NCLEX-PN® ExaminationSafety and Infection ControlMedium

An LPN is assisting with the care of a client who has a seizure disorder and is currently having a generalized tonic-clonic seizure. Which action should the LPN prioritize?

  1. ARestrain the client's extremities to prevent injury.
  2. BAdminister an oral anti-seizure medication immediately.
  3. CPlace a pillow under the client's head and turn them to their side.
  4. DInsert a tongue blade into the client's mouth to prevent biting.
Show answer & explanation

Correct answer: C. Place a pillow under the client's head and turn them to their side.

During a tonic-clonic seizure, the priority is to protect the client from injury and maintain a patent airway. Placing a pillow under the head protects it from trauma, and turning the client to their side helps prevent aspiration of secretions.

Why the other options are wrong

  • A. Restraining extremities during a seizure can cause injury such as fractures or dislocations.
  • B. Administering oral medication during a seizure is unsafe due to aspiration risk and difficulty swallowing.
  • D. Inserting anything into the mouth during a seizure can cause tooth damage, oral injury, or airway obstruction.

Seizure Safety Interventions

Actions taken by healthcare providers to protect a client experiencing a seizure from injury and to ensure airway patency, while also observing and documenting seizure characteristics.

  • Do not restrain the client.
  • Do not insert anything into the mouth.
  • Protect the head and turn to the side.
  • Note specific seizure characteristics and duration.

Memory trick: Protect, Position, Observe

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