Deck 30: Drugs for Headache

Question 1

A patient on the unit complains of cluster headaches. A new graduate nurse is asked to differentiate between a migraine headache and cluster headaches. The graduate nurse is correct to state that manifestations and/or risk factors for a patient with cluster headaches include what? (Select all that apply.)

A) Female gender
B) Male gender
C) Complaints of nausea and vomiting
D) Short duration (15 minutes to 2 hours)
E) Auras before the onset of headache pain
F) Throbbing, sometimes piercing pain

Answer 1

Male gender
Short duration (15 minutes to 2 hours)
Throbbing, sometimes piercing pain

Question 2

A young woman with migraine headaches who has recently begun taking sumatriptan [Imitrex] calls the nurse to report a sensation of chest and arm heaviness. The nurse questions the patient and determines that she feels pressure and not pain. What will the nurse do?

A) Ask the patient about 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 sumatriptan.
D) Tell the patient to stop taking the medication immediately.

Answer 2

Reassure the patient that this is a transient, reversible side effect of sumatriptan.

Question 3

A patient who has recurrent migraine headaches is prescribed sumatriptan [Imitrex]. Which aspect of this patient's history is of concern when taking this drug?

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

Answer 3

Coronary artery disease

Question 4

Supplemental oxygen has been shown to help reduce symptoms for which type of headache?

A) Cluster
B) Menstrual migraine
C) Migraine
D) Tension-type

Question 5

Which medications are used to treat menstrually associated migraine (MAM)? (Select all that apply.)

A) Amitriptyline [Elavil]
B) Estrogen
C) Ergotamine [Ergomar]
D) Frovatriptan [Frova]
E) Naproxyn

Question 6

A prescriber orders sumatriptan [Imitrex] for a patient for a migraine headache. Before administration of this drug,it would be most important for the nurse to assess whether the patient:

A) has a family history of migraines.
B) has taken acetaminophen in the past 3 hours.
C) has taken ergotamine in the past 24 hours.
D) is allergic to sulfa compounds.

Question 7

Which drugs are used to prevent migraine headaches? (Select all that apply.)

A) Divalproex [Depakote]
B) Amitriptyline [Elavil]
C) Timolol
D) Ergotamine [Ergomar]
E) Acebutolol

Question 8

A patient who has a history of asthma experiences three or four migraine headaches each month. The patient uses sumatriptan [Imitrex] as an abortive medication and has developed medication overuse headaches. The patient asks the nurse what can be done to prevent migraines. The nurse will suggest that the patient discuss which preventive medication with the provider?

A) Botulinum toxin
B) Meperidine [Demerol]
C) Timolol
D) Topiramate [Topamax]

Question 9

A woman with moderate migraine headaches asks a nurse why the provider has ordered metoclopramide [Reglan] as an adjunct to aspirin therapy,because she does not usually experience nausea and vomiting with her migraines. The nurse will tell her that the metoclopramide is used to:

A) help induce sleep.
B) improve absorption of the aspirin.
C) prevent gastric irritation caused by the aspirin.
D) prolong the effects of the aspirin.

Question 10

A patient who has migraine headaches is prescribed sumatriptan [Imitrex] 5 mg unit-dose nasal spray. The patient has administered two sprays at 1400,1600,and 1800 and calls to report little relief from headache pain. What will the nurse instruct the patient to do?

A) Administer 2 sprays at 2000 and call the provider if no relief.
B) Continue using 2 sprays every 2 hours as needed to relieve discomfort.
C) Contact the provider to ask about using an ergot alkaloid medication.
D) Use 3 sprays at the next dose to increase the dose.

Question 11

A patient who has migraine headaches has been using sumatriptan [Imitrex] with good results,but reports frequent migraine recurrence 24 hours later. Which medication will the nurse expect the provider to order for this patient?

A) Aspirin
B) Ergotamine [Ergomar]
C) Naratriptan [Amerge]
D) Zolmitriptan [Zomig]

Question 12

A patient who has occasional migraine headaches tells a nurse that the abortive medication works well,but she would like to do more to prevent the occurrence of these headaches. The nurse will suggest that the patient:

A) ask the provider about an adjunct medication, such as prochlorperazine.
B) discuss the use of prophylactic medications with the provider.
C) keep a headache diary to help determine possible triggers.
D) take the abortive medication regularly instead of PRN.

Question 13

A patient arrives in the emergency department complaining of numbness in the extremities. The nurse notes that the patient's hands and feet are cool and pale. When conducting a health history,the nurse learns that the patient has a history of migraine headaches. The nurse recognizes this patient's symptoms as:

A) ergotamine withdrawal.
B) ergotism.
C) severe migraine symptoms.
D) sumatriptan side effects.