A patient shows loss of consciousness, jaw clenching, contraction ...

[Mr.Thesaxman]

A patient shows loss of consciousness, jaw clenching, contraction and relaxation of muscle groups, and periods of cyanosis. The nurse correctly identifies this as which type of seizure?
 
  a. Tonic-clonic
  b. Petit mal
  c. Myoclonic
  d. Atonic

Question 2

A patient is about to begin therapy with fingolimod (Gilenya) to treat multiple sclerosis. The nurse learns that the patient has not had chickenpox or the varicella zoster virus (VZV) vaccine. What will the nurse do?
 
  a. Advise the patient to avoid individuals with chickenpox.
  b. Give the VZV vaccine with the initial dose of fingolimod.
  c. Give the VZV vaccine and tell the patient to begin using fingolimod in 1 month.
  d. Obtain an order for a VZV antibody test.

[Zebsrer]

Answer to Question 1

ANS: A
Tonic-clonic seizures (or grand mal seizures) are considered generalized seizures and are manifested by a loss of consciousness, jaw clenching, muscle relaxation alternating with muscle contractions, and periods of cyanosis. Absence seizures (or petit mal seizures) are characterized by loss of consciousness for a brief period and usually involve eye blinking and staring into space. Myoclonic seizures consist of sudden contractions that may be limited to one limb or may involve the entire body. Atonic seizures are characterized by sudden loss of muscle tone.

Answer to Question 2

ANS: D
Patients who have not had chickenpox or the VZV vaccine should be tested for VZV antibodies before receiving fingolimod. It is not correct to advise patients to avoid people with chickenpox, because this disease is endemic. Patients who do not have VZV antibodies should receive the VZV vaccine 1 month before beginning the fingolimod. The VZV vaccine should be given only to those who do not have VZV antibodies.

[Mr.Thesaxman]

Excellent

[raenoj]

TYSM