NURS 5432 QUIZ 4 2026/2027 | Complete Solutions | UTA |
Pass Guaranteed - A+ Graded
SECTION 1: Neurological Disorders (Q1-Q12)
Q1: A 28-year-old woman presents with recurrent unilateral throbbing headaches
associated with nausea, photophobia, and phonophobia. Episodes last 8-12 hours and
are preceded by visual aura. Which medication is most appropriate for acute treatment?
A. Propranolol 20 mg daily
B. Sumatriptan 50 mg at headache onset [CORRECT]
C. Amitriptyline 25 mg at bedtime
D. Verapamil 240 mg daily
Correct Answer: B
Rationale: Sumatriptan, a serotonin 5-HT1B/1D receptor agonist, is first-line therapy for
acute migraine with or without aura. Propranolol and amitriptyline are preventive agents,
while verapamil is used for cluster headache prophylaxis.
Q2: A 45-year-old man presents with severe unilateral periorbital pain occurring daily for
2 weeks. He describes the pain as "stabbing" and notes ipsilateral lacrimation and nasal
congestion. Each episode lasts 45 minutes. What is the most likely diagnosis?
A. Migraine without aura
B. Tension-type headache
C. Cluster headache [CORRECT]
D. Trigeminal neuralgia
Correct Answer: C
Rationale: Cluster headache presents with severe unilateral periorbital pain, autonomic
symptoms (lacrimation, rhinorrhea), and short duration (15-180 minutes) in a circadian
,pattern. Migraine typically lasts 4-72 hours, tension-type headache is bilateral and
pressing, and trigeminal neuralgia causes brief electric shock-like pains.
Q3: Which characteristic best distinguishes tension-type headache from migraine?
A. Unilateral location
B. Pulsating quality
C. Bilateral pressing band-like pain without nausea [CORRECT]
D. Visual aura preceding headache
Correct Answer: C
Rationale: Tension-type headache is characterized by bilateral, pressing or tightening
pain of mild to moderate intensity without nausea or vomiting. Unilateral location,
pulsating quality, and aura are diagnostic features of migraine.
Q4: A 19-year-old college student is brought to the clinic after experiencing a sudden
loss of consciousness with generalized tonic-clonic movements lasting 2 minutes. He
had no warning, bit his tongue, and was confused postictally. What type of seizure is
this?
A. Absence seizure
B. Complex partial seizure
C. Generalized tonic-clonic seizure [CORRECT]
D. Simple partial seizure
Correct Answer: C
Rationale: Generalized tonic-clonic seizures involve sudden loss of consciousness,
bilateral tonic and clonic movements, tongue biting, and postictal confusion. Absence
seizures cause brief staring without postictal confusion, and partial seizures originate in
a focal area without initial bilateral involvement.
, Q5: A 72-year-old man with hypertension presents with sudden onset left-sided
weakness and slurred speech that resolved completely within 45 minutes. Brain MRI
shows no acute infarction. What is the most appropriate next step?
A. Initiate tissue plasminogen activator (tPA)
B. Start aspirin 81 mg daily and order carotid ultrasound and cardiac monitoring
[CORRECT]
C. Begin warfarin without further evaluation
D. Schedule elective coronary angiography
Correct Answer: B
Rationale: Transient ischemic attack management requires immediate antiplatelet
therapy, vascular imaging (carotid ultrasound), and cardiac monitoring to identify atrial
fibrillation or other embolic sources. tPA is contraindicated without acute infarction, and
anticoagulation requires identification of a cardioembolic source.
Q6: A 68-year-old man with type 2 diabetes presents with bilateral burning foot pain
worse at night and diminished sensation to monofilament testing. Which medication is
first-line for his diabetic peripheral neuropathy?
A. Oxycodone 5 mg twice daily
B. Pregabalin 50 mg three times daily [CORRECT]
C. Prednisone 20 mg daily
D. Levodopa/carbidopa 25/100 mg three times daily
Correct Answer: B
Rationale: Pregabalin (and gabapentin) are first-line agents for painful diabetic
peripheral neuropathy. Opioids are not first-line due to poor risk-benefit profile.
Corticosteroids do not treat diabetic neuropathy, and levodopa is used for Parkinson's
disease.
