CNRN Seizure Disorders and Epilepsy Management 2 — Questions and Answers
Question 1: A patient with a known seizure disorder reports an aura of a strange smell before their seizures. This type of aura localizes to which brain region?
- Frontal lobe
- Occipital lobe
- Temporal lobe (uncus) (Correct answer)
- Parietal lobe
Correct answer: Temporal lobe (uncus)
Olfactory auras (strange smells) localize to the medial temporal lobe (uncus), a common focus for temporal lobe epilepsy.
Question 2: Levetiracetam (Keppra) is frequently used as an antiseizure medication in neuroscience units. The nurse monitors for which MOST COMMON behavioral side effect?
- Euphoria
- Irritability, agitation, and mood changes ('Keppra rage') (Correct answer)
- Sedation and respiratory depression
- Visual hallucinations
Correct answer: Irritability, agitation, and mood changes ('Keppra rage')
Levetiracetam commonly causes irritability, agitation, and mood changes (colloquially called 'Keppra rage'), particularly in patients with prior psychiatric history.
Question 3: Which antiseizure medication requires routine monitoring of sodium levels due to its potential to cause hyponatremia?
- Levetiracetam
- Carbamazepine (Tegretol) (Correct answer)
- Phenobarbital
- Gabapentin
Correct answer: Carbamazepine (Tegretol)
Carbamazepine can cause syndrome of inappropriate antidiuretic hormone (SIADH) leading to hyponatremia, requiring regular sodium monitoring.
Question 4: A patient with epilepsy is admitted after a breakthrough seizure. Which factor should the nurse assess FIRST as the most common cause of breakthrough seizures?
- Sleep deprivation
- Antiseizure medication non-compliance (Correct answer)
- Alcohol consumption
- Stress
Correct answer: Antiseizure medication non-compliance
Non-compliance with antiseizure medication is the most common cause of breakthrough seizures in patients with established epilepsy.
Question 5: The nurse is caring for a patient in refractory status epilepticus requiring continuous EEG monitoring. The therapeutic goal of treatment is to achieve:
- Normal alpha rhythm
- Burst suppression pattern (Correct answer)
- Delta wave predominance
- Sleep spindles and K complexes
Correct answer: Burst suppression pattern
In refractory status epilepticus, treatment with anesthetic agents aims to achieve burst suppression on EEG, indicating adequate seizure suppression.
Question 6: Which vagus nerve stimulator (VNS) feature allows patients or caregivers to deliver an additional stimulation during a seizure?
- Auto-stimulation mode
- Magnet-activated stimulation (Correct answer)
- Scheduled stimulation cycles
- Closed-loop responsive stimulation
Correct answer: Magnet-activated stimulation
Swiping a magnet over the VNS device delivers an on-demand stimulation that may abort or shorten a seizure.
CNRN Seizure Disorders and Epilepsy Management 2
A patient with a known seizure disorder reports an aura of a strange smell before their seizures.
This type of aura localizes to which brain region?