RN ADULT MEDICAL SURGICAL NURSING FINAL EXAM NEW VERSION UPDATED 2024-2025, Exams of Nursing

Download RN ADULT MEDICAL SURGICAL NURSING FINAL EXAM NEW VERSION UPDATED 2024-2025 and more Exams Nursing in PDF only on Docsity! RN ADULT MEDICAL SURGICAL NURSING FINAL EXAM NEW VERSION UPDATED 2024-2025 BEST STUDIYING MATERIALS WITH VERIFIED ANSWERS. RN ADULT MEDICAL SURGICAL NURSING FINAL EXAM VERSION 2019 ALL FORMS AND 2023 ALL FORMS| ALL INCLUSIVE WITH DETAILED QUESTIONS AND ANSWERS | GUARANTEED PASS A nurse is reviewing the medical record of a client who has systemic lupus erythematosus. Which of the following findings should the nurse expect? Facial butterfly rash. R: A butterfly rash is a manifestation of SLE. It appears as a dry red rash on the clients cheeks and nose and can disappear during times of remission. A nurse is caring for a client who is receiving plasmapheresis through a venous access site. Which of the following actions should the nurse take? Check electrolyte levels before and after therapy. R: Plasmapheresis can cause citrate induced hypocalcemia. Therefore the nurse should monitor the clients electrolyte levels before and after therapy. A nurse is assessing a client who has Graves disease. Which of the following images should indicate to the nurse that the client has exophthalmos? The nurse should identify an outward protrusion of the eyes is exophthalmos a common finding of graves disease. An overproduction of the thyroid hormone causes edema of the extraocular muscle and increases fatty tissue behind the eye which results in the eyes protruding outward. Exophthalmos can cause the client to experience problems with vision including focusing on objects as well as pressure on the optic nerve. A nurse is performing a cardiac assessment for a client who had a myocardial infarction 2 days ago. Which of the following actions should the nurse take first after hearing the following sound? Listen with the client on his left side. When providing nursing care the nurse should first use the least invasive intervention. Therefore after auscultating a murmur the first action the nurse should take is to place the client on his left side and listen to his heart again. A nurse is providing teaching to an older adult female client who has stress incontinence and a BMI of 32. Which of the following statements by the client indicates an understanding of the teaching question mark I am dieting to lose weight. Excess weight cut creates increased abdominal pressure that can result in stress incontinence. A nurse is reviewing the ABG results of a client who has advanced COPD. Which of the following results should the nurse expect? Paco2 of 56. A client who has COPD retains paco2 due to the weakening and the collapse of the alveolar sacs which decreases the area and lungs for gas exchange and causes the paco2 to increase above the expected reference range. A nurse is providing teaching to a client who is perimenopausal and has a prescription for hormone replacement therapy. For which of the following adverse effects should the nurse instruct the client to notify the provider? Select all that apply. Calf pain, numbness in the arms and intense headache. Calf pain is an indication of DVT and the client should report this finding to the provider immediately. Numbness in the arms can indicate cerebrovascular accident which is an adverse effect of hormone replacement therapy and an intense headache can indicate a cerebrovascular accident. A nurse is providing teaching to a client who has chronic kidney disease and a new prescription for erythropoietin. Which of the following statements by the client indicates an understanding of the teaching? I am taking this medication to increase my energy level. The goal of erythropoietin therapy is to increase the level of hematocrit and clients who have anemia. When the medication is effective the client should have a decreasing fatigue and an improvement and activity tolerance. A nurse is teaching a client who has venous insufficiency about self-care. Which of the following statements should the nurse identify as an indication that the client understands teaching? I will wear clean graduated compression stockings everyday. The client should apply a clean pair of graduated compression stockings each day and clean soiled stockings with mild detergent and warm water by hand. A nurse is preparing to present a program about atherosclerosis at a health fair. Which of the following recommendations should the nurse plan to include? Select all that apply. Follow a smoking cessation program maintain an appropriate weight eat a low-fat diet and increase fluid intake. Smoking cessation is an important lifestyle modification to prevent Arthur sclerosis and preventing obesity through diet and exercise can help prevent atherosclerosis. Eating a low fat diet decreases LDL cholesterol and can prevent atherosclerosis. You will not be able to use sildenafil if you are taking nitroglycerin. The client should not use sildenafil when taking nitroglycerin because both medications can cause vasodilation and lead to significant hypotension A nurse is in a provider's office is providing teaching to a client who has a urinary tract infection and a new prescription for ciprofloxacin. Which of the following instructions should the nurse include Avoid taking magnesium