Chapter 51 Drug Therapy for Migraines and Other Headaches

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Chapter 51  Drug Therapy for Migraines and Other Headaches

 

 

Complete chapter Questions And Answers
 

Sample Questions

 

 

1. A patient has been diagnosed with migraines after experiencing headaches of increasing severity. When providing health education to this patient about her new diagnosis, what should the nurse convey?

  1. A)  The etiology of migraines is thought to have a genetic component.
  2. B)  Migraines are typically the result of prolonged psychosocial stress.
  3. C)  Migraines can be a precursor to transient ischemic attacks (TIAs) or stroke.
  4. D)  The pathophysiology of migraine headaches involves a disruption in the limbic

    system.

Ans: A

Feedback:

Migraines demonstrate a familial pattern, and authorities believe that they are inherited as autosomal dominant traits with incomplete penetrance. Stress may precipitate a migraine, but this is not an aspect of the etiology. They are not a precursor to TIAs or stroke, and they do not involve disruption of the limbic system.

2. A middle-aged patient describes her headaches as “utterly debilitating” and tells the nurse, “It’s hard to explain, but I just know when one is coming, and I’m never wrong.” This patient’s statement suggests that she has what diagnosis?

  1. A)  Migraines
  2. B)  Cluster headaches
  3. C)  Tension headaches
  4. D)  Ischemic headaches

Ans: A

Feedback:

The severity of her headaches coupled with the fact that she experiences a prodrome suggests that she experiences migraines. This clinical presentation is not typical of cluster headaches or tension headaches. Ischemic headache is not a recognized subtype.

3. A young man has been diagnosed with migraines, and the nurse is teaching him about abortive therapy. The primary goal of this form of therapy will be to

  1. A)  permanently correct the patient’s brain physiology.
  2. B)  ensure that the patient experiences fewer migraine headaches.
  3. C)  relieve the symptoms of the patient’s migraines.
  4. D)  foster coping skills that will allow the patient to live with his migraines.

Ans: C
Feedback:
Abortive therapy is the administration of medications to treat the symptoms of migraine headache. These medications do not provide a permanent correction of pathophysiological neurological function, and they are not preventative. Coping skills are not provided through medications.

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4. A patient who lives with migraines has been prescribed naproxen. The nurse should recognize that this drug achieves a therapeutic effect through which of the following means?

  1. A)  Demyelinizing pain fibers in the CNS
  2. B)  Selectively antagonizing opioid receptors in the CNS
  3. C)  Inhibiting the synthesis of COX-1 and COX-2
  4. D)  Slowing the reuptake of serotonin and acetylcholine in brain synapses

Ans: C
Feedback:
Naproxen is a nonselective inhibitor of cyclooxygenase resulting in the inhibition of prostaglandin synthesis of COX-1 and COX-2. It does not involve serotonin, acetylcholine, or opioid receptors.

5. A nurse has administered a scheduled dose of naproxen to a hospital patient who has been taking the drug for several weeks. What assessment finding should cause the nurse to suspect that the patient is experiencing adverse effects of this drug treatment?

  1. A)  There is an increase in the patient’s neutrophils but no increase in temperature.
  2. B)  The patient’s stool tests positive for occult blood.
  3. C)  The patient complains of itchy, dry skin.
  4. D)  The patient has peripheral edema and there is a steady increase in the patient’s

    weight.

Ans: B

Feedback:

GI bleeding is a significant adverse effect of naproxen. This drug does not typically cause leukocytosis, dry skin, or fluid imbalances.

6. The nurse at a long-term care facility is assessing a new resident’s current medication regimen, and the resident states that she often takes an OTC remedy when she experiences a migraine. She has brought the bottle with her, and the nurse notes it to be Anacin Advanced Headache Formula. The nurse should document that the patient takes which drugs? Select all that apply.

  1. A)  Codeine
  2. B)  Acetaminophen
  3. C)  Aspirin
  4. D)  Caffeine
  5. E)  Naproxen

Ans: B, C, D
Feedback:
Anacin Advanced Headache Formula and other similar OTC formulations include acetaminophen, aspirin, and caffeine.

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