
You are the RN at the local clinic; NR is a 41 year-old Caucasian female and single mother of 3 who presents with a “pounding and throbbing” headache, the third of its kind within the past month. She works part-time at Walmart and is taking nursing courses in the evening. She denies alcohol, tobacco or illegal drugs. She sleeps about 5 hours each night, admits to poor eating habits-drinking 3-4 cups caffeine, and eating candy “more than she should”. NR describes her pain as being localized to the right temple, increasing in intensity over the past hour rating her pain as a 9 out of 10. She also complains of non-radiating neck pain and states the bright lights in the clinic make her feel worse as she now feels nauseous and dizzy though she has not vomited. Lying in a dark quiet room makes her feel better. Sometimes taking ibuprofen 600mg also helps though her last dose was yesterday. She denies any previous medical history, has never been hospitalized except for childbirth (uncomplicated vaginal deliveries x3), no surgical history, no significant family history.
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