containing antacids with this medication. The nurse should instruct the client to take Ciprofloxacin either two hours before or 6 hours after taking an antacid but not to take Ciprofloxacin with an antacid because magnesium containing antacids decrease the absorption of Ciprofloxacin A nurse is providing follow-up care for a client who sustained a compound fracture three weeks ago. The nurse should recognize that an unexpected finding for which of the following laboratory values is a manifestation of osteomyelitis and should be reported to the provider Sedimentation rate. And increased sedimentation rate occurs when a client has any type of inflammatory process such as osteomyelitis A nurse is caring for a client who has hypothyroidism. Which of the following manifestations should the nurse expect Constipation. A client who has hypothyroidism can experience constipation due to the decrease in the client's metabolism resulting and slow motility of the gastrointestinal tract. The nurse should instruct the client to increase fiber and fluid and take to reduce the risk of constipation A nurse at an urgent care clinic is caring for a client who is experiencing an anaphylactic reaction. After ensuring a patent Airway which of the following interventions is the priority applying oxygen via face mask because the priority intervention is for the nurse to apply oxygen using a high-flow non-rebreather mask to deliver oxygen at 90 to 100% Where would you palpate to assess for an inguinal hernia The nurse should palpate at the right groin area because an inguinal hernia forms of the peritoneum which contains part of the intestine and can protrude into the scrotum in males A nurse is checking the ECG Rhythm strip for a client who has a temporary pacemaker the nurse notes a spike or a pacemaker artifact followed by a QRS complex. Which of the following actions should the nurse take Document that depolarization has occurred. When a pacing stimulus is delivered to The ventricle a spike appears on the ECG Rhythm strip this bike should be followed by a QRS complex which indicates pacemaker capture or depolarization A nurse is caring for a client who is eight hours post-operative following a total hip arthroplasty the client is unable to void on the bed pan Which of the following actions should the nurse take first Scan the bladder with a portable ultrasound the first action should be using the nursing process which is assisting the client scanning the bladder with a portable ultrasound device will determine the amount of urine in the bladder A nurse is caring for a client who is receiving tpn a new bag is not available when the current infusion is nearly completed which of the following actions should the nurse take Administer dextrose 10% in water until the new bag arrives. Tpn Solutions have a high concentration of dextrose therefore if a t-pn solution is temporarily unavailable the nurse administer dextrose 10% or 20% and water to avoid a precipitous drop in the client's blood glucose level A nurse is providing teaching to a client who has a gastric ulcer and a new prescription for Omeprazole. The nurse should instruct the client that the medication provides Relief by which of the following actions Suppressing gastric acid production. I love her soul is a proton pump inhibitor it relieves manifestations of gastric ulcers by suppressing gastric acid production A nurse is providing discharge teaching to a client who is to self administer heparin subcutaneously. Which of the following responses by the client indicates an understanding of the teaching I will use an electric razor to shave. Heparin is an anticoagulant that places the client at risk for bleeding therefore the nurse should instruct the client to use an electric razor when shaving to reduce the risk of cuts to the skin a nurse is caring for a client following excavation of her endotracheal tube 10 minutes ago. Which of the following findings should the nurse report to the provider immediately Strider. Using the Urgent vs. Non-urgent approach to client care the nurse should determine that the priority finding a Strider. Strider can indicate and narrowing Airway or possible obstruction caused by edema or laryngeal spasms the nurse should report the finding immediately Implement an intervention a nurse is caring for a client who had a nephrostomy tube inserted 12 hours ago. Which of the following findings should the nurse report to the provider The client reports back pain the nurse should notify the provider if the client reports back pain which can indicate that the nephrostomy tube is dislodged or clogged A nurse is assessing a client while suctioning the clients tracheostomy tube which of the following findings should indicate to the nurse that the client is experiencing hypoxia The clients heart rate increases because hypoxia related to suctioning can cause the clients heart rate to increase if this occurs the nurse should discontinue the sectioning and immediately oxygenate the client with 100% oxygen the nurse should instruct the client to take three or four deep breaths prior to suctioning to reduce the risk for hypoxia A nurse is planning teaching for a client who has bladder cancer and is to undergo a cutaneous diversion procedure to establish and ureterostomy. Which of the following statements should the nurse