Chapter 44: Migraine Medications

Chapter 44: Migraine Medications

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A patient who has migraine headaches takes sumatriptan as abortive therapy. The patient tells the primary care nurse practitioner (NP) that the sumatriptan is effective for stopping symptoms but that the episodes are occurring three to four times per month. The NP should consider the addition of:

ANS:  B

Topiramate is an anticonvulsant agent that is approved as a preventive medication for migraines. The other medications are indicated for abortive therapy.

DIF:    Cognitive Level: Applying (Application)                           REF:   477

2. A patient comes to the clinic concerned about possible migraine headaches. The primary care NP conducts a history and physical examination, and the patient describes vise-like pressure in the back of the head that occurs almost daily during the work week. The NP should recommend:

ANS:  A

This patient is describing symptoms typical of tension headaches. The NP should recommend acetaminophen, not migraine medications.

DIF:    Cognitive Level: Applying (Application)                           REF:   478

3. A patient comes to the clinic and reports recurrent headaches. The patient has a headache diary, which reveals irritability and food cravings followed the next day by visual disturbances and unilateral right-sided headache, nausea, and photophobia lasting 2 to 3 days. The NP should recognize these symptoms as _____ migraine.

ANS:  A

These are symptoms of classic migraine. Hemiplegic migraine is characterized by motor and sensory symptoms. Basilar-type migraine includes vertigo, diplopia, dysarthria, tinnitus, and decreased hearing. Ophthalmoplegic migraine affects the third, fourth, or fifth cranial nerve, causing permanent damage.

DIF:    Cognitive Level: Applying (Application)                           REF:   478

4. A patient who has migraine headaches tells the primary care NP that drinking coffee and taking nonsteroidal antiinflammatory drugs (NSAIDs) seems to help with discomfort. The NP should tell the patient that:

ANS:  A

Overuse of pain or migraine medications can cause a transformed migraine, which is a long-lasting headache. Following a migraine episode, the patient has rebound headache daily or nearly daily. NSAIDs, caffeine, opiates, and triptans can cause these rebound headaches. NSAIDs and caffeine are often used to treat migraines. Narcotics and barbiturates increase the risk for development of chronic migraine headaches and should not be first-line drugs.

DIF:    Cognitive Level: Applying (Application)                           REF:   478