Test #4 Pharmacology Bank Questions with Correct Answers 2023 The American Diabetic Association has recommended which of the following tests for ongoing management of diabetes? - Correct Answer HbA1C A patient who has migraine headaches takes sumatriptan as abortive therapy. The patient tells the primary care nurse practitioner (NP) that the sumatriptan is effective for stopping symptoms but that the episodes are occurring three to four times per month. The NP should consider the addition of: - Correct Answer topiramate.A patient comes to the clinic concerned about possible migraine headaches. The primary care NP conducts a history and physical examination, and the patient describes vise-like pressure in the back of the head that occurs almost daily during the work week. The NP should recommend: - Correct Answer acetaminophen.A patient comes to the clinic and reports recurrent headaches. The patient has a headache diary, which reveals irritability and food cravings followed the next day by visual disturbances and unilateral right- sided headache, nausea, and photophobia lasting 2 to 3 days. The NP should recognize these symptoms as _____ migraine. - Correct Answer classic patient who has migraine headaches tells the primary care NP that drinking coffee and taking nonsteroidal antiinflammatory drugs (NSAIDs) seems to help with discomfort. The NP should tell the patient that: - Correct Answer this combination can lead to longer lasting headache pain.A patient takes rizatriptan (Maxalt) to abort migraine headaches but tells the primary care NP that the headaches have become more frequent since a promotion at work. The NP's initial response should be
to: - Correct Answer stress the importance of establishing new routines.
A primary care NP prescribes sumatriptan for abortive treatment of migraine headaches. The patient returns to the clinic 1 month later to report increased frequency of the headaches. The NP should: - Correct Answer ask the patient how often the sumatriptan is used each week. 1 / 4
A patient who has migraine headaches without an aura reports difficulty treating the migraines in time because they come on so suddenly. The patient has been using over-the-counter NSAIDs. The primary
care NP should prescribe: - Correct Answer sumatriptan (Imitrex).
A patient who has mild to moderate migraine headaches has severe nausea and vomiting with each episode. For the best treatment of this patient, the primary care NP should prescribe: - Correct Answer triptan nasal spray.A patient who has migraine headaches usually has two to three severe migraines each month. The patient has been using a triptan nasal spray but reports little relief and is concerned about missing so many days of work. The primary care NP should consider: - Correct Answer an injectable triptan plus an oral corticosteroid.A patient who experiences migraines characterized by unilateral motor and sensory symptoms tells the primary care NP that despite abortive therapy with a triptan, the frequency of episodes has increased to three or four times each month. The NP - Correct Answer prescribe an anticonvulsant such as topiramate.A patient who is diagnosed with migraine headaches has a history of cardiovascular disease and hypertension. The NP should prescribe: - Correct Answer cyproheptadine (Periactin).A patient reports frequent headaches to the primary NP. The patient describes the headaches as unilateral and moderate in intensity, accompanied by nausea, vomiting, and photophobia. There is no aura, and the headaches generally last 24 to 48 hours. The NP should: - Correct Answer recognize these as classic migraines and order sumatriptan (Imitrex).Paige has a history of chronic migraines and would benefit from preventative medication. Education regarding migraine preventive medication includes: - Correct Answer The goal of treatment is to reduce migraine occurrence by 50% A first-line drug for abortive therapy in simple migraine is: - Correct Answer Naproxen (Aleve) Vicky, age 56 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 2 years for migraine and states one 2 / 4
dose usually works to abort her migraine. What is the best care for her? - Correct Answer Assess how often she is using Fiorinal and refill medication When prescribing ergotamine suppositories (Wigraine) to treat acute migraine, patient education would include: - Correct Answer They may need premedication with an antinausea medication Migraines in pregnancy may be safely treated with: - Correct Answer Acetaminophen with codeine (Tylenol #3) Xi, a 54-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. Appropriate decision making would be: - Correct Answer Prescribe Maxalt and arrange to have her observed in the clinic or urgent care with the first dose Kelly is a 14 year old who presents to clinic with a classic migraine. She says she is having a headache two to three times a month. The initial plan would be: - Correct Answer Prescribe NSAIDs as abortive therapy and have her keep a headache diary to identify her triggers Jayla is a 9 year old who has been diagnosed with migraines for almost 2 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? - Correct Answer Prescribe propranolol (Inderal) to be taken daily for at least 3 months Amber is a 24 year old who has had migraines for 10 years. She reports a migraine on average of once a month. The migraines are effectively aborted with naratriptan (Amerge). When refilling Amber's naratriptan education would include: - Correct Answer A.Naratriptan will interact with antidepressants, including SSRIs and St John's Wort, and she should inform any providers she sees that she has migraines B.Continue to monitor her headaches, if the migraine is consistently happening around her menses there is preventive therapy available C.Pregnancy is contraindicated when taking a triptan 3 / 4
When prescribing for migraine, patient education includes: - Correct Answer Stress reduction and regular sleep are integral to migraine treatment Juanita presents to clinic with a complaint of headaches off and on for months. She reports they feel like someone is "squeezing" her head. She occasionally takes Tylenol for the pain, but usually just "toughs it out." Initial treatment for tension headache includes asking her to keep a headache diary and a
prescription for: - Correct Answer Naproxen (Aleve)
Nonpharmacologic therapy for tension headaches includes: - Correct Answer A. Biofeedback
- Stress management
C.Massage therapy James has been diagnosed with cluster headaches. Appropriate acute therapy would be: - Correct Answer Oxygen 100% for 15 to 30 minutes Preventative therapy for cluster headaches includes: - Correct Answer Ergotamine nightly before bed When prescribing any headache therapy, appropriate use of medications needs to be discussed to prevent medication-overuse headaches. The clinical characteristics of medication-overuse headaches
include: - Correct Answer Headaches recur when medication wears off
Antonia is a 3 year old who has a history of status epilepticus. Along with her routine antiseizure medication, she should also have a home prescription for____ to be used for an episode of status epilepticus. - Correct Answer Rectal diazepam (Diastat) Rabi is being prescribed phenytoin for seizures. Monitoring includes: - Correct Answer Assessing for phenytoin hypersensitivity syndrome 3 to 8 weeks after starting treatment Dwayne has recently started on carbamazepine to treat seizures. He comes to see you and you note that while his carbamazepine levels had been in the therapeutic range, they are now low. The possible cause for the low carbamazepine levels include: - Correct Answer Carbamazepine auto-induces metabolism, leading to lower levels in spite of good compliance
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