question

Jayla is a nine-year-old who has been diagnosed with migraines for almost two years. She is missing up to a week of school each month. Her headache diary confirms she averages four or five migraines per month. Which of the following would be appropriate? A. Prescribe amitriptyline (Elavil) daily, start at a low dose and increase the dose slowly every two weeks until effective in eliminating migraines. B. Encourage her mother to give her Excedrin Migraine (aspirin, acetaminophen, and caffeine) at the first sign of a headache to abort the headache. C. Prescribe propranolol (Inderal) to be taken daily for at least three months. D. Explain that it is rare for a nine-year-old to get migraines and that she needs an MRI to rule out a brain tumor.

answer

C. Prescribe propranolol (Inderal) to be taken daily for at least three months.

question

When prescribed an opioid analgesic such as acetaminophen and codeine (Tylenol #3), which of the following instructions should the patient follow? A. The medication may cause sedation, so the patient should not drive. B. Constipation is a common side effect, so the patient should increase fluids and fiber. C. The patient should not take any other acetaminophen-containing medications at the same time. D. All the given options are correct.

answer

D. All the given options are correct

question

Patients whose total dose of prednisone exceed 1 gram will most likely need a second prescription for _________. A. metformin, a biguanide to prevent diabetes B. omeprazole, a proton pump inhibitor to prevent peptic ulcer disease C. naproxen, an NSAID to treat joint pain D. furosemide, a diuretic to treat fluid retention

answer

B. omeprazole, a proton pump inhibitor to prevent peptic ulcer disease

question

The chemicals that promote the spread of pain locally include _________. A. serotonin B. norepinephrine C. enkephalin D. neurokinin A

answer

D. neurokinin A

question

Different areas of the brain are involved in specific aspects of pain. The reticular and limbic systems in the brain influence ______. A. the sensory aspects of pain B. the discriminative aspects of pain C. the motivational aspects of pain D. the cognitive aspects of pain

answer

C. the motivational aspects of pain

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question

Kasey fractured his ankle in two places and is asking for pain medication. The appropriate first-line medication would be _________. A. ibuprofen (Advil) B. acetaminophen with hydrocodone (Vicodin) C. oxycodone (OxyContin) D. oral morphine ((Roxanol)

answer

B. acetaminophen with hydrocodone (Vicodin)

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question

The Pain Management Contract is most appropriate for: A. Patients with a history of chemical dependency or possible inappropriate use of pain medications B. All patients with chronic pain who will require long-term use of opiates C. Patients who have a complex drug regimen D. Patients who see multiple providers for pain control

answer

A. Patients with a history of chemical dependency or possible inappropriate use of pain medications

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question

Henry is eighty-two years old and takes two aspirin every morning to treat the arthritis pain in his back. He states that the aspirin helps him to "get going" each day. Lately, he has had some heartburn from the aspirin. After ruling out an acute GI bleed, what would be an appropriate course of treatment for Henry? A. Add an H2 blocker such as ranitidine to his therapy. B. Discontinue the aspirin and switch him to Vicodin for the pain. C. Decrease the aspirin dose to one tablet daily. D> Have Henry take an antacid fifteen minutes before taking the aspirin each day.

answer

A. Add an H2 blocker such as ranitidine to his therapy.

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question

Juanita presents to clinic with a complaint of headaches off and on for months. She reports she feels like someone is "squeezing" her head. She occasionally takes Tylenol for the pain but usually just "toughs it out." Initial treatment for tension headache includes asking her to keep a headache diary and a prescription for ________. A. sumatriptan (Imitrex) B. naproxen (Aleve) C. ergotamine (Ergostat) D. Tylenol with codeine (Tylenol #3)

answer

B. naproxen (Aleve)

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question

Sallie has been taking 10 mg of prednisone per day for the past six months. She should be assessed for ________. A. gout B. iron deficiency anemia C. osteoporosis D. renal dysfunction

answer

C. osteoporosis

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question

Age is a factor in different responses to pain. Which of the following age-related statements about pain is not true? A. Preterm and newborn infants do not yet have functional pain pathways. B. Painful experiences and prolonged exposure to analgesic drugs during pregnancy may permanently alter neuronal organization in the child. C. Increases in pain threshold in older adults may be related to peripheral neuropathies and changes in skin thickness. D. Decreases in pain tolerance are evident in older adults.

