Chapter 58, Nursing Management: Chronic Neurologic Problems: HA

The nurse finds that a patient has a tension-type headache. Which statement made by the patient supports the nurse's finding? "My eyes hurt during the headache." "My nose gets blocked during the headache." "I feel some pressure on my neck during the headache." "I can see bright lights before the onset of the headache."

"I feel some pressure on my neck during the headache."

The registered nurse is teaching the patient with chronic migraines about botulinum toxin A therapy. Which statement of the patient indicates effective learning? "I should gargle with salt water in case of throat pain." "I should avoid drinking water after taking the injection." "I should use the inhaler in case I have trouble breathing." "I should reach the health care center in case I have difficulty swallowing."

"I should reach the health care center in case I have difficulty swallowing."

The primary health care provider diagnoses that a patient has a cluster headache. Which statements made by the patient support the health care provider's diagnosis? Select all that apply. "My cheeks also ache during the headache." "My skin appears pale during the headache." "I feel like my limbs are moving during the headache." "I don't feel like sitting in one place during the headache." "I have a strong desire to eat ice cream and chocolates during the headache."

"My cheeks also ache during the headache." "My skin appears pale during the headache." "I don't feel like sitting in one place during the headache."

The primary health care provider diagnoses that a patient has a cluster headache. Which statements made by the patient support the health care provider's diagnosis? Select all that apply. "My cheeks also ache during the headache." "My skin appears pale during the headache." "I feel like my limbs are moving during the headache." "I don't feel like sitting in one place during the headache." "I have a strong desire to eat ice cream and chocolates during the headache."

"My cheeks also ache during the headache." "My skin appears pale during the headache." "I don't feel like sitting in one place during the headache."

Which suggestions given by the nurse to a patient with frequent headaches will be beneficial in determining the type of headache? Select all that apply. "Note the time of the onset of the headache." "Note where you are when you have a headache." "Remember the dates when you experience a headache." "Jot down the dates in a diary when you experience headache." "List the foods that you have consumed before the onset of headache."

"Note the time of the onset of the headache." "Jot down the dates in a diary when you experience headache." "List the foods that you have consumed before the onset of headache."

Which complaint made by the patient indicates that the individual may be suffering from a cluster headache? "The pain is constant." "The pain is followed by nausea." "The pain disturbs my sleep at night." "The pain lasts for longer than eight hours."

"The pain disturbs my sleep at night."

Which statement regarding cluster headaches is true? "The pain is unilateral." "The pain lasts for 4 to 72 hours." "The pain is associated with nausea." "The pain may switch to the anterior side."

"The pain is unilateral."

A patient complains of a throbbing headache. When the history is obtained, the nurse discovers that the patient has had this type of headache before and experienced photophobia before the headache occurred. The nurse should know that what is probably the cause of this patient's headache? Polycythemia vera A cluster headache A migraine headache A hemorrhagic stroke

A migraine headache

A patient complains of a severe headache with increased intensity upon exposure to sounds. These headaches are accompanied by neck stiffness. Which medication does the nurse anticipate to be beneficial for the patient? Acetaminophen Dexamethasone Dihydroergotamine Ergotamine tartarate

Acetaminophen

A patient complains of a severe headache with increased intensity upon exposure to sounds. These headaches are accompanied by neck stiffness. Which medication does the nurse anticipate to be beneficial for the patient? Acetaminophen Dexamethasone Dihydroergotamine Ergotamine tartarate

Acetaminophen

A patient with a history of headaches asks the nurse what cluster headaches are. What response(s) by the nurse are most appropriate? Select all that apply. Alcohol is the only known dietary trigger for cluster headaches. At the onset of cluster headaches, imaging studies are always negative. Cluster headaches have a pulsing type of pain like migraine headaches. Cluster headaches occur regularly and frequently at the same time each day. Cluster headaches can occur for weeks to months at a time, followed by remission periods. Cluster headaches are quite common and occur in about 10 percent of the American population.

Alcohol is the only known dietary trigger for cluster headaches. Cluster headaches occur regularly and frequently at the same time each day. Cluster headaches can occur for weeks to months at a time, followed by remission periods.

