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The Journal for Nurse Practitioners Continuing Education Credit Application
The Journal for Nurse Practitioners Continuing Education Credit Application Title: Thunderclap Headache # Contact Hours: 1.0 CE Code: TJNP52011 Valid until 6-2013 Pharmacology Credit: 0.5 Circle the best answer for each question. Required minimum passing score is 70%. 1. Which of the following classic symptoms would suggest thunderclap headache? a. Headache pain that increases in intensity over 24 hours b. Recurrent headaches triggered by caffeine intake c. Abrupt onset of intense, severe, overwhelming head pain d. Headache, diplopia, and ataxia
5. Regarding cerebral perfusion: a. Hypotension is associated with rebleed b. Cerebral artery vasospasm contributes to cerebral ischemia c. Pain assessment is usually optimal to prevent increased intracranial pressure d. Anemia increases cerebral oxygenation and perfusion
2. Which contributes to misdiagnosis of aSAH after thunderclap headache? a. Initial Glascow Coma Scale Score of 14 b. Evidence of subarachnoid blood on non-contrastenhanced CT c. High outpatient index of suspicion d. Initially ordering contrast-enhanced CT
6. After craniotomy for aSAH, which symptom would be the highest priority for the nurse? a. Temperature of 39°C b. Hct of 35% c. Blood glucose of 140 mg/dL d. ECG peaked T waves
3. Which symptoms reflect pathophysiology of ruptured cerebral aneurysms? a. Increased aneurysm wall pressure as a result of hypertension b. Limited aneurysm blood flow to the subdural space c. Minimal meningeal irritation and cranial nerve palsies d. Parasympathetic compensatory mechanism of hypotension that decreases cerebral blood flow 4. The most common complication after aSAH in hospitalized patients is: a. Fever b. Anemia c. Hyperglycemia d. Hypertension
7. Which medications are routinely administered to prevent cerebral vasospasm? a. Statins and heparin b. Corticosteroids and histamine receptor antagonists c. Phosphenytoin and Ativan d. Nimodipine and magnesium sulfate 8. Post-aneurysm clipping requires which of the following nursing assessments/interventions? a. Ensure femoral pressure dressing remains intact for 3 days b. Ensure craniotomy staples are clean, dry, and intact c. Encourage patient to shampoo as soon as discharged d. Evaluate pedal pulses every shift
EVALUATION OF THE CE ACTIVITY Purpose and Target Audience: This CE learning activity is designed to augment the knowledge, skills, and attitudes of nurse practitioners and assist in their understanding of aneurysmal subarachnoid hemorrhage. 1. Listed below are the educational activity objectives. Please rate the extent to which you are now able to meet each of the objectives or your level of agreement with the statements (with 1 as the lowest or “no”; 5 as the highest or “yes” ranking): a. Correlate presentation and physiology of aneurysmal subarachnoid hemorrhage b. Discuss most likely medical complications and nursing actions after aSAH c. Compare noninvasive vs invasive surgical and neuroradiologic interventions
2. 3. 4. 5. 6. 7. 8. 9.
The teaching method was appropriate and effective for the content presented The information presented was accurate, current, and at an appropriate level This activity met my personal professional expectations This content was relevant to my practice as an NP This content will cause me to change my practice as an NP I believe I will face barriers in my practice to implementing this information Overall I would rate this activity Minutes required to read this article and complete these questions__________________
www.npjournal.org
Low 1 2 1 2 1 2
3 3 3
4 4 4
Low 1 1 1 1 1 1 1
3 3 3 3 3 3 3
4 4 4 4 4 4 4
2 2 2 2 2 2 2
High 5 5 5
High 5 5 5 5 5 5 5
The Journal for Nurse Practitioners - JNP
367
To receive CE credits, read the article, answer each question, and mail the test answers and evaluation along with your processing fee check for $10 made out to Elsevier, PO Box 540, Ellicott City, MD 21041-0540. CE is provided without charge to premier subscribers registered at www.npjournal.org and to ACNP members at ACNPWeb.net who take the activity online.
Please Print Clearly
Name: _________________________________________________Date activity completed:______________ Address for mailing certificate: ______________________________________________________________ Phone number: __________________________________ E-mail: ____________________________________ This educational activity is provided by Nurse Practitioner Alternatives™. Nurse Practitioner Alternatives™ is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation Accreditation of this activity does not imply endorsement by the provider, ANCC, or Elsevier of any commercial products mentioned in conjunction with this activity. For questions, contact [email protected].
