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:

Contact the healthcare provider: Given the client’s history of anaphylactic reaction to penicillin, there is a potential risk of cross-reactivity with cephalexin, a cephalosporin. Although the risk of cross-reactivity is relatively low, it is still significant enough to warrant caution. Studies indicate that 1-4% of people with a true penicillin allergy may also react to cephalosporins. Therefore, the nurse should contact the healthcare provider to discuss alternative antibiotics or additional precautions.

Choice B Reason:

Give with prescribed antihistamine: While antihistamines can help manage mild allergic reactions, they are not sufficient to prevent or treat anaphylaxis. Anaphylactic reactions require immediate medical intervention, including epinephrine administration. Therefore, relying solely on antihistamines is not an appropriate or safe action in this scenario.

Choice C Reason:

Administer the medication as prescribed: Administering cephalexin without consulting the healthcare provider could put the client at risk of a severe allergic reaction. Given the client’s history of anaphylaxis to penicillin, it is crucial to verify the safety of cephalexin with the healthcare provider before administration.

Choice D Reason:

Monitor the client for a rash or hives: While monitoring for allergic reactions is essential, it should not be the primary action in this case. The priority is to prevent a potential severe allergic reaction by consulting the healthcare provider before administering the medication. Monitoring alone does not address the underlying risk of cross-reactivity.

A. Give the next scheduled dose. B. Obtain another blood sample. C. Monitor for signs of bleeding. D. Notify the healthcare provider.

Correct Answer is D

Explanation

Choice A reason: Giving the next scheduled dose without further assessment is not advisable. An INR of 2.8 is within the therapeutic range for many conditions treated with warfarin, but it is important to ensure that the INR is stable and not trending higher, which could increase the risk of bleeding.

Choice B reason: Obtaining another blood sample might be necessary if there is suspicion of an error or if the INR is unexpectedly high or low. However, in this scenario, the INR is within the therapeutic range, so this action is not immediately necessary.

Choice C reason: Monitoring for signs of bleeding is always important for clients on warfarin, but it does not address the immediate need to communicate with the healthcare provider about the current INR level and any potential adjustments to the medication.

Choice D reason: Notifying the healthcare provider is the most appropriate action. The healthcare provider needs to be aware of the current INR level to make any necessary adjustments to the warfarin dosage and to provide further instructions on monitoring and follow-up.

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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 with a history of anaphylactic reaction to penicillin receives a prescription for cephalexin 500 mg PO twice daily. Which action should the nurse take?

Correct Answer is A

Explanation

The nurse is caring for a client with atrial fibrillation who receives a prescription for warfarin. The international normalized ratio (INR) is 2.8. Which action should the nurse take?

Correct Answer is D

Explanation

A client who has been taking nonsteroidal anti-inflammatory drugs (NSAIDs) is experiencing gastric pain and blood in his stool. The healthcare provider discontinues the NSAIDs and prescribes esomeprazole. Which information should the nurse include in this client’s teaching plan?

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 who has been experiencing headaches since using the herbal remedy feverfew. Which information is important to include for this client?

A client with chronic kidney disease (CKD) is receiving calcium acetate 667 mg PO. A decrease in which blood value indicates to the nurse that the medication is having the desired effect?

A client is receiving tamsulosin, an alpha-adrenergic blocking agent, for the management of urinary retention due to benign prostatic hyperplasia (BPH). Which instruction is most important for the nurse to provide?

When administering zolpidem to an older client, which computer documentation indicates that the desired outcome has been achieved?

Based on a client’s serum digoxin level, the client is diagnosed with digoxin toxicity. Which action should the nurse expect to implement?

An older client with heart failure (HF), coronary artery disease (CAD), and hypertension (HTN) is receiving these daily prescriptions: atenolol, furosemide, and enalapril. Which assessments should the nurse include in evaluating the effectiveness of the medications? (Select all that apply.)