Before administering the initial dose of sumatriptan succinate to a client with a migraine headache, it is most important to determine if the client’s history includes which problem?

Irritable bowel syndrome.

Coronary artery disease.

Seasonal allergic rhinitis.

Type 2 diabetes mellitus.

Answer and Explanation

The Correct Answer is B

Choice A reason:

Irritable bowel syndrome (IBS) is not a primary concern when administering sumatriptan succinate. While IBS can cause significant discomfort and affect the quality of life, it does not pose a direct contraindication to the use of sumatriptan. Sumatriptan is primarily metabolized in the liver and excreted by the kidneys, and its use is not significantly impacted by gastrointestinal conditions like IBS1.

Choice B reason:

Coronary artery disease (CAD) is a critical consideration before administering sumatriptan succinate. Sumatriptan is a selective serotonin receptor agonist that causes vasoconstriction of cranial blood vessels to relieve migraine symptoms. However, it can also cause vasoconstriction in coronary arteries, which can be dangerous for clients with CAD. This can lead to serious cardiovascular events such as myocardial infarction or angina. Therefore, it is essential to assess for any history of CAD or other significant cardiovascular conditions before administering this medication.

Choice C reason:

Seasonal allergic rhinitis is not a significant concern when administering sumatriptan succinate. While allergic rhinitis can cause symptoms such as nasal congestion, sneezing, and itching, it does not interact with the pharmacological action of sumatriptan. Therefore, it is not a contraindication for the use of this medication.

Choice D reason:

Type 2 diabetes mellitus is not a primary concern when administering sumatriptan succinate. Although diabetes can increase the risk of cardiovascular disease, the presence of diabetes alone does not contraindicate the use of sumatriptan. However, it is important to consider the overall cardiovascular risk profile of the client, including any complications related to diabetes.

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Correct Answer is A

Explanation

Choice A reason:

Decreased night vision is a significant concern for clients receiving miotics for open-angle glaucoma. Miotics, such as pilocarpine, work by constricting the pupil (miosis), which can reduce the amount of light entering the eye. This effect is particularly problematic in low-light conditions, leading to decreased night vision and increasing the risk of injury due to poor visibility

Choice B reason:

Increased sensitivity to light, also known as photophobia, can occur with the use of miotics, but it is not the primary concern related to the risk of injury. While photophobia can cause discomfort and avoidance of bright environments, it does not directly contribute to the risk of injury as significantly as decreased night vision.

Choice C reason:

Increased frequency of lacrimation (tearing) can be a side effect of miotics, but it is not a major factor in the risk of injury. Excessive tearing can cause discomfort and blurred vision temporarily, but it does not pose a significant risk for injury compared to decreased night vision.

Choice D reason:

Diminished color perception is not a common side effect of miotics. Miotics primarily affect the pupil size and accommodation, rather than color vision. Therefore, this choice is not relevant to the risk of injury associated with the use of miotics.

A. Teach the client about foods high in calcium. B. Begin tapering the drug dose per protocol. C. Notify the healthcare provider of the finding. D. Administer the medication with a glass of milk.

Correct Answer is C

Explanation

Choice A reason:

Teaching the client about foods high in calcium is important, but it is not the most immediate action required. A serum calcium level of 5.5 mg/dL is significantly below the normal range (8.5-10.2 mg/dL) and indicates severe hypocalcemia. While dietary education is beneficial for long-term management, the nurse must first address the acute issue by notifying the healthcare provider.

Choice B reason:

Beginning to taper the drug dose per protocol is not appropriate without consulting the healthcare provider. Methylprednisolone, a corticosteroid, can cause decreased calcium absorption and increased calcium excretion. However, any changes to the medication regimen should be directed by the healthcare provider, especially in the context of severe hypocalcemia.

Choice C reason:

Notifying the healthcare provider of the finding is the most critical action. Severe hypocalcemia can lead to serious complications such as cardiac arrhythmias, muscle spasms, and seizures. Immediate medical intervention is necessary to correct the calcium imbalance and prevent potential life-threatening conditions.

Choice D reason:

Administering the medication with a glass of milk is not sufficient to address the severe hypocalcemia. While milk contains calcium, the amount is not enough to correct a serum calcium level as low as 5.5 mg/dL. The nurse must prioritize notifying the healthcare provider to ensure appropriate treatment is initiated.

Word count: 500 words.

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Before administering the initial dose of sumatriptan succinate to a client with a migraine headache, it is most important to determine if the client’s history includes which problem?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is receiving miotics for the treatment of open-angle glaucoma. The nurse determines that a priority nursing problem is the risk for injury. This nursing problem is based on which etiology?

Correct Answer is A

Explanation

Prior to administering an oral dose of methylprednisolone, the nurse determines the client’s serum total calcium level is 5.5 mg/dL (1.375 mmol/L). What action is most important for the nurse to take?

Correct Answer is C

Explanation

A female client who is starting a new prescription for doxycycline hyclate tells the nurse that she takes birth control pills. Which action should the nurse take?

A client with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in the client’s plan of care?

A client with chronic asthma receives a prescription for montelukast, a leukotriene modifier. Which statement by the client indicates to the nurse that medication teaching was effective?

A client who is receiving pregabalin for fibromyalgia complains of tremors in the hands. Which action should the nurse implement?

The nurse is administering sucralfate to a client with stomatitis secondary to chemotherapy. The client wants to take the medication after breakfast. How should the nurse respond?

Levothyroxine sodium is prescribed for a client with hypothyroidism. The nurse should instruct the client to report which symptom because it indicates that the client is taking too much levothyroxine sodium?

A client with multiple sclerosis starts a new prescription, baclofen, to control muscle spasticity. Three days later, the client calls the clinic nurse and reports feeling fatigued and dizzy. Which instruction should the nurse provide?