Which drug can be initiated to treat rebound headaches? Butalbital Ibuprofen Sumatriptan Amitriptyline

Amitriptyline

The primary health care provider finds that a patient on migraine therapy has developed upper gastrointestinal bleeding. Which medication would have resulted in this condition? Aspirin Phenytoin Topiramate Acetaminophen

Aspirin

Which parameter should the nurse assess while examining a patient with a history of tension-type headaches? Auscultate lung sounds Auscultate heart sounds Auscultate bowel sounds Auscultate carotid artery sounds

Auscultate carotid artery sounds

A patient with a cluster headache is connected to equipment that monitors the skin temperature of the patient's fingers. What therapy is the patient undergoing? Psychotherapy Biofeedback therapy Muscle relaxation therapy Cognitive-behavioral therapy

Biofeedback therapy

How does oxygen inhalation relieve cluster headaches? By increasing glutamate release By increasing serotonin synthesis By decreasing dopamine secretion By decreasing acetylcholine secretion

By increasing serotonin synthesis

A patient experiencing a headache describes it as occurring "on the right side with pain around my right eye." The pain is further described as "sharp and penetrating." Based on this information, what type of headache does the nurse suspect the patient is experiencing? Cluster Tension Migraine Medication overuse

Cluster

A patient complains of swelling around the eye, pain in the gums, and nasal congestion after using a perfume. Which condition does the nurse anticipate in the patient? Cluster headache Multiple sclerosis Parkinson's disease Migraine headache

Cluster headache

The primary health care provider decides to initiate invasive nerve block therapy. Which underlying condition does the patient have? Cluster headache Multiple sclerosis Myasthenia gravis Restless leg syndrome

Cluster headache

Which manifestation is associated with a cluster headache? Hemiparesis Photophobia Conjunctivitis Nuchal rigidity

Conjunctivitis

A patient with a history of cluster headaches complains to the nurse that he or she does not have any pain relief even after taking analgesics. Which treatment will be beneficial for the patient? Lithium therapy Melatonin therapy Deep brain stimulation Vagal nerve stimulation

Deep brain stimulation

A patient with migraines is on topiramate therapy. During a follow-up visit, the nurse finds that the patient has seizures. What action is responsible for this condition? Consuming red wine Limiting the fluid intake Discontinuing topiramate abruptly Consuming citric acid containing fruits

Discontinuing topiramate abruptly

The nurse is teaching a patient about precautions to take while on topiramate therapy during the patient's discharge. The patient is subsequently readmitted with renal stones. What action of the patient is a possible cause for this condition? Eating yogurt in the afternoon Eating two boiled eggs every day Drinking six glasses of water every day Drinking a glass of lemon juice in every other day

Drinking six glasses of water every day

What test is used to diagnose a tension-type headache? Polysomnography Electromyography Computed tomography Magnetic resonance imaging

Electromyography

A patient with a history of angina is diagnosed with migraines. Which medications does the nurse anticipate to be excluded from the patient's prescription? Select all that apply. Aspirin Eletriptan Zolmitriptan Dexamethasone Dihydroergotamine

Eletriptan Zolmitriptan

Which interventions would the nurse include in the care plan of a patient with chronic tension headaches? Select all that apply. Giving the patient a cup of coffee in the evening Including foods rich in vitamin A in the patient's diet Encouraging the patient to perform yoga in the morning Massaging the patient's shoulders with warm coconut oil Encouraging the patient to practice deep breathing exercises

Encouraging the patient to perform yoga in the morning Massaging the patient's shoulders with warm coconut oil Encouraging the patient to practice deep breathing exercises

A patient with a history of cluster headaches reports fear of recurrence of attack during his flight next week. Which medication would the nurse expect the primary health care provider to prescribe? Fluoxetine Divalproex Ergotamine Amitriptyline

Ergotamine

A patient was prescribed sumatriptan as treatment for severe migraine headaches. The patient has an appointment six weeks later with the health care provider. Besides asking about the effectiveness of the medication for headache control, what other question is appropriate for the nurse to ask? Have you noticed any blood in your urine? Have you experienced any chest discomfort? Have you had any problems with constipation? Have you been monitoring your glucose levels?