COMMENTS:
COMING SOON IN JNP Initial Office Evaluation of Hair Loss in Adult Women (CE) Atrophic Vaginitis: A Common Problem Often Not Treated Menstrual Migraine: Current Strategies for Diagnosis and Management Ambiguity in Defining Adolescent Sexual Activity: A Case Study for Nurse Practitioners Primary Hyperparathyroidism: A Symptomatically Mild Disease With Serious Complications Medical Management of Type 2 Diabetes Warfarin Drug Interactions: Strategies to Minimize Adverse Drug Events
368
The Journal for Nurse Practitioners - JNP
Volume 7, Issue 5, May 2011
5. Regarding cerebral perfusion: a. Hypotension is associated with rebleed b. Cerebral artery vasospasm contributes to cerebral ischemia c. Pain assessment is usually optimal to prevent increased intracranial pressure d. Anemia increases cerebral oxygenation and perfusion
2. Which contributes to misdiagnosis of aSAH after thunderclap headache? a. Initial Glascow Coma Scale Score of 14 b. Evidence of subarachnoid blood on non-contrastenhanced CT c. High outpatient index of suspicion d. Initially ordering contrast-enhanced CT
6. After craniotomy for aSAH, which symptom would be the highest priority for the nurse? a. Temperature of 39°C b. Hct of 35% c. Blood glucose of 140 mg/dL d. ECG peaked T waves
3. Which symptoms reflect pathophysiology of ruptured cerebral aneurysms? a. Increased aneurysm wall pressure as a result of hypertension b. Limited aneurysm blood flow to the subdural space c. Minimal meningeal irritation and cranial nerve palsies d. Parasympathetic compensatory mechanism of hypotension that decreases cerebral blood flow 4. The most common complication after aSAH in hospitalized patients is: a. Fever b. Anemia c. Hyperglycemia d. Hypertension
7. Which medications are routinely administered to prevent cerebral vasospasm? a. Statins and heparin b. Corticosteroids and histamine receptor antagonists c. Phosphenytoin and Ativan d. Nimodipine and magnesium sulfate 8. Post-aneurysm clipping requires which of the following nursing assessments/interventions? a. Ensure femoral pressure dressing remains intact for 3 days b. Ensure craniotomy staples are clean, dry, and intact c. Encourage patient to shampoo as soon as discharged d. Evaluate pedal pulses every shift
EVALUATION OF THE CE ACTIVITY Purpose and Target Audience: This CE learning activity is designed to augment the knowledge, skills, and attitudes of nurse practitioners and assist in their understanding of aneurysmal subarachnoid hemorrhage. 1. Listed below are the educational activity objectives. Please rate the extent to which you are now able to meet each of the objectives or your level of agreement with the statements (with 1 as the lowest or “no”; 5 as the highest or “yes” ranking): a. Correlate presentation and physiology of aneurysmal subarachnoid hemorrhage b. Discuss most likely medical complications and nursing actions after aSAH c. Compare noninvasive vs invasive surgical and neuroradiologic interventions
2. 3. 4. 5. 6. 7. 8. 9.
The teaching method was appropriate and effective for the content presented The information presented was accurate, current, and at an appropriate level This activity met my personal professional expectations This content was relevant to my practice as an NP This content will cause me to change my practice as an NP I believe I will face barriers in my practice to implementing this information Overall I would rate this activity Minutes required to read this article and complete these questions__________________
www.npjournal.org
Low 1 2 1 2 1 2
3 3 3
4 4 4
Low 1 1 1 1 1 1 1
3 3 3 3 3 3 3
4 4 4 4 4 4 4
2 2 2 2 2 2 2
High 5 5 5
High 5 5 5 5 5 5 5
The Journal for Nurse Practitioners - JNP
367
To receive CE credits, read the article, answer each question, and mail the test answers and evaluation along with your processing fee check for $10 made out to Elsevier, PO Box 540, Ellicott City, MD 21041-0540. CE is provided without charge to premier subscribers registered at www.npjournal.org and to ACNP members at ACNPWeb.net who take the activity online.
Please Print Clearly
Name: _________________________________________________Date activity completed:______________ Address for mailing certificate: ______________________________________________________________ Phone number: __________________________________ E-mail: ____________________________________ This educational activity is provided by Nurse Practitioner Alternatives™. Nurse Practitioner Alternatives™ is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation Accreditation of this activity does not imply endorsement by the provider, ANCC, or Elsevier of any commercial products mentioned in conjunction with this activity. For questions, contact [email protected].
COMMENTS:
COMING SOON IN JNP Initial Office Evaluation of Hair Loss in Adult Women (CE) Atrophic Vaginitis: A Common Problem Often Not Treated Menstrual Migraine: Current Strategies for Diagnosis and Management Ambiguity in Defining Adolescent Sexual Activity: A Case Study for Nurse Practitioners Primary Hyperparathyroidism: A Symptomatically Mild Disease With Serious Complications Medical Management of Type 2 Diabetes Warfarin Drug Interactions: Strategies to Minimize Adverse Drug Events
368
The Journal for Nurse Practitioners - JNP
Volume 7, Issue 5, May 2011