Nokea
The nurse is caring for a client with an acute migraine headache. Which medication would the nurse anticipate a prescription for an acute migraine? Select all that apply.
- A. Ketorolac
- B. Nitroglycerin
- C. Topiramate
- D. Dexamethasone
- E. Hydromorphone
- F. Acetaminophen-caffeine
Correct Answer: A,F
Rationale: Ketorolac (an NSAID) and acetaminophen-caffeine are used for acute migraine relief. Nitroglycerin can worsen migraines, topiramate is for prevention, dexamethasone is not standard, and hydromorphone is not typically used for migraines.
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A 24-year old woman presents to the emergency department and appears as shown in the exhibit. What type of injury does this assessment finding suggest?
- A. CSF leak
- B. Basilar skull fracture
- C. Brown-Sequard syndrome
- D. Subarachnoid hemorrhage
Correct Answer: B
Rationale: Without the exhibit, basilar skull fracture is assumed due to context (e.g., raccoon eyes or CSF leak signs).
The nurse is assessing a client who is suspected of having myasthenia gravis. Which of the following would be an expected finding?
- A. Diplopia
- B. Butterfly rash
- C. Facial muscle weakness
- D. Shuffling gait
- E. Ptosis
Correct Answer: A,C,E
Rationale: Diplopia, facial muscle weakness, and ptosis are common in myasthenia gravis due to neuromuscular junction dysfunction.
The nurse is caring for a client diagnosed with Multiple Sclerosis (MS). The nurse should anticipate a prescription for which medication?
- A. Topiramate
- B. Risperidone
- C. Prazosin
- D. Baclofen
Correct Answer: D
Rationale: Baclofen is a muscle relaxant commonly prescribed for spasticity in Multiple Sclerosis. Topiramate is used for seizures or migraines, risperidone for psychiatric conditions, and prazosin for hypertension, none of which are primary treatments for MS.
The emergency department (ED) nurse triages a client with suspected bacterial meningitis. The nurse plans on assessing the client for Kernig's sign. The nurse understands that this sign is positive when the client?
- A. Reports pain when the knee is extended and the hip flexed.
- B. Has a stiff neck when the neck is flexed towards the chest.
- C. Forearm spasms when a blood pressure cuff is inflated on the upper arm.
- D. Reports pain in the calf when the foot is dorsiflexed.
Correct Answer: A
Rationale: Kernig's sign is positive when hip flexion with knee extension causes pain, indicating meningitis.
The nurse is performing a medication reconciliation for a client taking prescribed phenytoin. Which medication should the nurse question with the physician while the client is taking phenytoin?
- A. Thiamine
- B. Prazosin
- C. Warfarin
- D. Acyclovir
Correct Answer: C
Rationale: Phenytoin induces liver enzymes, which can decrease warfarin's effectiveness, increasing the risk of clotting. Thiamine, prazosin, and acyclovir have no significant interactions with phenytoin.