse ask to identify the finding of tension headaches?
- "Do the headaches occur at the same time each day?"
- "Is there a pattern of headaches among family members?"
- "Does your headache pain feel like a band squeezing your head?"
- "Is your headache accompanied by profuse facial sweating?"
Explanation
C. "Does your headache pain feel like a band squeezing your head?"
Tension headaches are classically described as a “band-like” or “tightness” sensation around the head. Patients often report pressure, dull aching, or a squeezing feeling. This question helps identify the hallmark symptom of tension headaches and distinguishes them from migraines or cluster headaches, which present differently.
Correct Answer Is:
C. "Does your headache pain feel like a band squeezing your head?"
Prescribed: Acyclovir 12 mg/kg PO daily Available: Acyclovir 100 mg / 2 mL Patient weight: 115 lb How many mL will the nurse administer per dose? Record your answer to the tenth.
- 6.2 mL
- 9.8 mL
- 12.5 mL
- 15.4 mL
Explanation
First convert the patient’s weight from pounds to kilograms: 115 lb ÷ 2.2 = 52.3 kg Next calculate the prescribed dose: 12 mg × 52.3 kg = 627.6 mg Determine concentration of available medication: 100 mg in 2 mL → 50 mg per mL Now calculate required volume: 627.6 mg ÷ 50 mg/mL = 12.55 mL Rounded to the nearest tenth = 12.5 mL Therefore, the nurse should administer 12.5 mL per dose.
Correct Answer Is:
C. 12.5 mL
A nurse approaches the client with a known diagnosis of Bipolar Disorder. Which intervention is indicated?
- Offer another activity, such as exercise, music or reading, to the client.
- Provide client control using the least restrictive restraints needed.
- Try to shout in order to acquire and maintain the client's attention.
- During a calm moment, indicate you are interested in helping the client.
Explanation
Offering another activity helps redirect excess energy and agitation that commonly occur during manic episodes. Structured, calming, or physically engaging activities help reduce anxiety, promote self-regulation, and allow the client to channel hyperactivity in a safe way. This intervention also supports therapeutic rapport by giving the client choices and maintaining a calm, supportive environment without escalating confrontation or overstimulation.
Correct Answer Is:
A. Offer another activity, such as exercise, music or reading, to the client.
Which nursing diagnosis is most appropriate during the postictal phase of a seizure?
- Risk for infection
- Disturbed sensory perception
- Acute confusion
- Impaired memory
Explanation
C. Acute confusion
During the postictal phase, patients commonly experience disorientation, confusion, lethargy, and impaired awareness as the brain recovers from seizure activity. This period may last minutes to hours. Acute confusion is the most appropriate diagnosis because it directly reflects the immediate and expected neurologic recovery state following a seizure.
Correct Answer Is:
C. Acute confusion
A client diagnosed with chronic seizures is admitted to the emergency department. Select the nursing priorities in the emergency treatment of status epilepticus. Select all that apply.
- Administer IV lorazepam
- Monitor for respiratory depression
- Establish IV access
- Prep for immediate surgery
- Maintain airway
- Administer oral antiseizure medications
Explanation
A. Administer IV lorazepam
IV lorazepam is the first-line medication for stopping status epilepticus because it rapidly terminates seizure activity by enhancing GABA inhibition in the brain. Early benzodiazepine administration is critical to prevent prolonged seizures, neurological injury, and hypoxia.
B. Monitor for respiratory depression
Benzodiazepines used to treat status epilepticus can depress respiration. Additionally, prolonged seizures impair breathing and put the client at high risk for hypoxia. Continuous monitoring is essential so that airway support or ventilation can be provided immediately if needed.
C. Establish IV access
IV access is essential for administering emergency antiseizure medications such as lorazepam and IV antiepileptics that follow (e.g., phenytoin, levetiracetam). Without IV access, treatment is delayed, increasing risk of brain injury or death.
E. Maintain airway
Maintaining airway patency is a top priority because tonic-clonic seizure activity interferes with normal breathing patterns. The client may experience hypoxia, apnea, or airway obstruction. Positioning, suctioning as needed, and preparing for advanced airway support are essential.
Correct Answer Is:
A. Administer IV lorazepam
B. Monitor for respiratory depression
C. Establish IV access
E. Maintain airway
A client with schizophrenia becomes violent on the unit. What is the first nursing action?
- Discuss with the client the need to change their behavior according to policy.
- Engage the assistance of other clients to help subdue the violent client.
- Administer the pm medication to calm the client's violent tendencies.
- Call for staff assistance to ensure safety of staff and the other clients.
Explanation
When a client becomes violent, the nurse’s immediate priority is safety. Calling for staff assistance ensures enough trained personnel are present to protect the client, other patients, and staff members. This action allows the team to implement de-escalation techniques or physical intervention safely if needed. Addressing safety first prevents injury and creates a controlled environment in which further interventions can occur appropriately.
Correct Answer Is:
D. Call for staff assistance to ensure safety of staff and the other clients.
The patient diagnosed with schizophrenia is refusing medication and is displaying paranoid behavior. The nurse recognizes that schizophrenia can result in which patient belief?
- The medications will make them sick.
- They are not actually ill.
- Nurses are trying to control their minds.
- Medications provided are ineffective.
Explanation
C. Nurses are trying to control their minds.
Paranoia is a common positive symptom of schizophrenia. Patients may believe that staff are controlling, watching, or manipulating their thoughts. This delusional belief explains medication refusal and mistrust. Such paranoid delusions can severely impair insight and cooperation with treatment, making therapeutic communication essential.
Correct Answer Is:
C. Nurses are trying to control their minds.
The patient is in the clonic phase of a generalized seizure. The RN should expect the patient to exhibit which of the following? MARK ALL THAT APPLY
- excessive salivation and chewing
- urine or bowel incontinence
- cardiac arrhythmias
- cyanosis
- odd, loud verbal sounds
Explanation
B. urine or bowel incontinence
Loss of sphincter control can occur during a generalized tonic clonic seizure, especially during the transition into or during the clonic phase. Rhythmic jerking and lack of voluntary muscle control make incontinence a common and expected finding.
C. cardiac arrhythmias
During a generalized seizure, autonomic instability may occur, including changes in heart rate and rhythm. Although not present in every seizure, arrhythmias are possible due to the intense physiologic stress placed on the body during the clonic phase.
D. cyanosis
Impaired breathing, apnea, or irregular respirations often accompany the clonic phase. Reduced oxygenation can lead to temporary cyanosis, especially around the lips or face. This finding is expected due to decreased ventilation during seizure activity.
Correct Answer Is:
B. urine or bowel incontinence
C. cardiac arrhythmias
D. cyanosis
A patient is having a status epilepticus seizure. The nurse will anticipate which medication will be prescribed?
- Gabapentin
- Pregabalin
- Lorazepam
- Carbamazepine
Explanation
C. Lorazepam
Lorazepam is the first-line medication for status epilepticus because it rapidly stops ongoing seizure activity by enhancing GABA activity in the brain. It has a fast onset, can be given IV, and provides immediate seizure control while additional long-acting antiepileptic medications are prepared. Early administration is critical to prevent hypoxia, brain injury, or prolonged neurologic complications.
Correct Answer Is:
C. Lorazepam
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