Nokea
Which of the following would a nurse integrate into the explanation for a client about the mechanism of action for almotriptan? Select all that apply.
- A. Vasoconstriction
- B. Vasodilation
- C. Decreased neurotransmission
- D. Increased neurotransmission
- E. Inhibition of prostaglandin synthesis
Correct Answer: A,C
Rationale: Selective serotonin agonists like almotriptan (Axert) exert their effects by causing vasoconstriction and decreased neurotransmission.
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A 60-year-old client with rheumatoid arthritis visits the health care facility for a regular checkup. The client informs the nurse that he has been using an over-the-counter NSAID for the last few days. The nurse cautions the client about the use of NSAIDs on a long-term basis because of the increased risk for which of the following?
- A. Ulcer disease
- B. CNS disorders
- C. Hearing impairment
- D. Blindness
Correct Answer: A
Rationale: Age appears to increase the possibility of adverse reactions to NSAIDs. The risk of serious ulcer disease in adults older than 65 years is increased with higher doses of NSAIDs. CNS disorders, hearing impairment, and blindness are not effects associated with using NSAIDs on a long-term basis in older clients.
A client who is receiving ibuprofen asks the nurse, 'What should I take the drug with?' Which of the following would the nurse suggest in the response? Select all that apply.
- A. Milk
- B. Orange juice
- C. Food
- D. Clear liquids
- E. Antacids
Correct Answer: A,C,E
Rationale: The nurse should advise the patient to take ibuprofen (Motrin) with food, milk, or antacids.
The nurse would question an order for a selective serotonin agonist as treatment for a migraine headache for a client with which condition? Select all that apply.
- A. Diabetes
- B. Uncontrolled hypertension
- C. Angina
- D. Hyperlipidemia
- E. Transient ischemic attacks
Correct Answer: B,C,E
Rationale: 5-HT agonists should not be used in patients with ischemic heart disease (such as angina or myocardial infarction), transient ischemic attacks (TIA), uncontrolled hypertension, or those patients taking monoamine oxidase inhibitor (MAOI) antidepressants.
A nurse is caring for a client who is required to take NSAIDS on an outpatient basis. Which of the following would the nurse include in the teaching plan for the client and family?
- A. Take aspirin if necessary strictly with a full glass of water.
- B. Use the drug on a very regular basis during treatment.
- C. Call your primary care provider if you have no relief after 2 weeks.
- D. Take the drugs strictly with a glass of milk or juice.
Correct Answer: C
Rationale: The nurse should instruct the patient to consult the primary health care provider if the pain, swelling, inflammation, or tendemess is not relieved after 2 weeks. The drug takes several days to relieve the discomfort, so it is important for the patient to give the drug time to work. The nurse should instruct the patient to avoid the use of aspirin. The drug should be taken with a full glass of water or with food. It is not necessary to take NSAIDs strictly with a glass of juice or milk. These drugs are not to be used on a regular basis unless the patient is strictly instructed to do so by the primary health care provider.
When discussing effective pain management with a group of nursing students, the instructor would include barriers that need to be overcome. Which of the following would the instructor most likely include? Select all that apply.
- A. Pharmacists do not provide an adequate supply of pain medication.
- B. Primary health care providers prescribe improper pain medicine doses.
- C. Nurses do not administer adequate medication for pain relief.
- D. Clients do not report accurate levels of pain.
- E. Clients have misperceptions about receiving pain medication.
Correct Answer: B,C,D
Rationale: The main barriers a nurse must overcome to obtain effective pain management in a client are primary health care providers who do not prescribe proper pain medicine doses, nurses who do not administer adequate medication for pain relief, and clients who do not report accurate levels of pain.