answer

A. Preterm and newborn infants do not yet have functional pain pathways.

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question

Kelly is a fourteen-year-old who presents to clinic with a classic migraine. She says she is having a headache two to three times a month. The initial plan would be which of the following? A. Prescribe NSAIDs as abortive therapy and have her keep a headache diary to identify her triggers. B. Prescribe zolmitriptan (Zomig) as abortive therapy and recommend relaxation therapy to reduce her stress. C. Prescribe acetaminophen with codeine (Tylenol #3) for her to take at the first onset of her migraine. D. Prescribe sumatriptan (Imitrex) nasal spray and arrange for her to receive the first dose in the clinic.

answer

A. Prescribe NSAIDs as abortive therapy and have her keep a headache diary to identify her triggers.

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question

Jamie has fractured his ankle and has received a prescription for acetaminophen and hydrocodone (Vicodin). Education when prescribing Vicodin includes which one of the following instructions? A. It is OK to double the dose of Vicodin if the pain is severe. B. Vicodin is not habit forming. C. He should not take any other acetaminophen-containing medications. D. Vicodin may cause diarrhea; therefore, he should increase his fluid intake.

answer

C. He should not take any other acetaminophen-containing medications.

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question

Which of the following is the goal of treatment of acute pain? A. Pain at a tolerable level where patient may return to activities of daily living B. Reduction of pain with a minimum of drug adverse effects C. Reduction or elimination of pain with minimum adverse reactions D. Adequate pain relief without constipation or nausea from the drugs

answer

C. Reduction or elimination of pain with minimum adverse reactions

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question

Vicky, age fifty-six years, comes to clinic requesting a refill of her Fiorinal (aspirin and butalbital) that she takes for migraines. She has been taking this medication for over two years for migraine and states one dose usually works to abort her migraine. What is the best care for her? A. Switch her to sumatriptan (Imitrex) to treat her migraines. B. Assess how often she is using Fiorinal and refill medication. C. Switch her to a beta-blocker such as propranolol to prevent her migraine. D. Request her to return to the original prescriber of Fiorinal as you do not prescribe butalbital for migraines.

answer

B. Assess how often she is using Fiorinal and refill medication.

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question

Chemical dependency assessment is integral to the initial assessment of chronic pain. Which of the following raises a "red flag" about potential chemical dependency? A. Use of more than one drug to treat the pain B. Multiple times when prescriptions are lost with requests to refill C. Preferences for treatments that include alternative medicines D. Presence of a family member who has abused drugs

answer

B. Multiple times when prescriptions are lost with requests to refill

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question

A first-line drug for abortive therapy in simple migraine is ______. A. Sumatriptan (Imitrex) B. Naproxen (Aleve) C. Butorphanol nasal spray (Stadol NS) D. Butalbital and acetaminophen (Fioricet)

answer

B. Naproxen (Aleve)

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question

Amber is a twenty-four-year-old who has had migraines for ten years. She reports a migraine on average of once a month. The migraines are effectively aborted with naratriptan (Amerge). When refilling Amber's naratriptan education would include which of the following? A. Naratriptan will interact with antidepressants, including selective serotonin reuptake inhibitors and St John's Wort, and she should inform any providers she sees that she has migraines. B. Continue to monitor her headaches; if the migraine is consistently happening around her menses, then there is preventive therapy available. C. Pregnancy is contraindicated when taking a triptan. D. All the given options are correct.

answer

D. All the given options are correct.

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NSG 6005 WEEK 6 Pharmacology – Flashcards

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