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A nurse is admitting a patient with a severe migraine headache and a history of acute coronary syndrome. What migraine medication would the nurse question for this patient?
- A. Rizatriptan (Maxalt)
- B. Naratriptan (Amerge)
- C. Sumatriptan succinate (Imitrex)
- D. Zolmitriptan (Zomig)
Correct Answer: C
Rationale: Sumatriptan and other triptans can cause chest pain and are contraindicated in ischemic heart disease. All listed medications are triptans, but sumatriptan is specifically noted for this risk.
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A patient is postoperative day 1 following intracranial surgery. The nurses assessment reveals that the patients LOC is slightly decreased compared with the day of surgery. What is the nurses best response to this assessment finding?
- A. Recognize that this may represent the peak of post-surgical cerebral edema.
- B. Alert the surgeon to the possibility of an intracranial hemorrhage.
- C. Understand that the surgery may have been unsuccessful.
- D. Recognize the need to refer the patient to the palliative care team.
Correct Answer: A
Rationale: Cerebral edema peaks 24-36 hours post-surgery, often causing decreased LOC. Hemorrhage is not confirmed, surgery success is premature to judge, and palliative care is not indicated.
The nurse is participating in the care of a patient with increased ICP. What diagnostic test is contraindicated in this patients treatment?
- A. Computed tomography (CT) scan
- B. Lumbar puncture
- C. Magnetic resonance imaging (MRI)
- D. Venous Doppler studies
Correct Answer: B
Rationale: Lumbar puncture risks brain herniation in patients with increased ICP due to pressure changes. CT, MRI, and Doppler studies are safe and non-invasive.
During the examination of an unconscious patient, the nurse observes that the patients pupils are fixed and dilated. What is the most plausible clinical significance of the nurses finding?
- A. It suggests onset of metabolic problems.
- B. It indicates paralysis on the right side of the body.
- C. It indicates paralysis of cranial nerve X.
- D. It indicates an injury at the midbrain level.
Correct Answer: D
Rationale: Fixed, dilated pupils suggest midbrain injury, often from increased ICP. Metabolic issues, unilateral paralysis, or CN X damage do not typically cause this finding.
A patient with a documented history of seizure disorder experiences a generalized seizure. What nursing action is most appropriate?
- A. Restrain the patient to prevent injury.
- B. Open the patients jaws to insert an oral airway.
- C. Place patient in high Fowlers position.
- D. Loosen the patients restrictive clothing
Correct Answer: D
Rationale: Loosening restrictive clothing prevents injury during a seizure. Restraining or inserting an airway can cause harm, and high Fowlers is inappropriate during a seizure.
A nurse is collaborating with the interdisciplinary team to help manage a patients recurrent headaches. What aspect of the patients health history should the nurse identify as a potential contributor to the patients headaches?
- A. The patient leads a sedentary lifestyle.
- B. The patient takes vitamin D and calcium supplements.
- C. The patient takes vasodilators for the treatment of angina.
- D. The patient has a pattern of weight loss followed by weight gain.
Correct Answer: C
Rationale: Vasodilators are known to trigger headaches. Sedentary lifestyle, supplements, or weight fluctuations are not directly linked to recurrent headaches.