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NR 603 WEEK 6 – CLINICAL EDUCATION
ASSESSMENT (CEA) PRACTICE EXAM 2026 (CASE-
BASED, ADVANCED CLINICAL REASONING)
COMPLETE (100) CURRENT TESTING QUESTIONS
AND CORRECT ANSWERS WITH DETAILED
EXPLANATIONS|GUARANTEED PASS.
NR 603
Maximize your success with this NR 603 Week 6 CEA-Style Practice Exam,
designed to reinforce advanced practice nursing concepts. It focuses on
clinical evaluation, assessment strategies, differential diagnosis, and
evidence-based treatment planning. The exam strengthens critical thinking and
readiness for certification-style assessments. Suitable for graduate nursing
students preparing for exams and clinical practice.
MULTIPLE CHOICE.
CASE 1: Headache & Neurological (Questions 1–10)
A 45-year-old female presents with throbbing right-sided headache,
photophobia, nausea, and aura (fortification spectra) lasting 45 minutes
before headache onset. She has had similar headaches since age 20. Her
father has migraines. Vital signs normal.
1. Which of the following is the most likely diagnosis?
A. Tension-type headache
B. Migraine with aura
C. Cluster headache
D. Subarachnoid hemorrhage
Answer: B. Migraine with aura
Explanation: Migraine with aura requires fully reversible aura
symptoms (visual, sensory, speech) lasting 5–60 minutes, followed by
, Page 2 of 38
headache. Family history, throbbing pain, photophobia, nausea support
diagnosis.
2. Which medication is first-line for acute treatment of this
patient's migraine?
A. Sumatriptan (triptan) if no contraindications (e.g., uncontrolled
hypertension, hemiplegic migraine, cardiovascular disease)
B. Aspirin 81 mg daily
C. Warfarin
D. Topiramate
Answer: A. Sumatriptan (triptan) if no contraindications (e.g.,
uncontrolled hypertension, hemiplegic migraine, cardiovascular
disease)
Explanation: Triptans (sumatriptan, rizatriptan, eletriptan) are first-
line for acute moderate-severe migraine. Contraindications: CAD,
uncontrolled hypertension, basilar/hemiplegic migraine, MAOI use,
pregnancy caution.
3. The patient reports that triptans are not always effective. Which
nonpharmacologic intervention is evidence-based for migraine
prevention?
A. Acupuncture, riboflavin (400 mg daily), magnesium, feverfew,
butterbur (with caution for hepatotoxicity)
B. High-dose opioids
C. Daily benzodiazepines
D. Alcohol
Answer: A. Acupuncture, riboflavin (400 mg daily), magnesium,
feverfew, butterbur (with caution for hepatotoxicity)
Explanation: Nutraceuticals with some evidence for migraine
prevention: riboflavin (vitamin B2), magnesium (400–600 mg),
coenzyme Q10, feverfew, butterbur (risk of liver injury – use PA-free
extract with caution). Also consider acupuncture.
4. The patient's headaches increase in frequency to 12 days per
month. Which medication is FDA-approved for migraine
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prophylaxis?
A. Propranolol (beta-blocker), topiramate, amitriptyline, candesartan,
onabotulinumtoxinA (chronic migraine, ≥15 days/month), erenumab
(CGRP mAb)
B. Sumatriptan daily
C. Opioids
D. Naproxen alone
Answer: A. Propranolol (beta-blocker), topiramate, amitriptyline,
candesartan, onabotulinumtoxinA (chronic migraine, ≥15
days/month), erenumab (CGRP mAb)
Explanation: FDA-approved migraine preventives: propranolol,
timolol, topiramate, divalproex, onabotulinumtoxinA (chronic
migraine), and CGRP monoclonal antibodies (erenumab, galcanezumab,
fremanezumab).
5. During a severe attack, the patient vomits. Which would be the
best route of triptan administration?