Have you experienced any chest discomfort?

A patient with a history of severe migraines reports a throbbing headache. After further inquiry, the nurse finds that the patient experiences migraines after eating. Which foods may be causing the headache? Select all that apply. Biscuits Hot dog Ice cream Cucumber Orange juice

Hot dog Ice cream Orange juice

While caring for a patient on topiramate therapy, the nurse believes that the patient has developed drug-associated side effects. Which finding in the patient supports the nurse's diagnosis? Hirsutism Neck pain Hypoglycemia Gingival hyperplasia

Hypoglycemia

Which part of the brain is activated at the onset of a cluster headache? Thalamus Telencephalon Diencephalon Hypothalamus

Hypothalamus

A patient who is on migraine therapy complains to the nurse of a severe headache and vision problems. The nurse observes that the patient's body temperature is 101° F. What action should the nurse perform immediately? Administer rasagiline Administer ergotamine tartarate Inform the primary health care provider Turn off the lights in the patient's room

Inform the primary health care provider

What is a clinical manifestation of a cluster headache? Weakness Lacrimation Photophobia Food cravings

Lacrimation

On a follow-up visit, a patient with migraines reveals that she has had fewer headaches. Which actions of the patient would be responsible for this improvement? Select all that apply. Meditating in the evening Taking lithium in the morning Taking sumatriptan once a day Performing yoga in the morning Taking muscle relaxants before going to bed

Meditating in the evening Taking sumatriptan once a day Performing yoga in the morning

A patient experiences headaches during the evening. Upon examination, the nurse finds that the patient has cluster headaches. Which medication is beneficial to prevent further attacks? Fluoxetine Gabapentin Amitriptyline Methysergide

Methysergide

A patient complains of pain on one side of the head along with nausea, vomiting, and sensitivity to light. The primary health care provider prescribes corticosteroids. Which is the possible condition of the patient? Migraine Multiple sclerosis Cluster headache Parkinson's disease

Migraine

Which drug is used as a prophylactic agent in tension-type headache? Mirtazapine Zolmitriptan Dexamethasone Dihydroergotamine

Mirtazapine

Which factor may trigger cluster headaches? Stress Napping Head trauma Menstruation

Napping

The patient with a history of tension headaches complains of head pain. The nurse determines that the patient has normal vital signs and a normal brief neurologic assessment. Which next action by the nurse would be most appropriate? Call the stroke team. Obtain a neurologic consult. Obtain a detailed past medical history. Anticipate a prescription for a computed axial tomography (CAT; computed tomography [CT]) scan of the head.

Obtain a detailed past medical history.

Which rebound headache-causing medication needs dose tapering before withdrawal? Opioids Ibuprofen Butalbital Sumatriptan

Opioids

What is a clinical manifestation of migraine? Paralysis Neck pain Facial flushing Pupil constriction

Paralysis

The student nurse is documenting the prophylactic medications of four patients. Which patient's medication record needs correction? Patient A- Migraine headache- methysergide Patient B-Cluster headache- Verapimil Patient C- Tension headache- Gabapentin Patient D- Cluster- Prednisone

Patient C

While reviewing the medication charts of four patients, the nurse observes that a patient's prescription is incorrect. Which patient's medication chart supports the nurse's observation? Patient A- absence seizures- clonazepam Patient B-MS- Fingolimod Patient C- Migraine headache- Lamotrigine Patient D- Parkinsons disease- trihexyphenidyl

Patient C

The nurse is reviewing the diagnostic and medication reports of a group of patients. Which patient's prescription requires immediate correction? Patient A- Migraine headache- Naratriptan Patient B-Cluster headache- Zolmitriptan Patient C- Tension headache- Sumatriptin/ Naproxexn Patient D- Migraine- Acetominophen/caffeine/aspirin

Patient C- Tension headache- Sumatriptin/ Naproxexn

What is a clinical manifestation of a tension-type headache? Pallor Nausea Vomiting Phonophobia

Phonophobia

A patient with migraines asks the nurse about complementary therapies to use alongside her prescription medication. What suggestions should the nurse provide to the patient? Select all that apply. See a hypnotist to treat your migraines. Take ginseng to improve mental performance and treat pain. Practice yoga to possibly enhance the benefits of your prescription medication. Visit an acupuncturist to treat migraine pain, along with your usual prescription. Try Feverfew instead of your usual prescription medication to prevent migraine pain.