include in the teaching Cut the opening of The Skin Barrier one eighth of an inch wider than the stoma. The client should cut the opening of The Skin Barrier 1/8 inch wider than the stoma to minimize irritation of the skin from exposure to urine A nurse is teaching a client who has atrial fibrillation about the purpose of wearing a Holter monitor. Which of the following information should the nurse include in the teaching This device can detect when you have an irregular heart rate because it reports and transmits electrical impulses of the heart and alerts the nurse to dysrhythmias myocardial injury or conduction defects a Holter monitor allows the client freedom of movement while cardiac activity is recorded A nurse is providing discharge teaching to a client who has heart failure and a new prescription for potassium sparing diuretic which of the following information should the nurse include in the teaching Try to walk at least 3 times per week for exercise because the development of a regular exercise routine can improve outcomes in clients who have heart failure A nurse is caring for a client who has chronic glomerulonephritis with oliguria which of the following findings should the nurse identify as a manifestation of chronic glomerulonephritis Hyperkalemia as a result of kidney failure because kidney failure results in decreased excretion of potassium A nurses in an acute care facility is caring for a client who is at risk for seizures which of the following precautions should the nurse implement Ensure that the client has a patent IV in the event that the client requires medication to stop seizure activity A nurse is caring for a client who has bilateral pneumonia and an spo2 of 88% the client is dyspneic and productive cough and is using accessory muscles to breathe which of the following actions should the nurse take first Place the client in a high Fowler's position A nurse is caring for a client who has a new diagnosis of hyperthyroidism which of the following is the priority assessment finding that the nurse should report to the provider Blood pressure of 170 over 80 because using the Urgent vs. Non-urgent approach to client care the nurse determines that the priority funding is a systolic blood pressure of 170 which indicates that the client is at risk for thyroid storm A nurse is reviewing the medication history of a client who is to undergo allergy testing the nurse should instruct the client to discontinue which of the following medications before testing A nurse is caring for a client who presents to a clinic for a one-week follow-up visit after hospitalization for heart failure based on the information in the clients chart which of the following findings should the nurse report to the provider Heart rate of 55 per minute is a significant drop from the clients Baseline of 74 permanent and it can indicate the development of digoxin toxicity A nurse is assessing for compartment syndrome in a client who has a short leg cast which of the following findings should the nurse identify as a manifestation of this condition Pain that increases with passive movement because compartment syndrome results from a decrease in blood flow in the extremities because of a decrease in the muscle compartment size due to a cast that is too tight A nurse is planning care for a client who is post-operative following a laparotomy and has a closed suction drain which of the following actions should the nurse take to manage the drain Compress the drain Reservoir after emptying because it creates a vacuum that draws fluid out of the room through the drain and into the reservoir A pacu nurse is assessing a client who is post-operative following a right nephrectomy the client's initial vital signs for heart rate 80 permanent blood pressure 130 over 70 respiratory rate 16 and temperature 96.8 which of the following Vital sign changes should alert the nurse the client might be hemorrhaging heart rate of 110 per minute because one of the first signs of hemorrhage is an increase in the heart rate from the clients Baseline which occurs to compensate for blood A nurse is assessing a client following the completion of hemodialysis which of the following findings is the nurses priority to report to the provider Restlessness because using the Urgent vs. Non-virgin approach to client care the nurse to determine that the priority funding to report to the provider is restlessness which can be an indication of the client is experiencing disequilibrium syndrome which is caused by the rapid removal of electrolytes for the clients blood and can lead to dysrhythmias or seizures other manifestations include nausea vomiting fatigue and headache A nurse is caring for a client who is having a seizure which of the following interventions is the nurses priority Turn the client to the side because the greatest risk to this client is hypoxia from an impaired Airway A nurse is obtaining a medication history from a client who is scheduled to undergo cataract surgery the nurse should recognize that which of the following client medications is a contraindication for the surgery and notify the provider Warfarin because it is an anticoagulant which increases the client's risk for bleeding and is contraindicated for a client scheduled for I or Central Nervous System since surgery A nurse is providing teaching