Nokea
A nurse is caring for a patient who experiences debilitating cluster headaches. The patient should be taught to take appropriate medications at what point in the course of a new headache?
- A. As soon as the pain becomes unbearable
- B. As soon as the patient senses the onset of symptoms
- C. Twenty to thirty minutes after the onset of symptoms
- D. When the patient senses his or her symptoms peaking
Correct Answer: B
Rationale: Early administration of medication at symptom onset aborts cluster headaches effectively. Delaying treatment prolongs pain unnecessarily.
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A patient is being admitted to the neurologic ICU following an acute head injury that has resulted in cerebral edema. When planning this patients care, the nurse would expect to administer what priority medication?
- A. Hydrochlorothiazide (HydroDIURIL)
- B. Furosemide (Lasix)
- C. Mannitol (Osmitrol)
- D. Spirolactone (Aldactone)
Correct Answer: C
Rationale: Mannitol, an osmotic diuretic, reduces cerebral edema by dehydrating brain tissue. Other diuretics like hydrochlorothiazide, furosemide, and spirolactone are not typically used for increased ICP.
A school nurse is called to the playground where a 6-year-old girl has been found unresponsive and staring into space, according to the playground supervisor. How would the nurse document the girls activity in her chart at school?
- A. Generalized seizure
- B. Absence seizure
- C. Focal seizure
- D. Unclassified seizure
Correct Answer: B
Rationale: Staring and unresponsiveness characterize an absence seizure, common in children. Generalized and focal seizures involve motor activity, and unclassified seizures lack clear patterns.
The nurse is providing care for a patient who is withdrawing from heavy alcohol use. The nurse and other members of the care team are present at the bedside when the patient has a seizure. In preparation for documenting this clinical event, the nurse should note which of the following?
- A. The ability of the patient to follow instructions during the seizure.
- B. The success or failure of the care team to physically restrain the patient.
- C. The patients ability to explain his seizure during the postictal period.
- D. The patients activities immediately prior to the seizure.
Correct Answer: D
Rationale: Documenting pre-seizure activities helps identify triggers. Patients cannot follow instructions or explain seizures during or postictally, and restraint is contraindicated.
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.
While completing a health history on a patient who has recently experienced a seizure, the nurse would assess for what characteristic associated with the postictal state?
- A. Epileptic cry
- B. Confusion
- C. Urinary incontinence
- D. Body rigidity
Correct Answer: B
Rationale: Confusion is typical in the postictal state after a seizure. Epileptic cry, incontinence, and rigidity occur during the seizure, not afterward.