Deck 6: Drugs for Pain

Question 1

The provider has prescribed a vasoconstrictor to be given in combination with a local anesthetic. What is the expected goal for this action? (Select all that apply.)

A) Enhanced absorption of the anesthetic
B) A reduction of the risk of anesthetic toxicity
C) The prevention of bradycardia
D) A shortened duration of action
E) A prolonging of the anesthesic effect

Answer 1

A reduction of the risk of anesthetic toxicity
A prolonging of the anesthesic effect

Question 2

Within a few minutes of administration a local anesthetic, the patient has a pulse of 54 beats/minute, respirations of 18 breaths/minute, and a blood pressure of 90/42 mm Hg. The provider should monitor the patient for further signs of what condition?

A) Heart block
B) Anaphylaxis
C) Central nervous system excitation
D) Respiratory depression

Answer 2

Heart block

Question 3

A patient with a history of asthma experiences three or four migraine headaches each month, uses sumatriptan as an abortive medication but has developed medication-overuse headaches. When asked what can be done to prevent migraines, the provider suggests prescribing which medication?

A) Botulinum toxin
B) Meperidine
C) Timolol
D) Topiramate

Answer 3

Topiramate

Question 4

A provider has prescribed the topical anesthetic lidocaine for a patient who has a second-degree burn on one arm. Which statement by the patient indicates understanding of the teaching regarding this treatment?

A) "I will apply a thin layer of the medication to only the burned area."
B) "I will cover the burn with a dressing after applying the medication."
C) "Applying an occlusive dressing is needed to increase absorption to relieve pain."
D) "I need to limit use of the medication to areas where the blisters have ruptured."

Question 5

A patient reports numbness in the extremities. The assessment history notes that the patient's hands and feet are cool and pale and that the patient has a history of migraine headaches. The provider focuses on further assessing for what likely cause of the symptoms?

A) Ergotamine withdrawal
B) Ergotism
C) Severe migraine symptoms
D) Sumatriptan side effects

Question 6

A patient has been taking oxycodone to manage severe, chronic pain for the last 6 months but now reports that it is no longer effective. The provider will discuss prescribing which medication for the patient?

A) Fentanyl transdermal patch
B) Hydrocodone PO
C) Meperidine PO
D) Pentazocine PO

Question 7

A patient has been taking methadone for 5 months to overcome an opioid addiction. The provider will monitor the patient for which electrocardiographic change?

A) Prolonged QT interval
B) Prolonged P-R interval
C) Bundle branch block
D) Elevated ST segment

Question 8

A patient who has migraine headaches has been using sumatriptan with good initial results but now reports frequent migraine recurrence 24 hours later. Which medication will the provider order for this patient?

A) Aspirin
B) Ergotamine
C) Naratriptan
D) Zolmitriptan

Question 9

A provider considers prescribing sumatriptan for a patient experiencing a migraine headache. Before prescribing this drug, what is the most important information to obtain?

A) Is there a family history of migraines?
B) Has acetaminophen been taken in the past 3 hours?
C) Has the patient taken ergotamine in the past 24 hours?
D) Is the patient allergic to sulfa compounds?

Question 10

Which medications would a provider prescribe to treat menstrually associated migraine? (Select all that apply.)

A) Amitriptyline
B) Estrogen
C) Ergotamine
D) Frovatriptan
E) Naproxen

Question 11

The provider used lidocaine with epinephrine as a local anesthetic when suturing a laceration on a patient's hand. Following the procedure, which patient symptom causes the most concern?

A) Difficulty moving the fingers of the affected hand
B) Inability to feel pressure at the suture site
C) Nervousness and tachycardia
D) Sensation of pain returning to the wound

Question 12

A young female adult who has recently begun taking sumatriptan reports a sensation of chest pressure, without pain, and arm heaviness. What action will the provider take?

A) Focus on identifying any history of hypertension or coronary artery disease.
B) Determine whether the patient might be pregnant.
C) Reassure the patient that this is a transient, reversible side effect of the medication.
D) Discontinue the sumatriptan.

Question 13

A patient receives an epidural anesthetic during labor and delivery. What effect in the newborn in the immediate postpartum period must the provider be prepared to address?

A) Bradycardia
B) Hypoglycemia
C) Jitteriness
D) Tachypnea

Question 14

A patient who has recurrent migraine headaches is prescribed sumatriptan. Which condition in this patient's history is of concern to the prescriber?

A) Asthma
B) Coronary artery disease
C) Diabetes
D) Renal disease

Question 15

A patient who has infrequent migraine headaches wants to prevent them from occurring. What intervention will the provider take?

A) Prescribe prochlorperazine.
B) Prescribe amitriptyline.
C) Ask the patient to keep a headache diary to help determine possible triggers.
D) Schedule the abortive medication to be taken regularly instead of PRN.