sou nsg6005 Week 6 Assignment 2 Quiz latest 2017

Week 6 Assignment 2
Quiz

1.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?

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.

Question 2. Chronic
pain is a complex problem. Some specific strategies to deal with it include
________.

telling the patient to “let pain be your
guide” to using treatment therapies

prescribing pain medication on a pro re nata
(PRN) basis to keep down the amount used

scheduling return visits on a regular basis
rather than waiting for poor pain control to drive the need for an appointment

All the given options

Question 3. Phil
is starting treatment with febuxostat (Uloric). Education of patients starting
febuxostat includes which one of the following instructions?

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.

Question 4. The
Pain Management Contract is most appropriate for:

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

Question 5. Patients
whose total dose of prednisone exceed 1 gram will most likely need a second
prescription for _________.

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

Question 6. Sallie
has been taking 10 mg of prednisone per day for the past six months. She should
be assessed for ________.

gout

iron deficiency anemia

osteoporosis

renal dysfunction

Question 7. All
NSAIDs have an FDA black box warning regarding __________.

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

Question 8. Which
of the following statements is true about age and pain?

Use of drugs that depend heavily on the renal
system for excretion may require dosage adjustments in very young children.

Among the NSAIDs, indomethacin is the preferred
drug because of lower adverse effects profiles than other NSAIDs.

Older adults who have dementia probably do not
experience much pain due to loss of pain receptors in the brain.

Acetaminophen is especially useful in both
children and adults because it has no effect on platelets and has fewer adverse
effects than NSAIDs.

Question 9. Kirk
sprained his ankle and is asking for pain medication for his mild-to-moderate
pain. The appropriate first-line medication would be __________.

ibuprofen (Advil)

acetaminophen with hydrocodone (Vicodin)

oxycodone (OxyContin)

oral morphine (Roxanol)

Question 10. Patients
who are on or who will be starting chronic corticosteroid therapy need
monitoring of __________.

serum glucose

stool culture

folate levels

vitamin B12

Question 11. 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?

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.

Question 12. Patients
prescribed aspirin therapy require education regarding the signs of aspirin
toxicity. An early sign of aspirin toxicity is _____.

black, tarry stools

vomiting

tremors

tinnitus

Question 13. Henry
is eighty-two years old and takes two aspirin every morning to treat the
arthritis pain in his back. He states that the aspirin helps him to “get going”
each day. Lately, he has had some heartburn from the aspirin. After ruling out
an acute GI bleed, what would be an appropriate course of treatment for Henry?

Add an H2 blocker such as ranitidine to his
therapy.

Discontinue the aspirin and switch him to
Vicodin for the pain.

Decrease the aspirin dose to one tablet daily.

Have Henry take an antacid fifteen minutes
before taking the aspirin each day.

Question 14. Patients
with RA who are on chronic low-dose prednisone will need co-treatment with
which medications to prevent further adverse effects?

A bisphosphonate

Calcium supplementation

Vitamin D

All of the above

Question 15. One
of the main drug classes used to treat acute pain is NSAIDs. They are used due
to which of the following reasons?

They have less risk for liver damage than
acetaminophen.

Inflammation is a common cause of acute pain.

They have minimal GI irritation.

Regulation of blood flow to the kidney is not
affected by these drugs.

Question 16. Chemical
dependency assessment is integral to the initial assessment of chronic pain.
Which of the following raises a “red flag” about potential chemical dependency?

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

Question 17. 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?

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.

Question 18. Narcotics
are exogenous opiates. They act by ______.

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

Question 19. Pathological
similarities and differences between acute pain and chronic pain include which
of the following options?

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.

Question 20. Different
areas of the brain are involved in specific aspects of pain. The reticular and
limbic systems in the brain influence ______.

the sensory aspects of pain

the discriminative aspects of pain

the motivational aspects of pain

the cognitive aspects of pain

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