The nurse practitioner is reviewing the chart of a patient who is scheduled to receive their first dose of sumatriptan (Imitrex) in the clinic today. Past medical history is positive for only migraines. Which of the following requires further evaluation before the medication is administered?

Correct Answer: B

Rationale: The correct answer is B: Current blood pressure 142/90 mmHg. Before administering sumatriptan, the nurse practitioner should further evaluate the patient's elevated blood pressure to ensure it is not contraindicated for the medication. Sumatriptan can potentially increase blood pressure, so it is crucial to monitor and address any hypertension before giving the medication. Choice A: Recent naproxen use is not a direct contraindication for sumatriptan. Both medications are commonly used together for migraine treatment. Choice C: A resting pulse rate of 61 bpm is within the normal range and does not require further evaluation before administering sumatriptan. Choice D: Adverse reaction to ubrogepant is not relevant for evaluating the safety of sumatriptan. Each medication has its own set of potential side effects and interactions.

Correct Answer: C

Rationale: The correct answer is C: partially successful. This is because the patient is showing improvement in symptoms and functioning, indicating some progress in treatment effectiveness. It is not considered unsuccessful (A) as there is improvement noted. It is not minimally successful (B) as the patient is experiencing noticeable improvement in pain and activity levels. It is also not totally achieved (D) as the patient still has some pain despite improvement in functioning. Overall, option C best reflects the patient's progress at this stage of treatment.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) It's OK to take over-the-counter medications. The reason this statement requires intervention is that some over-the-counter medications can interact with antiepileptic drugs, potentially reducing their effectiveness or causing harmful side effects. Patients with epilepsy should always consult their healthcare provider before taking any new medications to ensure they are safe and appropriate. Option A) You should avoid consumption of all forms of alcohol is correct because alcohol can lower the seizure threshold and may interfere with the efficacy of antiepileptic medications. It is essential for patients with epilepsy to avoid alcohol consumption. Option B) Wear your medical alert bracelet at all times is also correct as it can inform others about the patient's condition in case of an emergency, ensuring appropriate care is provided. Option C) Protect your loved one's airway during a seizure is important as it helps prevent aspiration and ensures the safety of the individual having a seizure by keeping their airway clear. In an educational context, it is crucial for nursing students to understand the importance of providing accurate and comprehensive information to patients and their families regarding epilepsy management. Patients need to be educated on lifestyle modifications, medication management, and safety measures to effectively manage their condition and prevent complications. By addressing misconceptions and providing evidence-based information, healthcare providers can empower patients to take control of their health and well-being.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) The student instructs the patient to sit up straight, resulting in the patient's puzzled expression. This action requires intervention because patients with right hemisphere strokes often have spatial awareness deficits, making it challenging for them to understand and follow spatial instructions correctly. Asking the patient to sit up straight may be confusing and frustrating for them due to difficulties in processing spatial information. Option B is incorrect because moving the patient's tray to the right side aligns with the principle of compensating for the patient's right-sided neglect, a common deficit in right hemisphere strokes. Option C is also acceptable as assisting the patient with passive range-of-motion exercises is a beneficial nursing intervention for stroke patients. Option D, combing the left side of the patient's hair, is not necessarily wrong but may not be the most optimal action since focusing on the neglected side (right side in this case) is crucial for rehabilitation. Educationally, understanding the specific deficits associated with right hemisphere strokes and how they manifest in patient care is vital for nursing students. This rationale highlights the importance of tailored care approaches based on the patient's neurological condition to promote effective communication and rehabilitation.

Correct Answer: B

Rationale: In the context of caring for a patient in status epilepticus, the foremost observation to make is the patency of the airway, making option B the correct answer. Ensuring a clear airway is vital as it allows for proper oxygenation and ventilation, which are crucial during a seizure to prevent hypoxia and subsequent brain damage. Hydration (option A) is important in overall patient care but is not the primary concern during an active seizure. Temperature elevation (option C) may occur during a seizure but is not the first priority when managing status epilepticus. Response to environmental stimuli (option D) is also important but is secondary to ensuring proper airway management during an acute seizure event. Educationally, understanding the priority actions in managing status epilepticus is crucial for healthcare providers, especially those working in emergency or critical care settings. This question highlights the immediate action required to ensure patient safety and prevent complications during a seizure emergency. Healthcare professionals must be adept at prioritizing care interventions to provide optimal outcomes for patients experiencing neurological emergencies.