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CE Tests

Ketamine for Migraine in the Emergency Department

Advanced Emergency Nursing Journal: April/June 2020 - Volume 42 - Issue 2 - p E4-E5
doi: 10.1097/TME.0000000000000301
  • Free

Test Instructions

Read the article. The test for this CE activity can only be taken online at http://www.nursingcenter.com/CE/AENJ. Tests can no longer be mailed or faxed.

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There is only one correct answer for each question. A passing score for this test is 14 correct answers. If you pass, you can print your certificate of earned contact hours and access the answer key. If you fail, you have the option of taking the test again at no additional cost.

For questions, contact Lippincott Professional Development: 1-800-787-8985.

  • Registration deadline is June 3, 2022.

Provider Accreditation

Lippincott Professional Development will award 1.5 contact hours for this continuing nursing education activity. This activity has been assigned 1.5 pharmacology credits.

Lippincott Professional Development is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 1.5 contact hours. LPD is also an approved provider of continuing nursing education by the District of Columbia, Georgia, and Florida CE Broker #50-1223.

The ANCC's accreditation status of Lippincott Professional Development refers only to its continuing nursing educational activities and does not imply Commission on Accreditation approval or endorsement of any commercial product.

Payment: The registration fee for this test is $17.95.

Disclosure Statement

The authors and planners have disclosed no potential conflicts of interest, financial or otherwise.

CE TEST QUESTIONS

General Purpose: To present historical and recent data surrounding ketamine as an abortive migraine agent for adult patients.

Learning Objectives/Outcomes: After completing this continuing education activity, you should be able to:

  1. Outline the actions of, indications for, administration of, adverse effects of, and recommendations for ketamine.
  2. Summarize the reported evidence about the use of ketamine to treat migraine symptoms.
  1. To produce anesthesia, ketamine primarily acts on which of the following receptors?
    1. nicotinic acetylcholine receptor (nAChR)
    2. N-methyl-d-aspartate (NMDA) receptor
    3. 5-hydroxytryptamine (5-HT3) receptor
  2. Sanacora et al. reported that ketamine has been investigated as a treatment option for
    1. fibromyalgia.
    2. mood disorders.
    3. peripheral neuropathy.
  3. In animal models, ketamine has been found to affect which of the following receptors?
    1. opioid
    2. glycine
    3. glutamate
  4. Compared with the racemic mixture of both s-ketamine and r-ketamine, s-ketamine alone for the treatment of pain is likely to require doses that are
    1. higher.
    2. similar.
    3. lower.
  5. At doses of less than 0.3 mg/kg, ketamine is generally
    1. well tolerated.
    2. dissociative.
    3. ineffective.
  6. A common adverse effect of ketamine is
    1. tinnitus.
    2. dizziness.
    3. diplopia.
  7. Of the following, a preferred route of administration of ketamine for treating pain is
    1. oral.
    2. inhalation.
    3. intravenous.
  8. Nicolodi and Sicuteri reported that, for 17 patients with chronic migraines refractory to their prevention regimens, the effect of the addition of ketamine, compared with placebo, was
    1. inferior.
    2. superior.
    3. similar.
  9. According to Krusz et al., nine outpatients treated with ketamine intramuscularly as three separate injections decreased pain severity from 8.65 to
    1. 2.71.
    2. 4.52.
    3. 6.13.
  10. In the outpatients who received ketamine intramuscularly, Krusz et al. observed transient
    1. drowsiness.
    2. confusion.
    3. dysphoria.
  11. Kaube et al. stated that, when 11 migraine patients were treated with intranasal delivery of 25 mg of ketamine, five reported reduction in
    1. stress levels.
    2. migraine pain.
    3. aura symptoms.
  12. Afridi et al. reported that, when 30 patients with migraine were randomized to receive either 25 mg of intranasal ketamine or 2 mg of intranasal midazolam, both ketamine and midazolam decreased migraine
    1. aura duration.
    2. aura severity.
    3. pain.
  13. Krusz et al. reported that treating patients with migraine with intravenous ketamine reduced severity per the visual analog scale from 6.61/10 to
    1. 2.2/10.
    2. 3.4/10.
    3. 4.6/10.
  14. In a study by Lauritsen et al., how many of the six patients who received a continuous ketamine infusion to reduce migraine pain scores of 9/10 to 10/10 met the goal of having scores of 3/10 or less?
    1. two
    2. four
    3. six
  15. According to Pomeroy et al., how many of the 77 patients who received a continuous ketamine infusion to reduce migraine pain had at least a 2-point decrease in visual analog scale scores?
    1. 66%
    2. 71%
    3. 90%
  16. About half of the patients in the study by Pomeroy et al. also received
    1. neuroleptics.
    2. dihydroergotamine.
    3. nonsteroidal anti-inflammatory drugs.
  17. When Zitek et al. conducted a study to compare ketamine and ondansetron versus prochlorperazine and diphenhydramine, all via intravenous push, to relieve migraine pain in 54 patients, the prochlorperazine and diphenhydramine arm improved pain scores
    1. less.
    2. more.
    3. similarly.
  18. When Etchison et al. compared ketamine by intravenous push with placebo in 34 patients with migraine, at 30 min there was
    1. better pain relief with ketamine.
    2. better pain relief with placebo.
    3. no difference in pain relief.
  19. According Chen et al., long-term recreational use of ketamine in China carries a risk of dependence of
    1. 53%
    2. 71%.
    3. 92%.
  20. The authors recommendation is that ketamine, for treating acute migraine pain, should
    1. not be considered for routine use.
    2. be considered a routine option for adults but not for children.
    3. be considered a routine option only for those with no history of substance abuse.
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