Chapter 37. Headaches
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. Paige has a history of chronic migraines and would benefit from preventative medication. Education
regarding migraine preventive medication includes:
1. Medication is taken at the beginning of the headache to prevent it from getting
worse.
2. Medication alone is the best preventative against migraines occurring.
3. Medication should not be used more than four times a month.
4. The goal of treatment is to reduce migraine occurrence by 50%.
2. A first-line drug for abortive therapy in simple migraine is:
1. Sumatriptan (Imitrex)
2. Naproxen (Aleve)
3. Butorphanol nasal spray (Stadol NS)
4. Butalbital and acetaminophen (Fioricet)
3. Vicky, age 56 years, comes to the clinic requesting a refill of her Fiorinal (aspirin and butalbital) that
she takes for migraines. She has been taking this medication for over 2 years for migraines and states
one dose usually works to abort her migraine. What is the best care for her?
1. Switch her to sumatriptan (Imitrex) to treat her migraines.
2. Assess how often she is using Fiorinal and refill her medication.
3. Switch her to a beta blocker such as propranolol to prevent her migraine.
, 4. Request she return to the original prescriber of Fiorinal as you do not prescribe
butalbital for migraines.
4. When prescribing ergotamine suppositories (Wigraine) to treat acute migraine, patient education
would include:
1. Ergotamine will briefly make the migraine worse before the migraine resolves.
2. The patient may experience bradycardia and dizziness.
3. They may need premedication with an antinausea medication.
4. Ergotamine works best if the patient starts off with a full suppository to get the full
effect.
5. Migraines in pregnancy may be safely treated with:
1. Acetaminophen with codeine (Tylenol #3)
2. Sumatriptan (Imitrex)
3. Ergotamine tablets (Ergostat)
4. Dihydroergotamine (DHE)
6. Xi, a 54-year-old female, has a history of migraines that do not respond well to OTC migraine
medication. She is asking to try Maxalt (rizatriptan) because it works well for her friend.
Appropriate decision making would be:
1. Prescribe the Maxalt, but only give her four tablets with no refills to monitor the
use.
2. Prescribe Maxalt and arrange to have her observed in the clinic or urgent care with
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. Paige has a history of chronic migraines and would benefit from preventative medication. Education
regarding migraine preventive medication includes:
1. Medication is taken at the beginning of the headache to prevent it from getting
worse.
2. Medication alone is the best preventative against migraines occurring.
3. Medication should not be used more than four times a month.
4. The goal of treatment is to reduce migraine occurrence by 50%.
2. A first-line drug for abortive therapy in simple migraine is:
1. Sumatriptan (Imitrex)
2. Naproxen (Aleve)
3. Butorphanol nasal spray (Stadol NS)
4. Butalbital and acetaminophen (Fioricet)
3. Vicky, age 56 years, comes to the clinic requesting a refill of her Fiorinal (aspirin and butalbital) that
she takes for migraines. She has been taking this medication for over 2 years for migraines and states
one dose usually works to abort her migraine. What is the best care for her?
1. Switch her to sumatriptan (Imitrex) to treat her migraines.
2. Assess how often she is using Fiorinal and refill her medication.
3. Switch her to a beta blocker such as propranolol to prevent her migraine.
, 4. Request she return to the original prescriber of Fiorinal as you do not prescribe
butalbital for migraines.
4. When prescribing ergotamine suppositories (Wigraine) to treat acute migraine, patient education
would include:
1. Ergotamine will briefly make the migraine worse before the migraine resolves.
2. The patient may experience bradycardia and dizziness.
3. They may need premedication with an antinausea medication.
4. Ergotamine works best if the patient starts off with a full suppository to get the full
effect.
5. Migraines in pregnancy may be safely treated with:
1. Acetaminophen with codeine (Tylenol #3)
2. Sumatriptan (Imitrex)
3. Ergotamine tablets (Ergostat)
4. Dihydroergotamine (DHE)
6. Xi, a 54-year-old female, has a history of migraines that do not respond well to OTC migraine
medication. She is asking to try Maxalt (rizatriptan) because it works well for her friend.
Appropriate decision making would be:
1. Prescribe the Maxalt, but only give her four tablets with no refills to monitor the
use.
2. Prescribe Maxalt and arrange to have her observed in the clinic or urgent care with
