66. A 55-year-old patient speaks with an advanced practice registered nurse (APRN) about newly emergent problems with headaches, nausea, vomiting, and photophobia, The APRN examines the patient and rules out any triggering diseases. A diagnosis of migraine without aura is suspected. Which characteristics support this diagnosis?
Answer: B
Unilateral, pulsating, moderate-to-severe pain during activity, lasting 4-72 hours
The diagnosis of migraine without aura is supported by the characteristics of unilateral, pulsating, moderate-to-severe pain that occurs during physical activity and lasts between 4 to 72 hours.
A) Bilateral, pulsating, moderate-to-severe pain while standing, lasting 3-6 hours
This option describes bilateral pain that is not typical of migraines, which are usually unilateral. Additionally, the duration of 3-6 hours does not align with the migraine classification, as migraines typically last longer.
B) Unilateral, pulsating, moderate-to-severe pain during activity, lasting 4-72 hours
This option accurately describes the characteristics of migraine without aura. The pain is unilateral, pulsating, and moderate to severe, which aligns perfectly with the diagnostic criteria for migraines. Furthermore, the pain's association with physical activity and its duration of 4-72 hours are key indicators for this type of headache.
C) Unilateral, pulsating, moderate-to-severe pain with vertigo, lasting 6-12 hours
While this option includes unilateral and pulsating pain, the presence of vertigo is not a typical characteristic of migraine without aura. Additionally, the duration of 6-12 hours is shorter than the typical duration for migraines, which can last up to 72 hours.
D) Bilateral, pulsating, moderate-to-severe pain upon wakening, lasting 3-24 hours
This description refers to bilateral pain, which is inconsistent with migraines. The onset of pain upon waking and the duration of 3-24 hours do not align with the standard characteristics of migraine headaches, which are usually unilateral and can last significantly longer.
Conclusion
Option B is definitively correct as it encompasses the essential characteristics of migraine without aura, including unilateral location, pulsating quality, and appropriate duration. The other options either describe bilateral pain or fail to meet the specific criteria necessary for diagnosing migraines, making them incorrect choices.