to a female client who has a history of urinary tract infections which of the following information should the nurse include in the teaching Clean the perineum from front to back after voiding or defecating to avoid introducing bacteria to the urethra A nurse is assessing a client who has had a suspected cerebrovascular accident the nurse should place the priority on which of the following findings Dysphasia because it indicates that the client is at greatest risk for aspiration due to impaired sensation and function within the oral cavity A nurse is planning care for a client who is post-operative following a parathyroidectomy which of the following actions should the nurse identify as the priority Placed a tracheostomy tray at the bedside in case of Airway obstruction A nurse is providing teaching to a client who has Type 1 diabetes mellitus and a new prescription for insulin lispro which of the following statements by the client indicates an understanding of the teaching I will need to take this bro in addition to my other prescribed insulin because it is a rapid-acting insulin that the client can use in conjunction with an intermediate or long-acting insulin A nurse is providing medication teaching to a group of clients who have seizure disorders which of the following information should the nurse include about phenytoin Phenytoin decreases the effectiveness of oral contraceptives because it stimulates the synthesis of hepatic enzymes which can decrease the activity of other medications including oral contraceptives A nurse is providing discharge instructions to a client who has active tuberculosis which of the following information should the nurse include in the instructions Sputum specimens are necessary every 2 to 4 weeks until there are three negative cultures after three negative sputum cultures the client is no longer considered infectious A nurse is planning care for a client who was having a modified radical mastectomy of the right breast which of the following interventions should the nurse include in the plan of care Instruct the client that the drain is removed when there is 25 milliliters of output or less over a 24-hour period the drain will remain in place for one to three weeks after surgery and we've removed when there is 25 milliliters of output or less in a 24-hour period A nurse is teaching to a client who has hypertension and a new prescription for Verapamil. Which of the following juices should the nurse instruct the client to avoid Grapefruit because it inhibits the hepatic metabolism of the medication and then place the current client at risk for toxicity A nurse is providing teaching to a client who has asthma about the use of a metered dose inhaler the nurse should identify that which of the following client actions indicates an understanding of the teaching Holding breath for 10 seconds after inhaling so that the medication can move deep into the Airways A nurse is providing instructions to a client who has Type 2 diabetes mellitus and a new prescription for metformin which of the following statements by the client indicates an understanding of the teaching I should take this medication with a meal to improve absorption and to minimize gastrointestinal distress A nurse is providing teaching to a client who has irritable bowel syndrome which of the following instructions should the nurse include in teaching Increase fiber intake to at least 30 grams per day to produce bulky soft stools and establish regular bowel patterns A nurse in an emergency department is assessing an older adult client who has a fractured wrist following a fall during the assessment the client states last week I crashed my car because my vision suddenly became blurry which of the following actions is the nurses priority Check the clients neurologic status because the first action you should take is to assess the client A nurse is providing teaching to a client who has a new prescription for psyllium which of the following information should the nurse include in the teaching Drink 240 milliliters of water after Administration A nurse on a medical-surgical unit is receiving change of shift report on four clients which of the following clients should the nurse identify as having the greatest risk for developing an infection A client who has COPD and is receiving steroid therapy because of decreased oxygenation and increased mucus production additionally taking a steroid medication increases the client's risk for infection by suppressing the immune system and masking the presence of an infection A nurse is planning discharge teaching for a client who has an external fixation device for a fracture of the lower extremity which of the following instructions should the nurse include in the plan of care Used crutches with rubber tips to prevent the client from slipping and decrease the risk of Falls A nurse in an emergency department is caring for a client who has full thickness Burns over 20% of his total body surface area after ensuring a patent Airway and administering oxygen which of the following items should the nurse prepared to administer first IV fluids to provide circulatory support A nurse is providing teaching to a client who has hypothyroidism and is receiving Levothyroxine the nurse should instruct the client that which of the following could interfere with the absorption of the medication Calcium supplements a In what time frame will brain injury or death occur due to hypoxia if the patients airway is not patent? 