Review Practice Exercise 2

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Practice Exercise 2

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Total Questions : 5

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Question 1:

A client with chronic tension-type headaches asks about non-pharmacological treatment options. Which of the following therapies would a nurse recommend? Select all that apply

A. Acupuncture B. Relaxation training C. Biofeedback D. Feverfew supplements E. Botox injections

Answer and Explanation

Choice A:

Acupuncture: Stimulates specific points in the body to help reduce headache frequency and intensity; may benefit some clients with tension-type headaches.

Choice B:

Relaxation training: Techniques like progressive muscle relaxation and deep breathing reduce stress and muscle tension, helping prevent headache onset.

Choice C:

Biofeedback: Teaches clients to monitor and control muscle tension and other physiological processes to reduce headache occurrence.

Choice D:

Feverfew supplements: Primarily used for migraine prevention; limited evidence supports its use for tension-type headaches.

Choice E:

Botox injections: Approved for chronic migraine prevention, not indicated for tension-type headaches.

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Question 2:

A nurse is providing education to a client with a new prescription for sumatriptan (Imitrex) for migraine headaches. Which of the following statements should the nurse include in the teaching?

A. "You should take this medication daily to prevent headaches from occurring." B. "This medication should be taken at the first sign of a migraine headache." C. "This medication can be safely used with St. John's Wort to enhance its effects." D. "You may crush or chew the tablet for faster absorption if the headache is severe."

Answer and Explanation

Choice A:

"You should take this medication daily to prevent headaches from occurring.": Daily use is not recommended; it increases the risk of rebound headaches.

Choice B:

"This medication should be taken at the first sign of a migraine headache.": Early administration increases its ability to stop the migraine before it becomes severe.

Choice C:

"This medication can be safely used with St. John's Wort to enhance its effects.": This combination increases the risk of serotonin syndrome, which can be life-threatening.

Choice D:

"You may crush or chew the tablet for faster absorption if the headache is severe.": Crushing or chewing may alter absorption and effectiveness; the tablet should be swallowed whole.

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Question 3:

A client with a history of cluster headaches is prescribed high-flow oxygen therapy. The nurse should provide which of the following instructions regarding this treatment?

A. "The oxygen should be delivered at a low flow rate of 2 L/min." B. "You should use a nasal cannula for delivery of the oxygen." C. "You should use a non-rebreather mask and sit upright during a headache attack." D. "Treatment should continue for at least 60 minutes, even if symptoms subside."

Answer and Explanation

Choice A:

"The oxygen should be delivered at a low flow rate of 2 L/min.": This is insufficient for cluster headache relief; high flow is required.

Choice B:

"You should use a nasal cannula for delivery of the oxygen.": A nasal cannula cannot deliver the necessary high concentration of oxygen.

Choice C:

"You should use a non-rebreather mask and sit upright during a headache attack.": This ensures high oxygen concentration delivery and optimal breathing mechanics to relieve pain quickly.

Choice D:

"Treatment should continue for at least 60 minutes, even if symptoms subside.": Extended therapy is unnecessary and may cause oxygen toxicity; therapy usually lasts 10–20 minutes.

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Question 4:

A nurse is teaching a client about preventative medications for frequent migraine headaches. Which of the following drug classes are commonly used for prophylaxis? Select all that apply

A. Beta-adrenergic blockers B. Antidepressants C. Nonsteroidal anti-inflammatory drugs (NSAIDs) D. Calcium channel blockers E. Triptans F. Opioids

Answer and Explanation

Choice A:

Beta-adrenergic blockers: Effective in migraine prophylaxis by reducing vascular reactivity and stabilizing sympathetic tone.

Choice B:

Antidepressants: Tricyclic antidepressants like amitriptyline can reduce migraine frequency, especially when tension-type headaches or depression coexist.

Choice C:

NSAIDs: Primarily used for acute migraine relief, not long-term prevention.

Choice D:

Calcium channel blockers: Reduce migraine frequency by preventing abnormal vascular constriction and stabilizing neuronal excitability.

Choice E:

Triptans: Designed for acute migraine attacks; not used for daily prophylaxis due to cardiovascular risks.

Choice F:

Opioids: Not recommended for migraines due to dependency risks and lack of preventive efficacy.

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Question 5:

A client arrives at the emergency department with a severe, debilitating migraine headache. The nurse anticipates administering which of the following medications for an acute migraine attack?

A. Divalproex sodium (Depakote) B. Topiramate (Topamax) C. Propranolol (Inderal) D. Metoclopramide (Reglan)

Answer and Explanation

Choice A:

Divalproex sodium (Depakote): Used for migraine prophylaxis, not acute attacks.

Choice B:

Topiramate (Topamax): An anticonvulsant used for migraine prevention, not for immediate symptom relief.

Choice C:

Propranolol (Inderal): A beta-blocker for migraine prophylaxis, not acute treatment.

Choice D:

Metoclopramide (Reglan): Effective for acute migraine management, especially when nausea or vomiting limits oral medication absorption. Often given IV along with other acute migraine treatments such as NSAIDs or triptans.

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Practice Exercise 2

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