The parents of a pediatric client describe occasional episodes where the client seems to experience a temporary loss of awareness and a blank stare. The nurse suspects which of the following disorders?

Focal awareness seizure

Absence seizure

Transient ischemic attack (TIA)

Tonic clonic seizure

Answer and Explanation

The Correct Answer is B

A. Focal awareness seizure:
Focal awareness seizures (formerly known as simple partial seizures) involve abnormal electrical activity in a specific area of the brain. These seizures typically cause motor symptoms (such as jerking or twitching in one part of the body) or sensory disturbances (like tingling or visual changes), but the person remains fully aware during the episode. The client’s presentation of a temporary loss of awareness and blank stare is more consistent with an absence seizure than a focal awareness seizure, as focal seizures do not cause a loss of consciousness.

B. Absence seizure:
Absence seizures are a type of generalized seizure often seen in children. These seizures are characterized by a sudden, brief loss of awareness, typically lasting only a few seconds. During the episode, the child may exhibit a blank stare and seem unresponsive, often without any noticeable physical movements. These seizures are often mistaken for daydreaming or inattention, but they can be diagnosed with an EEG (electroencephalogram) showing characteristic patterns. This description matches the parents’ observations of occasional episodes of loss of awareness and a blank stare.

C. Transient ischemic attack (TIA):
A TIA, also known as a mini-stroke, involves temporary neurological symptoms due to a brief disruption in blood flow to the brain. However, TIAs usually last longer than the brief episodes of loss of awareness described in this case, and they are more likely to cause focal neurological not just a transient loss of awareness. Additionally, TIAs are much less common in children and are usually associated with other risk factors like cardiovascular disease or clotting disorders.

D. Tonic clonic seizure:
Tonic-clonic seizures (formerly known as grand mal seizures) involve generalized shaking or convulsions, loss of consciousness, and can last from 1 to 3 minutes. These seizures are usually much more dramatic and prolonged compared to the brief, absence-like episodes described here. While they do involve a loss of awareness, the physical manifestations (muscle stiffening and jerking) and duration are distinctively different from the blank stare and brief loss of awareness typical of an absence seizure.

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. "Following up with your dentist frequently will be important.":
This is the correct and important advice to give. Phenytoin (Dilantin), an anticonvulsant, can cause gum overgrowth (gingival hyperplasia), which makes it important for the patient to have regular dental check-ups. Poor oral hygiene combined with gingival hyperplasia can increase the risk of infection and other oral health issues. Therefore, advising the patient to follow up frequently with a dentist is essential to manage this side effect.

B. "Take an antacid with the medication if indigestion occurs.":
advice. Taking an antacid with phenytoin can interfere with its absorption. Antacids, especially those containing aluminum or magnesium, can reduce the effectiveness of phenytoin, leading to suboptimal therapeutic levels. It’s important to separate phenytoin from antacids by at least 2 hours to avoid this interaction. Therefore, antacids should not be used with phenytoin to manage indigestion.

C. "Alcoholic beverages should be limited to 1-2 per day while taking phenytoin.":
This is inaccurate advice. Alcohol can significantly affect the metabolism of phenytoin, increasing the risk of both toxicity and reduced effectiveness. Alcohol may lower the seizure threshold and interfere with the therapeutic effect of phenytoin, especially in higher amounts. Therefore, it is generally recommended that patients taking phenytoin avoid alcohol altogether, or at the very least limit consumption significantly and discuss it with their healthcare provider.

D. "Phenytoin may turn your urine orange.":
information. Phenytoin does not cause urine to turn orange. Urine discoloration can occur with some medications (like rifampin, for example), but not with phenytoin. This statement could cause unnecessary confusion for the patient. It is essential to provide accurate information to avoid misconceptions about medication side effects.

A. Nitrofurantoin (Macrobid) B. Sulfamethoxzole-trimethoprim (SMX TMP) Bactrim) C. This is expected with a UTI not related to medications. D. Phenazopryidine (Pyridium)

Correct Answer is D

Explanation

A) Nitrofurantoin (Macrobid): While nitrofurantoin is commonly prescribed for urinary tract infections (UTIs), it does not typically cause a red-orange discoloration of the urine. Nitrofurantoin may cause other side effects, such as gastrointestinal upset or pulmonary issues, but urine discoloration is not a common or expected side effect.

B) Sulfamethoxazole-trimethoprim (SMX TMP, Bactrim): Sulfamethoxazole-trimethoprim is another common medication for UTIs, but it does not cause urine to turn red-orange. Some individuals may experience allergic reactions, rash, or gastrointestinal side effects, but urine discoloration is not typically associated with this medication.

C) This is expected with a UTI not related to medications: While it’s true that UTIs can cause changes in urine color due to blood or infection, the red-orange discoloration specifically linked to a UTI is often caused by medications, not the infection itself. Therefore, this statement is not accurate in explaining the cause of the urine color change.

D) Phenazopyridine (Pyridium): This is the correct answer. Phenazopyridine is a medication commonly used to alleviate urinary tract pain and discomfort. One of its well-known side effects is causing urine to turn a red-orange color. This discoloration is harmless and typically resolves once the medication is discontinued. However, patients should be informed about this effect to avoid unnecessary concern.

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The parents of a pediatric client describe occasional episodes where the client seems to experience a temporary loss of awareness and a blank stare. The nurse suspects which of the following disorders?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing teaching to a client who has seizures and a new prescription for phenytoin. Which of the following information should the nurse provide?

Correct Answer is A

Explanation

A client who following prescribed multiple medications for recurring urinary tract infections tells the nurse that her urine has turned red-orange. Which of the following prescribed medications does the nurse suspect is responsible for this change?

Correct Answer is D

Explanation

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