A. Oral
B. Intranasal or subcutaneous (sumatriptan injectable, zolmitriptan
nasal spray)
C. Intravenous
D. Rectal
Answer: B. Intranasal or subcutaneous (sumatriptan injectable,
zolmitriptan nasal spray)
Explanation: Nausea/vomiting reduces oral
absorption. Intranasal or subcutaneous triptans bypass GI tract. IV
triptans are not available.
6. The patient’s headache becomes constant daily, with features of
chronic daily headache. Medication overuse headache (MOH) is
suspected. Which is the most likely culprit if she uses triptans ≥10
days/month?
A. Triptan overuse headache (MOH) – withdraw offending agent
B. Caffeine
C. Acetaminophen
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D. Propranolol
Answer: A. Triptan overuse headache (MOH) – withdraw offending
agent
Explanation: Medication overuse headache occurs with triptans ≥10
days/month, opioids, butalbital, ergots, or simple analgesics ≥15
days/month. Treatment: withdrawal of overused medication,
preventive therapy.
7. Which of the following features would raise concern for a
secondary headache requiring imaging?
A. Throbbing pain
B. Sudden onset thunderclap headache (subarachnoid hemorrhage)
C. Family history of migraine
D. Nausea
Answer: B. Sudden onset thunderclap headache (subarachnoid
hemorrhage)
Explanation: Red flags (SNOOP): Systemic symptoms (fever, weight
loss), Neurologic symptoms or signs, Onset sudden (thunderclap), Older
age (>50 new headache), Previous headache pattern change
or Papilledema.
8. After 3 months of migraine prophylaxis, the patient's headache
frequency decreases by 50%. This is considered:
A. Inadequate
B. Successful response (≥50% reduction in headache days is goal)
C. Harmful
D. Placebo effect
Answer: B. Successful response (≥50% reduction in headache days
is goal)
Explanation: ≥50% reduction in monthly migraine days is a standard
measure of preventive treatment efficacy.
9. The patient is considering pregnancy. Which migraine
preventive is contraindicated in pregnancy?
A. Riboflavin
NR 603 WEEK 6 – CLINICAL EDUCATION
ASSESSMENT (CEA) PRACTICE EXAM 2026 (CASE-
BASED, ADVANCED CLINICAL REASONING)
COMPLETE (100) CURRENT TESTING QUESTIONS
AND CORRECT ANSWERS WITH DETAILED
EXPLANATIONS|GUARANTEED PASS.
NR 603
Maximize your success with this NR 603 Week 6 CEA-Style Practice Exam,
designed to reinforce advanced practice nursing concepts. It focuses on
clinical evaluation, assessment strategies, differential diagnosis, and
evidence-based treatment planning. The exam strengthens critical thinking and
readiness for certification-style assessments. Suitable for graduate nursing
students preparing for exams and clinical practice.
MULTIPLE CHOICE.
CASE 1: Headache & Neurological (Questions 1–10)
A 45-year-old female presents with throbbing right-sided headache,
photophobia, nausea, and aura (fortification spectra) lasting 45 minutes
before headache onset. She has had similar headaches since age 20. Her
father has migraines. Vital signs normal.
1. Which of the following is the most likely diagnosis?
A. Tension-type headache
B. Migraine with aura
C. Cluster headache
D. Subarachnoid hemorrhage
Answer: B. Migraine with aura
Explanation: Migraine with aura requires fully reversible aura
symptoms (visual, sensory, speech) lasting 5–60 minutes, followed by
, Page 2 of 38
headache. Family history, throbbing pain, photophobia, nausea support
diagnosis.
2. Which medication is first-line for acute treatment of this
patient's migraine?
A. Sumatriptan (triptan) if no contraindications (e.g., uncontrolled
hypertension, hemiplegic migraine, cardiovascular disease)
B. Aspirin 81 mg daily
C. Warfarin
D. Topiramate
Answer: A. Sumatriptan (triptan) if no contraindications (e.g.,
uncontrolled hypertension, hemiplegic migraine, cardiovascular
disease)
Explanation: Triptans (sumatriptan, rizatriptan, eletriptan) are first-
line for acute moderate-severe migraine. Contraindications: CAD,
uncontrolled hypertension, basilar/hemiplegic migraine, MAOI use,
pregnancy caution.