Practice yoga to possibly enhance the benefits of your prescription medication. Visit an acupuncturist to treat migraine pain, along with your usual prescription.

A patient with a migraine is advised to take sumatriptan. During data collection, the nurse finds that the patient recently had a stroke. What nursing intervention is appropriate for this patient? Continue taking sumatriptan Decrease the dosage of sumatriptan Increase the dosage of sumatriptan Replace sumatriptan with another drug

Replace sumatriptan with another drug

Which drug is used as a first line therapy for severe migraines? Propanolol Topiramate Sumatriptan Amitriptyline

Sumatriptan

A patient with a history of cluster headaches is planning to travel overseas by air. What advice should the nurse give to this patient to decrease the likelihood of such attacks during air travel? Do not travel by air. Avoid eating chocolate while in flight. Take ergotamine before the flight takes off. Massage the neck and apply moist hot packs while in flight.

Take ergotamine before the flight takes off.

When taking the history of a patient with a migraine headache, what features of a migraine headache is the patient likely to report? Select all that apply. The headache is usually unilateral. The headache is preceded by an aura. The headache is sharp and stabbing in nature. The headache lasts from a few minutes to three hours. The headache is usually triggered by certain foods, such as chocolate.

The headache is usually unilateral. The headache is preceded by an aura. The headache is usually triggered by certain foods, such as chocolate.

A nurse is interviewing a patient who is seeking relief for frequent headaches. Which description is consistent with symptoms of a migraine headache? The pain of the headache wakes the patient from sleep. Extreme tenseness in the area of the neck and shoulders. The pain throbs and is synchronous with the patient's pulse. Tears flow from one eye and nasal drainage occurs with the headache.

The pain throbs and is synchronous with the patient's pulse.

A patient asks the nurse what causes migraine headaches. What responses by the nurse are correct? Select all that apply. These headaches generally last from 4 to 72 hours. The pain is a continuous, throbbing, and pulsating pain. Neuroimaging studies are recommended for routine evaluation of headaches. Migraine headaches just happen and do not have any genetic or familial connection. Some risk factors of migraines include a low level of education and socioeconomic status.

These headaches generally last from 4 to 72 hours. The pain is a continuous, throbbing, and pulsating pain. Some risk factors of migraines include a low level of education and socioeconomic status.

Which drug prevents migraine attack if taken daily? Paroxetine Topiramate Ergotamine Mirtazapine

Topiramate

Which statement is true about triptans? Triptans are most effective if taken during aura. Triptans are used in patients with thromboembolism. Triptans are effective in preventing cluster headache. Triptans are effective in preventing tension-type headache.

Triptans are most effective if taken during aura.

A nurse is providing information to a group of nursing students, explaining the difference between a migraine headache and a tension-type headache. What should the nurse include as diagnostic criteria for a migraine headache? Unilateral pain Nonthrobbing pain Movement does not affect its severity Photophobia or phonophobia but not both

Unilateral pain

What part of the central nervous system is involved in migraine headaches? Cerebrum Spinal cord Cerebral cortex Medulla oblongata

cerebral cortex

Which condition requires immediate treatment with 100% oxygen? Cluster headache Multiple sclerosis Parkinson's disease Migraine headache

cluster headache

The nurse teaches a patient newly diagnosed with migraine headaches about dietary restrictions aimed at headache prevention. During follow-up visits, the patient reports a recurrence of migraine attacks. Which action by the patient is responsible for this condition? Eating corn Eating cheese Eating soybeans Eating cucumbers

eating cheese

What is an adverse effect of botox injection? Headache Knee pain Chest pain Stomach ache

headache

What drug would be beneficial to prevent a cluster headache? Lithium Eletriptan Gabapentin Amitriptyline

lithium