1
NR 547 CEA Exam 1 2026 – Pre-Clinical
Diagnostic Exam Questions with 100%
Correct Answers| Graded A – Chamberlain.
Question
Based on the given history and physical examination, what is an effective preventative
medication that might prevent these headaches in the future?
Answer Choices
1 Triptans
, 2
2 Calcium channel blockers
3 Local anesthetic –
Correct Answer :CCB (like Verapamil)
The patient in the above scenario is experiencing a cluster headache. Cluster headaches are
headaches that occur more commonly in middle-aged men. Patients will complain of severe
unilateral periorbital pain that occurs daily for several weeks and potentially are associated
with 1 or more of the following symptoms: ipsilateral nasal congestion, rhinorrhea,
lacrimation, or redness of the eye. Patients are restless and agitated during the acute phase
of these headaches. Episodes vary in length from around 15 minutes up to 3 hours; at the
same time, these occurrences may last for several weeks and then resolve for many weeks at
a time.
Any time a healthcare provider or a patient approaches a headache of any type, treatments
for the acute signs/symptoms as well as preventative treatments should be considered. Fast
acting treatments to give the patient immediate relief from the signs and symptoms of a
cluster headache include oxygen, triptans, octreotide, local anesthetics, and
dihydroergotamine (intravenous only). Various NSAIDs may also be attempted for symptoms,
but not for prevention of cluster headaches.
Preventative therapies are used at the onset of the cluster episode with the overall goal of
suppressing the severity of the headaches. Various options may be attempted as
preventative therapy; corticosteroids, lithium carbonate, nerve blocks, ergots (sublingual),
calcium channel blockers, and even melatonin usage have been effective. At times, the anti-
seizure medications divalproex and topiramate may also be considered. The calcium channel
blocker verapamil is very often the first choice for preventing cluster headaches.
A 19-year-old woman presents to the Accident and Emergency Department following a road
traffic accident 20 minutes prior. She states her car was just lightly bumped from behind, but
she is concerned she might have whiplash, as her neck is stiff and sore. She also says she's
experiencing tingling in her left arm down to her thumb.
, 3
On physical examination, her bicep strength is +3/5 on the left and +5/5 on the right. Her bicep
tendon reflex is 2+ on the left and 2+ on the right. In addition, her brachioradialis tendon reflex
is 1+ on the left and 2+ on the right. The remainder of the physical examination is normal.
Question
Based on the above presentation, what cervical nerve root is most likely affected?
Answer Choices
1 C4
2 C5
3 C6
4 C7
5 C8 –
Correct Answer :c6
The most likely nerve affected in this case is the C6 nerve root. Impingement of this nerve can
cause numbness and tingling down the arm into the thumb, with weakness in the bicep
muscle and diminished brachioradialis tendon reflex in the affected extremity.
Impingement of the C4 nerve root may cause neck and upper shoulder numbness and pain.
Impingement of C5 nerve root may cause deltoid and shoulder numbness and pain, and bicep
tendon reflex may be diminished.
Impingement of C7 also causes numbness and pain down the affected arm, but reflex may be
diminished into the middle finger and the triceps,.
, 4
Impingement of C8 may cause numbness and tingling primarily on the lateral surface of the
arm and into the lateral hand into the fourth and fifth digits. It may also cause dysfunction of
the hand as it innervates the small hand muscles.
A 65-year-old woman presents with general weakness. She had the weakness for the past
few days, and it gets worse as the day progresses. She says she has been having double
vision, and you notice she has poor posture. A blood test reveals presence of antibodies to
acetylcholine receptor. A repetitive nerve stimulation test showed a decremental response.
What is the most likely diagnosis?
Answer Choices
1 Marfan's syndrome
2 Myasthenia gravis
3 Duchenne's muscular dystrophy
4 Rheumatoid arthritis
5 Systemic lupus erythematosus –
Correct Answer :Myasthenia Gravis
Myasthenia gravis, a disorder more common in women, is characterized by chronic weakness
of voluntary muscles. This weakness improves with rest and worsens with activity. The body
produces an immune response (autoantibodies) against the nicotinic acetylcholine receptors
at the neuromuscular junction. The most common presentation is muscle weakness that
progressively worsens as the day progresses. The clinical features include ocular
manifestations such as ptosis and diplopia, extra-ocular manifestations including limb and
trunk weakness, dysphagia, generalized weakness, depressed gag reflex, limp body,
slackening of the jaw, and respiratory depression. The diagnostic tests are anti-ACh receptor
antibody assay, repetitive nerve stimulation (shows a decremental response), and
electromyography. Treatment consists of the administration of acetylcholinesterase
inhibitors, immunosuppressive agents like corticosteroids, cyclosporine, azathioprine,
plasmapheresis, and intravenous gamma globulin. Thymectomy can also be done.
