NSG 6005 WEEK 6 KNOWLEDGE CHECK QUIZ 1 ANSWERS (UPDATE)

NSG 6005 WEEK 6 KNOWLEDGE CHECK QUIZ 1 ANSWERS Question : Jamie has fractured his ankle and has received a prescription for acetaminophen and hydrocodone (Vicodin). Education when prescribing Vicodin includes which one of the following instructions? Student Answer: It is OK to double the dose of Vicodin if the pain is severe. Vicodin is not habit forming. He should not take any other acetaminophen-containing medications. Vicodin may cause diarrhea; therefore, he should increase his fluid intake. Points Received: 2.5 of 2.5 Comments: Question 2. Question : Vicky, age fifty-six years, comes to clinic requesting a refill of her Fiorinal (aspirin and butalbital) that she takes for migraines. She has been taking this medication for over two years for migraine and states one dose usually works to abort her migraine. What is the best care for her? Student Answer: Switch her to sumatriptan (Imitrex) to treat her migraines. Assess how often she is using Fiorinal and refill medication. Switch her to a beta-blocker such as propranolol to prevent her migraine. Request her to return to the original prescriber of Fiorinal as you do not prescribe butalbital for migraines. Points Received: 2.5 of 2.5 Comments: Question 3. Question : The trial period to determine effective anti-inflammatory activity when starting a patient on aspirin for RA is _____. Student Answer: forty-eight hours four to six days four weeks two months Points Received: 2.5 of 2.5 Comments: Question 4. Question : Sallie has been taking 10 mg of prednisone per day for the past six months. She should be assessed for ________. Student Answer: gout iron deficiency anemia osteoporosis renal dysfunction Points Received: 2.5 of 2.5 Comments: Question 5. Question : Pathological similarities and differences between acute pain and chronic pain include which of the following options? Student Answer: Both have decreased levels of endorphins. Chronic pain has a predominance of C-neuron stimulation. Acute pain is most commonly associated with irritation of peripheral nerves. Acute pain is diffuse and hard to localize. Points Received: 2.5 of 2.5 Comments: Question 6. Question : Phil is starting treatment with febuxostat (Uloric). Education of patients starting febuxostat includes which one of the following instructions? Student Answer: Gout may worsen with therapy. Febuxostat may cause severe diarrhea. The patients should consume a high-calcium diet. The patients will need frequent CBC monitoring. Points Received: 2.5 of 2.5 Comments: Question 7. Question : All NSAIDs have an FDA black box warning regarding __________. Student Answer: potential for causing life-threatening GI bleeds increased risk of developing systemic arthritis with prolonged use risk of life-threatening rashes, including Stevens-Johnson potential for transient changes in serum glucose Points Received: 2.5 of 2.5 Comments: Question 8. Question : Jayla is a nine-year-old who has been diagnosed with migraines for almost two years. She is missing up to a week of school each month. Her headache diary confirms she averages four or five migraines per month. Which of the following would be appropriate? Student Answer: Prescribe amitriptyline (Elavil) daily, start at a low dose and increase the dose slowly every two weeks until effective in eliminating migraines. Encourage her mother to give her Excedrin Migraine (aspirin, acetaminophen, and caffeine) at the first sign of a headache to abort the headache. Prescribe propranolol (Inderal) to be taken daily for at least three months. Explain that it is rare for a nine-year-old to get migraines and that she needs an MRI to rule out a brain tumor. Points Received: 2.5 of 2.5 Comments: Question 9. Question : Xi, a fifty-four-year-old female, has a history of migraine that does not respond well to OTC migraine medication. She is asking to try Maxalt (rizatriptan) because it works well for her friend. Which of the following actions would you take for appropriate decision making? Student Answer: Prescribe Maxalt, but to monitor the use, only give her four tablets with no refills. Prescribe Maxalt and arrange to have her observed in the clinic or urgent care with the first dose. Explain that rizatriptan is not used for postmenopausal migraines and recommend Fiorinal (aspirin and butalbital). Prescribe sumatriptan (Imitrex) with the explanation that it is the most effective triptan. Points Received: 2.5 of 2.5 Comments: Question 10. Question : Patients prescribed aspirin therapy require education regarding the signs of aspirin toxicity. An early sign of aspirin toxicity is _____. Student Answer: black, tarry stools vomiting tremors tinnitus Points Received: 2.5 of 2.5 Comments: Question 11. Question : Patients whose total dose of prednisone exceed 1 gram will most likely need a second prescription for _________. Student Answer: metformin, a biguanide to prevent diabetes omeprazole, a proton pump inhibitor to prevent peptic ulcer disease naproxen, an NSAID to treat joint pain furosemide, a diuretic to treat fluid retention Points Received: 2.5 of 2.5 Comments: Question 12. Question : Kasey fractured his ankle in two places and is asking for pain medication. The appropriate first-line medication would be _________. Student Answer: ibuprofen (Advil) acetaminophen with hydrocodone (Vicodin) oxycodone (OxyContin) oral morphine ((Roxanol) Points Received: 2.5 of 2.5 Comments: Question 13. Question : When prescribed an opioid analgesic such as acetaminophen and codeine (Tylenol #3), which of the following instructions should the patient follow? Student Answer: The medication may cause sedation, so the patient should not drive. Constipation is a common side effect, so the patient should increase fluids and fiber. The patient should not take any other acetaminophen-containing medications at the same time. All the given options are correct. Points Received: 2.5 of 2.5 Comments: Question 14. Question : Narcotics are exogenous opiates. They act by ______. Student Answer: inhibiting pain transmission in the spinal cord attaching to receptors in the afferent neuron to inhibit the release of substance P blocking neurotransmitters in the midbrain increasing beta-lipoprotein excretion from the pituitary Points Received: 2.5 of 2.5 Comments: Question 15. Question : The Pain Management Contract is most appropriate for: Student Answer: Patients with a history of chemical dependency or possible inappropriate use of pain medications All patients with chronic pain who will require long-term use of opiates Patients who have a complex drug regimen Patients who see multiple providers for pain control Points Received: 0 of 2.5 Comments: Question 16. Question : Which of the following is the goal of treatment of acute pain? Student Answer: Pain at a tolerable level where patient may return to activities of daily living Reduction of pain with a minimum of drug adverse effects Reduction or elimination of pain with minimum adverse reactions Adequate pain relief without constipation or nausea from the drugs Points Received: 2.5 of 2.5 Comments: Question 17. Question : The chemicals that promote the spread of pain locally include _________. Student Answer: serotonin norepinephrine enkephalin neurokinin A Points Received: 2.5 of 2.5 Comments: Question 18. Question : A first-line drug for abortive therapy in simple migraine is ______. Student Answer: Sumatriptan (Imitrex) Naproxen (Aleve) Butorphanol nasal spray (Stadol NS) Butalbital and acetaminophen (Fioricet) Points Received: 2.5 of 2.5 Comments: Question 19. Question : Chemical dependency assessment is integral to the initial assessment of chronic pain. Which of the following raises a “red flag” about potential chemical dependency? Student Answer: Use of more than one drug to treat the pain Multiple times when prescriptions are lost with requests to refill Preferences for treatments that include alternative medicines Presence of a family member who has abused drugs Points Received: 2.5 of 2.5 Comments: Question 20. Question : Different areas of the brain are involved in specific aspects of pain. The reticular and limbic systems in the brain influence ______. Student Answer: the sensory aspects of pain the discriminative aspects of pain the motivational aspects of pain the cognitive aspects of pain Points Received: 2.5 of 2.5