Pass Guaranteed - A+ Graded
SECTION 1: Neurological Disorders (Q1-Q12)
Q1: A 28-year-old woman presents with recurrent unilateral throbbing headaches
associated with nausea, photophobia, and phonophobia. Episodes last 8-12 hours and
are preceded by visual aura. Which medication is most appropriate for acute treatment?
A. Propranolol 20 mg daily
B. Sumatriptan 50 mg at headache onset [CORRECT]
C. Amitriptyline 25 mg at bedtime
D. Verapamil 240 mg daily
Correct Answer: B
Rationale: Sumatriptan, a serotonin 5-HT1B/1D receptor agonist, is first-line therapy for
acute migraine with or without aura. Propranolol and amitriptyline are preventive agents,
while verapamil is used for cluster headache prophylaxis.
Q2: A 45-year-old man presents with severe unilateral periorbital pain occurring daily for
2 weeks. He describes the pain as "stabbing" and notes ipsilateral lacrimation and nasal
congestion. Each episode lasts 45 minutes. What is the most likely diagnosis?
A. Migraine without aura
B. Tension-type headache
C. Cluster headache [CORRECT]
D. Trigeminal neuralgia
Correct Answer: C
Rationale: Cluster headache presents with severe unilateral periorbital pain, autonomic
symptoms (lacrimation, rhinorrhea), and short duration (15-180 minutes) in a circadian
,pattern. Migraine typically lasts 4-72 hours, tension-type headache is bilateral and
pressing, and trigeminal neuralgia causes brief electric shock-like pains.
Q3: Which characteristic best distinguishes tension-type headache from migraine?
A. Unilateral location
B. Pulsating quality
C. Bilateral pressing band-like pain without nausea [CORRECT]
D. Visual aura preceding headache
Correct Answer: C
Rationale: Tension-type headache is characterized by bilateral, pressing or tightening
pain of mild to moderate intensity without nausea or vomiting. Unilateral location,
pulsating quality, and aura are diagnostic features of migraine.
Q4: A 19-year-old college student is brought to the clinic after experiencing a sudden
loss of consciousness with generalized tonic-clonic movements lasting 2 minutes. He
had no warning, bit his tongue, and was confused postictally. What type of seizure is
this?
A. Absence seizure
B. Complex partial seizure
C. Generalized tonic-clonic seizure [CORRECT]
D. Simple partial seizure
Correct Answer: C
Rationale: Generalized tonic-clonic seizures involve sudden loss of consciousness,
bilateral tonic and clonic movements, tongue biting, and postictal confusion. Absence
seizures cause brief staring without postictal confusion, and partial seizures originate in
a focal area without initial bilateral involvement.
, Q5: A 72-year-old man with hypertension presents with sudden onset left-sided
weakness and slurred speech that resolved completely within 45 minutes. Brain MRI
shows no acute infarction. What is the most appropriate next step?
A. Initiate tissue plasminogen activator (tPA)
B. Start aspirin 81 mg daily and order carotid ultrasound and cardiac monitoring
[CORRECT]
C. Begin warfarin without further evaluation
D. Schedule elective coronary angiography
Correct Answer: B
Rationale: Transient ischemic attack management requires immediate antiplatelet
therapy, vascular imaging (carotid ultrasound), and cardiac monitoring to identify atrial
fibrillation or other embolic sources. tPA is contraindicated without acute infarction, and
anticoagulation requires identification of a cardioembolic source.
Q6: A 68-year-old man with type 2 diabetes presents with bilateral burning foot pain
worse at night and diminished sensation to monofilament testing. Which medication is
first-line for his diabetic peripheral neuropathy?
A. Oxycodone 5 mg twice daily
B. Pregabalin 50 mg three times daily [CORRECT]
C. Prednisone 20 mg daily
D. Levodopa/carbidopa 25/100 mg three times daily
Correct Answer: B
Rationale: Pregabalin (and gabapentin) are first-line agents for painful diabetic
peripheral neuropathy. Opioids are not first-line due to poor risk-benefit profile.
Corticosteroids do not treat diabetic neuropathy, and levodopa is used for Parkinson's
disease.