3-5 minutes What all should a nurse inspect for if a client's ability to maintain an airway is lost? for blood, broken teeth, vomitus, or other foreign materials in the airway that can cause obstruction What should the nurse do if a client is unresponsive WITHOUT suspicion of trauma? The airway should be opened with a head-tilt/chin-lift maneuver When should a nurse not perform the head-tilt/chin-lift maneuver? If the patient has a potential cervical spine injury What should the nurse do if the patient is unresponsive WITH suspicion of trauma? The airway should be opened with a modified jaw thrust maneuver What type of oxygen is indicated for clients who are spontaneously breathing? nonbreather mask with 100% oxygen How does a nurse assess a patient's breathing? auscultation of breath sounds, observation of chest expansion and respiratory effort, notation of rate and depth of respirations, identification of chest trauma, assessment of tracheal position, assessment of jugular vein distention What should the nurse do if the client is not breathing or is breathing inadequately? manual ventilation should be performed by a bag valve mask with supplemental oxygen or mouth-to-mask ventilation until bag valve mask can be obtained How does a nurse assess a patient's circulation? assess HR, BP, peripheral pulses, and capillary refill for adequate perfusion What should nurses consider when it comes to ineffective circulation? cardiac arrest, myocardial disfunction, and hemorrhage as precursors to shock How does a nurse restore effective circulation? CPR, assess for external bleeding, hemorrhage control, obtain IV access using large-bore IV catheters inserted into the antecubital fossa of both arms, infuse isotonic IV fluids What can develop if a patients circulation if compromised? Shock What are the nursing interventions to alleviate shock? administer oxygen, apply pressure to obvious bleeding, elevate lower extremities to shunt blood to vital organs, administer IV fluids and blood products, monitor vs, remain with the client How does a nurse prevent hypothermia? remove wet clothing from patient, cover the patient with warm blankets, increase the temperature of the room, use a heat lamp to provide additional warmth, infuse warm IV fluids What can hypothermia lead to ? eventual coma, hypoxemia, and acidosis What is the sudden cessation of cardiac function caused most commonly by ventricular fibrillation or ventricular asystole? cardiac arrest What is the fluttering of the ventricles causing loss of consciousness, pulselessness, and no breathing that requires collaborative care to defibrillate immediately using ACLS protocol? Ventricular fibrillation What is the irritable firing of ectopic ventricular beats at a rate of 140 to 180 beats per min that over time a client will become unconscious and deteriorate into VF? Pulseless ventricular tachycardia What is the complete absence of electrical ectopic ventricular movement of the heart where the client is in complete cardiac arrest and requires implementation of BLS and ACLS protocol? Ventricular asystole What is a rhythm that appears to have electrical activity but is not sufficient to stimulate effective cardiac contractions and requires implementation of BLS and ACLS protocol? Pulseless electrical activity (PEA) What is the response of the receptor site Alpha 1? activation of receptors in the arterioles of skin, viscera and mucous membranes, and veins that lead to vasoconstriction What is the response of the receptor site Beta 1? heart stimulation leads to increased heart rate, increase myocardial contractility, and increased rate of conduction through the AV node, and activation of receptors in the kidney leading to the release of renin What is the response of the receptor site Beta 2? Bronchodilation, relaxation of uterine smooth muscle, breakdown of glycogen into glucose, muscle contraction What is the response of the receptor site dopamine? activation of receptors in the kidney cause the renal blood vessels to dilate What are the 5 H's when it comes to common causes of PEA? Hypovolemia, hypoxia, hydrogen ion accumulation, resulting in acidosis, hyperkalemia or hypokalemia, and hypothermia What are the 5 T's when it comes to common causes of PEA? Toxins, Tamponade, Tension pneumothorax, Thrombosis (coronary), Thrombosis (pulmonary) What do the drugs MAOIs do in response to epinephrine? the release of norepinephrine from sympathetic nerves and thereby prolong and intensify the effects of epinephrine and can cause hypertensive crisis What is the nursing interventions for MAOIs? avoid the use of MAOIs in clients who are receiving epinephrine What do the drugs tricyclic antidepressants do in response to epinephrine? block the reuptake of epinephrine which will prolong and intensify the effects of epinephrine What is the nursing intervention for tricyclic antidepressants ? clients taking these medications concurrently can need a lower dose of epinephrine What do general anesthetics do in response to epinephrine? can cause the heart to become hypersensitive to the effects of epinephrine, which leads to dysrhythmias What is the nursing interventions for general anesthetics and epinephrine? perform continuous ECG monitoring, notify the provider if the client experiences chest pain, dysrhythmias, or an elevated heart rate What do beta-adrenergic blocking agents do? block the action at beta receptors When do we use the beta-adrenergic blocking agent propranolol? identify tumors and infarctions, detect abnormalities, monitor response to treatment, and guide needles used for biopsies What is an electroencephalography? a noninvasive procedure that assesses the electrical activity of the brain What is the electroencephalography used for? abnormalities in brain patterns, such as seizure activity, detecting sleep disorders and behavior changes What is the best possible Glascow Coma Scale score? 