Which type of headache would the nurse suspect when the headaches are unilateral and throbbing, preceded by a premonitory symptom of photophobia, and associated with a family history?
Cluster
Tension-type
Frontal-type
Migraine
The Correct Answer is D
A: "Cluster." Cluster headaches are characterized by severe, unilateral pain, often described as sharp or burning rather than throbbing. They typically occur in cyclical patterns or clusters and are often accompanied by autonomic symptoms, such as nasal congestion or tearing, rather than photophobia.
B: "Tension-type." Tension-type headaches are generally bilateral and described as a dull, pressing, or tightening sensation rather than throbbing. They are not usually associated with photophobia or a family history of migraines, making this option less likely.
C: "Frontal-type." Frontal-type headaches can occur in the forehead area but do not have a specific classification as a primary headache type. They may be associated with sinus issues or tension but do not fit the description of unilateral, throbbing pain with photophobia or family history.
D: "Migraine." Migraines are typically unilateral and throbbing, often preceded by premonitory symptoms such as photophobia or aura. The association with family history suggests a genetic predisposition to migraines, further supporting this diagnosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Whisper in one of the client's ears while occluding the other. This assesses cranial nerve VIII (vestibulocochlear nerve), which controls hearing and balance. It does not evaluate cranial nerve XII (hypoglossal nerve).
B. Have the client identify specific smells. This tests cranial nerve I (olfactory nerve), which is responsible for the sense of smell. Cranial nerve XII does not play a role in olfaction.
C. Ask the client to stick out their tongue and observe if it is midline. Cranial nerve XII (hypoglossal nerve) controls tongue movement. Asking the client to stick out their tongue and observing for deviation helps assess nerve function. A deviation to one side suggests nerve damage on that side. This nerve is essential for speech, swallowing, and controlling tongue position.
D. Observe for the ability of the client to turn their head side to side. This assesses cranial nerve XI (spinal accessory nerve), which controls the sternocleidomastoid and trapezius muscles. It does not assess cranial nerve XII, which is responsible for tongue movement.
Correct Answer is ["31"]
Explanation
Calculate the total infusion time in minutes:
Total infusion time (minutes) = Infusion time (hours) × 60 minutes/hour
= 2 hours × 60 minutes/hour
= 120 minutes
Calculate the flow rate in drops per minute:
Flow rate (gtts/minute) = (Volume (mL) × Drop factor (gtts/mL)) / Total infusion time (minutes)
= (250 mL × 15 gtts/mL) / 120 minutes
= 31.25 gtts/minute
Round to the nearest whole number:
31.25 gtts/minute is 31 gtts/minute
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