3. The patient reports that triptans are not always effective. Which
nonpharmacologic intervention is evidence-based for migraine
prevention?
A. Acupuncture, riboflavin (400 mg daily), magnesium, feverfew,
butterbur (with caution for hepatotoxicity)
B. High-dose opioids
C. Daily benzodiazepines
D. Alcohol
Answer: A. Acupuncture, riboflavin (400 mg daily), magnesium,
feverfew, butterbur (with caution for hepatotoxicity)
Explanation: Nutraceuticals with some evidence for migraine
prevention: riboflavin (vitamin B2), magnesium (400–600 mg),
coenzyme Q10, feverfew, butterbur (risk of liver injury – use PA-free
extract with caution). Also consider acupuncture.
4. The patient's headaches increase in frequency to 12 days per
month. Which medication is FDA-approved for migraine
, Page 3 of 38
prophylaxis?
A. Propranolol (beta-blocker), topiramate, amitriptyline, candesartan,
onabotulinumtoxinA (chronic migraine, ≥15 days/month), erenumab
(CGRP mAb)
B. Sumatriptan daily
C. Opioids
D. Naproxen alone
Answer: A. Propranolol (beta-blocker), topiramate, amitriptyline,
candesartan, onabotulinumtoxinA (chronic migraine, ≥15
days/month), erenumab (CGRP mAb)
Explanation: FDA-approved migraine preventives: propranolol,
timolol, topiramate, divalproex, onabotulinumtoxinA (chronic
migraine), and CGRP monoclonal antibodies (erenumab, galcanezumab,
fremanezumab).
5. During a severe attack, the patient vomits. Which would be the
best route of triptan administration?
A. Oral
B. Intranasal or subcutaneous (sumatriptan injectable, zolmitriptan
nasal spray)
C. Intravenous
D. Rectal
Answer: B. Intranasal or subcutaneous (sumatriptan injectable,
zolmitriptan nasal spray)
Explanation: Nausea/vomiting reduces oral
absorption. Intranasal or subcutaneous triptans bypass GI tract. IV
triptans are not available.
6. The patient’s headache becomes constant daily, with features of
chronic daily headache. Medication overuse headache (MOH) is
suspected. Which is the most likely culprit if she uses triptans ≥10
days/month?
A. Triptan overuse headache (MOH) – withdraw offending agent
B. Caffeine
C. Acetaminophen
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D. Propranolol
Answer: A. Triptan overuse headache (MOH) – withdraw offending
agent
Explanation: Medication overuse headache occurs with triptans ≥10
days/month, opioids, butalbital, ergots, or simple analgesics ≥15
days/month. Treatment: withdrawal of overused medication,
preventive therapy.
7. Which of the following features would raise concern for a
secondary headache requiring imaging?
A. Throbbing pain
B. Sudden onset thunderclap headache (subarachnoid hemorrhage)
C. Family history of migraine
D. Nausea
Answer: B. Sudden onset thunderclap headache (subarachnoid
hemorrhage)
Explanation: Red flags (SNOOP): Systemic symptoms (fever, weight
loss), Neurologic symptoms or signs, Onset sudden (thunderclap), Older
age (>50 new headache), Previous headache pattern change
or Papilledema.
8. After 3 months of migraine prophylaxis, the patient's headache
frequency decreases by 50%. This is considered:
A. Inadequate
B. Successful response (≥50% reduction in headache days is goal)
C. Harmful
D. Placebo effect
Answer: B. Successful response (≥50% reduction in headache days
is goal)
Explanation: ≥50% reduction in monthly migraine days is a standard
measure of preventive treatment efficacy.
9. The patient is considering pregnancy. Which migraine
preventive is contraindicated in pregnancy?
A. Riboflavin
