Absence seizures typically cause staring spells that last only a few seconds.
Correct Answer
True
True. Absence seizures are brief generalized seizures with staring or rapid blinking and sudden return to normal activity. They are most common in children.
Category: Seizure Basics
Question 2
Focal seizures begin with abnormal electrical activity in both cerebral hemispheres at the same time.
Correct Answer
False
False. Focal seizures start in one area of one hemisphere, and their symptoms depend on that area. Seizures that involve both hemispheres from the start are generalized seizures.
Category: Seizure Basics
Question 3
Antiepileptic drugs as a class carry a warning about an increased risk of suicidal thoughts and behavior.
Correct Answer
True
True. The FDA requires a warning about suicidal thoughts and behavior for antiepileptic drugs, so nurses monitor mood and teach families to report depression or behavior changes.
Category: Anticonvulsant Nursing Care
Question 4
A triptan may be safely taken within a few hours of a dose of ergotamine.
Correct Answer
False
False. Triptans and ergot alkaloids both constrict blood vessels, so they are not taken within 24 hours of each other because of the risk of severe vasospasm.
Category: Migraine Drugs
Question 5
Carbamazepine induces its own metabolism, so its blood level can fall during the first weeks of therapy.
Correct Answer
True
True. This autoinduction of liver enzymes speeds carbamazepine's own clearance, which is why levels are rechecked and doses often adjusted after therapy starts. Carbamazepine also speeds the metabolism of many other drugs.
Category: Other Anticonvulsants
Question 6
Long-term benzodiazepine use carries no risk of physical dependence.
Correct Answer
False
False. Benzodiazepines can cause tolerance and physical dependence, and stopping them abruptly can cause withdrawal, including seizures. Use is monitored and the drug is tapered when stopped.
Category: Benzodiazepines and Status Epilepticus
Question 7
Diazepam is available as a rectal gel that caregivers can give at home to stop a prolonged seizure.
Correct Answer
True
True. Rectal diazepam gel is a rescue drug for seizure clusters or prolonged seizures outside the hospital. Caregivers are taught when to give it and when to call emergency services.
Category: Benzodiazepines and Status Epilepticus
Question 8
Ergotamine is considered safe for treating migraines during pregnancy.
Correct Answer
False
False. Ergotamine is contraindicated in pregnancy because it can stimulate uterine contractions and reduce blood flow to the fetus. Patients who could become pregnant discuss contraception and alternatives with their provider.
Category: Migraine Drugs
Question 9
Keeping a headache diary helps a patient with migraines identify personal triggers.
Correct Answer
True
True. A diary of attacks, foods, sleep, stress and menstrual timing helps reveal triggers such as aged cheese, alcohol or missed sleep, so they can be avoided.
Category: Migraine Drugs
Question 10
Frequent use of acute migraine drugs can lead to medication overuse headache.
Correct Answer
True
True. Taking abortive drugs such as triptans or analgesics on many days each month can cause more frequent headaches. Patients who need acute drugs often are evaluated for preventive therapy.
Category: Migraine Drugs
Question 11
Sumatriptan relieves migraine by blocking serotonin receptors.
Correct Answer
False
False. Sumatriptan is a serotonin receptor agonist at 5-HT1B and 5-HT1D receptors. Stimulating these receptors constricts dilated cranial vessels and reduces release of inflammatory neuropeptides.
Category: Migraine Drugs
Question 12
Acetazolamide lowers intracranial pressure by increasing the production of cerebrospinal fluid.
Correct Answer
False
False. Acetazolamide inhibits carbonic anhydrase and decreases cerebrospinal fluid production, which lowers pressure. It is used for idiopathic intracranial hypertension.
Category: Intracranial Pressure Drugs
Question 13
Because phenytoin is highly bound to albumin, a patient with low albumin can show toxicity even when the total serum level looks normal.
Correct Answer
True
True. Only unbound phenytoin is active, and low albumin leaves more drug unbound. Older adults and patients with malnutrition or kidney disease may need free phenytoin levels.
Category: Hydantoins and Barbiturates
Question 14
Carbamazepine can make hormonal contraceptives less effective.
Correct Answer
True
True. Carbamazepine induces liver enzymes that speed the breakdown of estrogen and progestin, so a backup or nonhormonal method of contraception is recommended.
Category: Other Anticonvulsants
Question 15
Topiramate commonly causes weight gain.
Correct Answer
False
False. Topiramate is associated with appetite loss and weight loss. Other effects include drowsiness, fatigue and word-finding difficulty.
Category: Other Anticonvulsants
Question 16
Triptans can cause a feeling of tightness or pressure in the chest.
Correct Answer
True
True. Chest, throat or jaw tightness is a known triptan effect, and because triptans constrict vessels they are avoided in coronary artery disease. Chest pain that is severe or persistent is reported at once.
Category: Migraine Drugs
Question 17
Mannitol decreases urine output.
Correct Answer
False
False. Mannitol is an osmotic diuretic, so it increases urine output. Intake and output, electrolytes and serum osmolality are monitored closely during therapy.
Category: Intracranial Pressure Drugs
Question 18
Phenobarbital controls seizures by blocking the action of GABA.
Correct Answer
False
False. Phenobarbital enhances the inhibitory action of GABA at its receptor, which slows brain activity. This also explains its sedation and respiratory depression.
Category: Hydantoins and Barbiturates
Question 19
Hypertonic saline lowers intracranial pressure by drawing water out of brain tissue into the blood.
Correct Answer
True
True. Raising serum sodium and osmolality creates a gradient that pulls water from swollen brain tissue into the vessels. Serum sodium is monitored frequently during therapy.
Category: Intracranial Pressure Drugs
Question 20
A generalized tonic-clonic seizure begins with rhythmic jerking that is followed by muscle stiffening.
Correct Answer
False
False. The tonic phase of stiffening comes first and is followed by the clonic phase of rhythmic jerking. The seizure is often followed by a period of confusion and drowsiness.
Category: Seizure Basics