15 What is a score less than 8 on the GCS indicate? severe head injury or coma What is a score of 9 to 12 on the GCS indicate? moderate head injury What is a score greater than 13 on the GCS indicate? mild head injury What is the ICP monitor? records intracranial pressure What do we use the ICP monitor for? early identification and treatment of increased intracranial pressure What are some manifestations of increased ICP? severe headache, deteriorating level of consciousness, restlessness, irritability, dilated or pinpoint pupils, slowness to react, alterations in breathing pattern, deterioration in motor function, and abnormal posturing What are some important nursing actions that need to be taken after a patient undergoes ICP monitoring? inspect the insertion site at least every 24 hours for redness, swelling, and drainage; observe ICP waveforms, assess the clients clinical status What is a complication of ICP monitoring? infection and bleedings What is a lumbar puncture procedure? where a small amount of CSF fluid is withdrawn from the spinal canal and then analyzed to determine its constituents What do we use a lumbar puncture for? detect the presence of some diseases such as MS, syphilis, meningitis; also infection and malignancies What is are some complications of a lumbar puncture procedure? If clotting does not occur to seal the dura puncture site, CSF can leak, resulting in a headache and increasing the potential for infection What is a MRI? A scan that provides a cross-sectional image of the cranial cavity What do we use MRIs for? detect abnormalities, monitor response to treatment, and guide needles used for biopsies What is a PET scan? nuclear medicine procedures that produce three-dimensional images of the head What do we use PET scans for? determining tumor activity and/or response to treatment; also determines the presence of dementia What do we use nonopioid analgesics for? treating mild to moderate pain What are some examples of nonopioid analgesics? NSAIDS, including salicylates; acetaminophen What properties do nonopioid analgesics have? antipyretic and anti-inflammatory What is meningitis? inflammation of the meninges What are the meninges? membranes that protect the brain and spinal cord What type of meningitis is contagious with a high mortality rate? Bacterial What are the risk factors for viral meningitis? there is no vaccine for viral What are some subjective data findings of a patient who has meningitis? excruciating, constant headache; nuchal rigidity, and photophobia What are some objective data findings of a patient who has meningitis? fever and chills, N/V, altered LOC, positive kernels sign, positive Brudzinskis sign, hyperactive deep tendon reflexes, tachycardia, seizures, red macular rash, restlessness, irritability How does a nurse detect a positive Kernig's sign? the patient has resistance and pain with extension of the client's leg from a flexed position How does a nurse detect a positive Brudzinskis sign? a patient has flexion of the knees and hips occurring with deliberate flexion of the clients neck What lab tests are done with a patient who could have meningitis? Urine, throat, use, and blood culture and sensitivity; CBC What is the definitive diagnostic procedure for meningitis? CSF analysis What are the results from a CSF analysis that indicate meningitis? Appearance of CSF: cloudy (bacterial) or clear (viral); elevated WBC, elevated protein, decreased glucose (bacterial), and elevated CSF pressure What nursing actions are done with a patient who has been diagnosed with meningitis? Isolate the client as soon as meningitis is suspected, maintain isolation precautions, implement fever reduction measures, decrease environmental stimuli, provide a quiet environment, minimize exposure to bright light, maintain bed rest with the head of bed elevated to 30 degrees, monitor for increased ICP, tell the client to avoid coughing and sneezing, seizure precautions, replace fluid and electrolytes, Why would a nurse give Ceftriaxone in combination with vancomycin to a patient with possible meningitis? These are given until culture and sensitivity results are available; effective for bacterial infections Why would a nurse give Phenytoin (anti-convulsant) to a patient with meningitis? in case ICP increases or if the client experiences a seizures What are some complications of meningitis? Increased ICP, SIADH, and Septic emboli What are abrupt, excessive, and uncontrolled electrical discharge of neurons within the brain that can cause alterations in the LOC and/or changes in motor and sensory ability and/or behavior? Seizures