Chapter 30: Drugs for Headache

Chapter 30: Drugs for Headache

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient who has occasional migraine headaches tells a nurse that the abortive medication works well, but she would like to do more to prevent the occurrence of these headaches. The nurse will suggest that the patient:

a.	ask the provider about an adjunct medication, such as prochlorperazine.
b.	discuss the use of prophylactic medications with the provider.
c.	keep a headache diary to help determine possible triggers.
d.	take the abortive medication regularly instead of PRN.

 

 

ANS:  C

Keeping a headache diary to try to identify triggers to migraines can be helpful when a patient is trying to prevent them and is the first step in managing headaches. Prochlorperazine is an antiemetic and does not prevent or abort migraine headaches. Prophylactic medications are used when headaches are more frequent. To prevent medication overuse headache, abortive medications should not be used more than 1 to 2 days at a time.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 305-306

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

2. A woman with moderate migraine headaches asks a nurse why the provider has ordered metoclopramide [Reglan] as an adjunct to aspirin therapy, because she does not usually experience nausea and vomiting with her migraines. The nurse will tell her that the metoclopramide is used to:

a.	help induce sleep.
b.	improve absorption of the aspirin.
c.	prevent gastric irritation caused by the aspirin.
d.	prolong the effects of the aspirin.

 

 

ANS:  B

Besides reducing nausea and vomiting, metoclopramide also reverses gastric stasis and improves absorption of oral antimigraine drugs. When aspirin-like analgesics are combined with metoclopramide, they may work as well as sumatriptan. Metoclopramide is not used to induce sleep. It does not prevent gastric irritation or prolong the effects of the aspirin.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 305-307

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

3. A patient who has recurrent migraine headaches is prescribed sumatriptan [Imitrex]. Which aspect of this patient’s history is of concern when taking this drug?

a.	Asthma
b.	Coronary artery disease
c.	Diabetes
d.	Renal disease

 

 

ANS:  B

Serotonin receptor agonists can cause vasoconstriction and coronary vasospasm and should not be given to patients with coronary artery disease, current symptoms of angina, or uncontrolled hypertension. There is no contraindication for asthma, diabetes, or renal disease.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 307-308

TOP:   Nursing Process: Assessment

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential

 

4. A prescriber orders sumatriptan [Imitrex] for a patient for a migraine headache. Before administration of this drug, it would be most important for the nurse to assess whether the patient:

a.	has a family history of migraines.
b.	has taken acetaminophen in the past 3 hours.
c.	has taken ergotamine in the past 24 hours.
d.	is allergic to sulfa compounds.

 

 

ANS:  C

Sumatriptan, other triptans, and ergot alkaloids all cause vasoconstriction and should not be combined, or excessive and prolonged vasospasm could result. Sumatriptan should not be used within 24 hours of an ergot derivative and another triptan. A family history is important, but it is not vital assessment data as it relates to this scenario. Acetaminophen has no drug-to-drug interaction with sumatriptan. Sulfa is not a component of sumatriptan and therefore is not relevant.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 307-308 | p. 310

TOP:   Nursing Process: Assessment

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential