NURS 550 FINAL Questions and
100% Correct Answers | Grade A+
Migraine Headache:
Ans: one of the most common vascular types; Lasts 4-76 hours
o More frequently in women
o Onset: age 6 through adolescence
o Signs and symptoms: begins unilaterally but may become generalized and may lateralize to
the opposite side and/or radiate to the face of neck; pain ranges from dull ache to throbbing or
pulsatile pain , aggravated by movement, light and noise, incapacitating.
• Accompanying symptoms: nausea, vomiting, photophobia, phonophobia, osmophobia,
dizziness, chills, and/or ataxia.
• May be tenderness to palpation of the temporal arteries
• AURAS: may include blurred vision, and scotoma and/or other prodromal symptoms such
as anorexia, irritability, restlessness, or paresthesias lasting from 30 min to 3 hours before the
onset of the migraine
Cluster Headache:
Ans: one of the most severe and incapacitating forms of a headache, pain occurs
episodically, pain can be so intense as to precipitate suicidal thoughts or actions to find relief
,o More Common in men
o Rare in children
o Signs and symptoms: Complaint of headache that is episodic and unpredictable in nature
and may be cyclic. Occur more often in spring and autumn, Cluster periods lasts: 2-3 months
and may remit for months to years. Remissions are typically shorter than 2 years. Pain is
NOT preceded by aura. Have rapid crescendo patterns, peaking in approximately 10-15 min
and often lasting 30-60 minutes per episode (rarely last > 2 hours). Usually in area of
trigeminal nerve area and is described as unilateral, penetrating, sharp, excruciating, and
unrelenting in nature.
• Associated symptoms: unilateral lacrimation, nasal congestion or rhinorrhea, pallor,
flushing, conjunctival redness, ptosis - all on the same side of the pain. Some experience
bradycardia during episode.
Tension headache:
Ans: . (other terms: stress, essential, idiopathic, or muscle contraction headache).
o Occur with equal frequency between men and women
o Signs and symptoms: Mild to moderate, non-throbbing pressure or squeezing pain that
occur anywhere in the head or neck. The pain often starts slowly as a dull and aching
discomfort that progress to holocranial pain and pressure. Pain can last minutes to hours.
Remits usually with rest or removal of stressful trigger.
• Associated symptoms: NO nausea or vomiting is usually associated. Although some report
photophobia and phonophobia.
,o Neck muscles are often tight to palpation
• Subdural Hematoma
o Signs and symptoms: usually dull and aching in nature and may be transient. Pain will
gradually worsen over days to weeks. In elderly change in mentation may precede pain.
o History: usually includes an acute head injury
Subarachnoid Hemorrhage
Ans: : Head trauma is most common cause of SAH. However it can be spontaneous
stemming from a ruptured aneurysm, vascular malformation, uncontrolled hypertension, or
hemorrhagic disease.
o Higher risk: smokers
o Usually occur in adults ages 50 - 60 years old
o Signs and Symptoms: pain is described as "severe" "the worst headache of my life." Made
worse by lying down.
o Associated symptoms: nausea and vomiting and rapid deterioration in neurological function
Viral/Bacterial Meningitis:
Ans: inflammatory process of CNS
o Signs and Symptoms: Headache described as diffuse and throbbing and is often severe or
intense in nature.
, • Associated symptoms: Fever, photophobia, phonophobia, nausea, vomiting, and nuchal
rigidity
• Neuro exam: lethargic, febrile, altered mentation along with nuchal rigidity and/or guarding,
contracted and sluggish pupils and a general "toxic" appearance
• +Brudzinski's test: with patient lying on exam table, gently flex the patient's neck to a chin-
to-chest position. The test is positive if the patient attempts to lift legs and flex hips to relieve
pain by the maneuver
• +Kernig's test: when patient resting on exam table hold leg with hip and knee flexed.
Without moving the upper leg, slowly extend the knee, straightening the leg. The test is
positive if the maneuver results in pain, with the patient flexing the neck in an attempt to
relieve pain
+Brudzinski's test:
Ans: with patient lying on exam table, gently flex the patient's neck to a chin-to-chest
position. The test is positive if the patient attempts to lift legs and flex hips to relieve pain by
the maneuver
+Kernig's test:
Ans: when patient resting on exam table hold leg with hip and knee flexed. Without moving
the upper leg, slowly extend the knee, straightening the leg. The test is positive if the
maneuver results in pain, with the patient flexing the neck in an attempt to relieve pain
100% Correct Answers | Grade A+
Migraine Headache:
Ans: one of the most common vascular types; Lasts 4-76 hours
o More frequently in women
o Onset: age 6 through adolescence
o Signs and symptoms: begins unilaterally but may become generalized and may lateralize to
the opposite side and/or radiate to the face of neck; pain ranges from dull ache to throbbing or
pulsatile pain , aggravated by movement, light and noise, incapacitating.
• Accompanying symptoms: nausea, vomiting, photophobia, phonophobia, osmophobia,
dizziness, chills, and/or ataxia.
• May be tenderness to palpation of the temporal arteries
• AURAS: may include blurred vision, and scotoma and/or other prodromal symptoms such
as anorexia, irritability, restlessness, or paresthesias lasting from 30 min to 3 hours before the
onset of the migraine
Cluster Headache:
Ans: one of the most severe and incapacitating forms of a headache, pain occurs
episodically, pain can be so intense as to precipitate suicidal thoughts or actions to find relief
,o More Common in men
o Rare in children
o Signs and symptoms: Complaint of headache that is episodic and unpredictable in nature
and may be cyclic. Occur more often in spring and autumn, Cluster periods lasts: 2-3 months
and may remit for months to years. Remissions are typically shorter than 2 years. Pain is
NOT preceded by aura. Have rapid crescendo patterns, peaking in approximately 10-15 min
and often lasting 30-60 minutes per episode (rarely last > 2 hours). Usually in area of
trigeminal nerve area and is described as unilateral, penetrating, sharp, excruciating, and
unrelenting in nature.
• Associated symptoms: unilateral lacrimation, nasal congestion or rhinorrhea, pallor,
flushing, conjunctival redness, ptosis - all on the same side of the pain. Some experience
bradycardia during episode.
Tension headache:
Ans: . (other terms: stress, essential, idiopathic, or muscle contraction headache).
o Occur with equal frequency between men and women
o Signs and symptoms: Mild to moderate, non-throbbing pressure or squeezing pain that
occur anywhere in the head or neck. The pain often starts slowly as a dull and aching
discomfort that progress to holocranial pain and pressure. Pain can last minutes to hours.
Remits usually with rest or removal of stressful trigger.
• Associated symptoms: NO nausea or vomiting is usually associated. Although some report
photophobia and phonophobia.
,o Neck muscles are often tight to palpation
• Subdural Hematoma
o Signs and symptoms: usually dull and aching in nature and may be transient. Pain will
gradually worsen over days to weeks. In elderly change in mentation may precede pain.
o History: usually includes an acute head injury
Subarachnoid Hemorrhage
Ans: : Head trauma is most common cause of SAH. However it can be spontaneous
stemming from a ruptured aneurysm, vascular malformation, uncontrolled hypertension, or
hemorrhagic disease.
o Higher risk: smokers
o Usually occur in adults ages 50 - 60 years old
o Signs and Symptoms: pain is described as "severe" "the worst headache of my life." Made
worse by lying down.
o Associated symptoms: nausea and vomiting and rapid deterioration in neurological function
Viral/Bacterial Meningitis:
Ans: inflammatory process of CNS
o Signs and Symptoms: Headache described as diffuse and throbbing and is often severe or
intense in nature.
, • Associated symptoms: Fever, photophobia, phonophobia, nausea, vomiting, and nuchal
rigidity
• Neuro exam: lethargic, febrile, altered mentation along with nuchal rigidity and/or guarding,
contracted and sluggish pupils and a general "toxic" appearance
• +Brudzinski's test: with patient lying on exam table, gently flex the patient's neck to a chin-
to-chest position. The test is positive if the patient attempts to lift legs and flex hips to relieve
pain by the maneuver
• +Kernig's test: when patient resting on exam table hold leg with hip and knee flexed.
Without moving the upper leg, slowly extend the knee, straightening the leg. The test is
positive if the maneuver results in pain, with the patient flexing the neck in an attempt to
relieve pain
+Brudzinski's test:
Ans: with patient lying on exam table, gently flex the patient's neck to a chin-to-chest
position. The test is positive if the patient attempts to lift legs and flex hips to relieve pain by
the maneuver
+Kernig's test:
Ans: when patient resting on exam table hold leg with hip and knee flexed. Without moving
the upper leg, slowly extend the knee, straightening the leg. The test is positive if the
maneuver results in pain, with the patient flexing the neck in an attempt to relieve pain