NR 547 CEA Exam 1 2026 – Pre-Clinical
Diagnostic Exam Questions with 100%
Correct Answers| Graded A – Chamberlain.
Question
Based on the given history and physical examination, what is an effective preventative
medication that might prevent these headaches in the future?
Answer Choices
1 Triptans
, 2
2 Calcium channel blockers
3 Local anesthetic –
Correct Answer :CCB (like Verapamil)
The patient in the above scenario is experiencing a cluster headache. Cluster headaches are
headaches that occur more commonly in middle-aged men. Patients will complain of severe
unilateral periorbital pain that occurs daily for several weeks and potentially are associated
with 1 or more of the following symptoms: ipsilateral nasal congestion, rhinorrhea,
lacrimation, or redness of the eye. Patients are restless and agitated during the acute phase
of these headaches. Episodes vary in length from around 15 minutes up to 3 hours; at the
same time, these occurrences may last for several weeks and then resolve for many weeks at
a time.
Any time a healthcare provider or a patient approaches a headache of any type, treatments
for the acute signs/symptoms as well as preventative treatments should be considered. Fast
acting treatments to give the patient immediate relief from the signs and symptoms of a
cluster headache include oxygen, triptans, octreotide, local anesthetics, and
dihydroergotamine (intravenous only). Various NSAIDs may also be attempted for symptoms,
but not for prevention of cluster headaches.
Preventative therapies are used at the onset of the cluster episode with the overall goal of
suppressing the severity of the headaches. Various options may be attempted as
preventative therapy; corticosteroids, lithium carbonate, nerve blocks, ergots (sublingual),
calcium channel blockers, and even melatonin usage have been effective. At times, the anti-
seizure medications divalproex and topiramate may also be considered. The calcium channel
blocker verapamil is very often the first choice for preventing cluster headaches.
A 19-year-old woman presents to the Accident and Emergency Department following a road
traffic accident 20 minutes prior. She states her car was just lightly bumped from behind, but
she is concerned she might have whiplash, as her neck is stiff and sore. She also says she's
experiencing tingling in her left arm down to her thumb.
, 3
On physical examination, her bicep strength is +3/5 on the left and +5/5 on the right. Her bicep
tendon reflex is 2+ on the left and 2+ on the right. In addition, her brachioradialis tendon reflex
is 1+ on the left and 2+ on the right. The remainder of the physical examination is normal.
Question
Based on the above presentation, what cervical nerve root is most likely affected?
Answer Choices
1 C4
2 C5
3 C6
4 C7
5 C8 –
Correct Answer :c6
The most likely nerve affected in this case is the C6 nerve root. Impingement of this nerve can
cause numbness and tingling down the arm into the thumb, with weakness in the bicep
muscle and diminished brachioradialis tendon reflex in the affected extremity.
Impingement of the C4 nerve root may cause neck and upper shoulder numbness and pain.
Impingement of C5 nerve root may cause deltoid and shoulder numbness and pain, and bicep
tendon reflex may be diminished.
Impingement of C7 also causes numbness and pain down the affected arm, but reflex may be
diminished into the middle finger and the triceps,.
, 4
Impingement of C8 may cause numbness and tingling primarily on the lateral surface of the
arm and into the lateral hand into the fourth and fifth digits. It may also cause dysfunction of
the hand as it innervates the small hand muscles.
A 65-year-old woman presents with general weakness. She had the weakness for the past
few days, and it gets worse as the day progresses. She says she has been having double
vision, and you notice she has poor posture. A blood test reveals presence of antibodies to
acetylcholine receptor. A repetitive nerve stimulation test showed a decremental response.
What is the most likely diagnosis?
Answer Choices
1 Marfan's syndrome
2 Myasthenia gravis
3 Duchenne's muscular dystrophy
4 Rheumatoid arthritis
5 Systemic lupus erythematosus –
Correct Answer :Myasthenia Gravis
Myasthenia gravis, a disorder more common in women, is characterized by chronic weakness
of voluntary muscles. This weakness improves with rest and worsens with activity. The body
produces an immune response (autoantibodies) against the nicotinic acetylcholine receptors
at the neuromuscular junction. The most common presentation is muscle weakness that
progressively worsens as the day progresses. The clinical features include ocular
manifestations such as ptosis and diplopia, extra-ocular manifestations including limb and
trunk weakness, dysphagia, generalized weakness, depressed gag reflex, limp body,
slackening of the jaw, and respiratory depression. The diagnostic tests are anti-ACh receptor
antibody assay, repetitive nerve stimulation (shows a decremental response), and
electromyography. Treatment consists of the administration of acetylcholinesterase
inhibitors, immunosuppressive agents like corticosteroids, cyclosporine, azathioprine,
plasmapheresis, and intravenous gamma globulin. Thymectomy can also be done.
