A client suffers from migraine headaches. Which assessment finding would the nurse expect during a migraine attack?

• A. Unilateral, pulsating pain quality
• B. Bilateral, pressing/tightening pain quality
• C. Ipsilateral nasal congestion and rhinorrhea
• D. Headache occurs after recovering from a headache treated with narcotics

Answer: (A)

During a migraine attack, the pain is typically unilateral and pulsating, and it tends to be moderate to severe in intensity, often worsened by physical activity. This description distinguishes it from tension-type headaches, which are usually bilateral and have a pressing or tightening quality. Some migraines may include nasal congestion or rhinorrhea as part of associated autonomic symptoms, but the defining feature that best matches an active migraine attack is the unilateral, throbbing nature of the pain. Rebound headaches from narcotic use describe a different pattern related to medication overuse, not the classic migrainous attack. So the unilateral, pulsating quality best fits migraine presentation.