NR 603
Advanced Health Assessment Final Exam
High-yield clinical knowledge Topics Covered
Neurological & Headache Differentials
Epilepsy & Seizure Management
Pediatric Assessment & Development
Clinical Primary Care Foundations
Musculoskeletal & Radiculopathy
150 Questions and Answers
What are the classic clinical features of a migraine headache? - ANSWER-Unilateral,
throbbing or pulsatile pain lasting 4 to 72 hours, aggravated by routine physical
activity, and accompanied by nausea, vomiting, photophobia, and phonophobia.
What is a migraine aura? - ANSWER-Transient focal neurological symptoms that
precede a migraine, most commonly visual (scintillating scotomas, zigzag lines),
lasting less than 60 minutes.
What are common triggers for migraine headaches? - ANSWER-Stress, hormonal
changes (menstruation), certain foods (aged cheeses, red wine, MSG), lack of
sleep, bright lights, and weather changes.
What is first-line acute treatment for mild to moderate migraines? - ANSWER-
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, or combination
analgesics containing acetaminophen, aspirin, and caffeine.
What is the mechanism of action and primary use of triptans in migraines? -
ANSWER-Serotonin 5-HT 1B/1D agonists that cause vasoconstriction and inhibit
pro-inflammatory neuropeptide release; used for acute moderate-to-severe
migraine attacks.
What are major contraindications for prescribing triptans? - ANSWER-Ischemic
heart disease, cerebrovascular disease, uncontrolled hypertension, peripheral
vascular disease, and familial hemiplegic migraine.
What are preventative pharmacological options for chronic migraines? - ANSWER-
Beta-blockers (propranolol), tricyclic antidepressants (amitriptyline),
anticonvulsants (topiramate, divalproex sodium), and CGRP monoclonal antibodies.
What are the clinical characteristics of a cluster headache? - ANSWER-Severe,
strictly unilateral retro-orbital or temporal pain lasting 15 to 180 minutes, occurring
in daily clusters, accompanied by ipsilateral autonomic symptoms.
What ipsilateral autonomic symptoms are associated with cluster headaches? -
, ANSWER-Conjunctival injection, lacrimation, nasal congestion, rhinorrhea,
forehead/facial sweating, miosis, and ptosis (Horner syndrome).
What is the acute treatment of choice for cluster headaches? - ANSWER-High-flow
oxygen at 12 to 15 liters per minute via non-rebreather mask and subcutaneous or
intranasal sumatriptan.
What is the primary preventative medication for cluster headaches? - ANSWER-
Verapamil is the first-line prophylactic agent used to suppress cluster periods.
What are the clinical features of a tension-type headache? - ANSWER-Bilateral,
band-like tightening or pressure sensation of mild to moderate intensity, lasting
from 30 minutes to 7 days, without nausea or vomiting.
What is the mainstay acute treatment for tension-type headaches? - ANSWER-
Simple analgesics such as acetaminophen, ibuprofen, or naproxen sodium.
What is medication overuse headache (rebound headache)? - ANSWER-Headaches
occurring 15 or more days per month in patients with preexisting primary
headaches due to regular overuse of acute headache medications for more than 3
months.
What clinical red flags in headache presentation require neuroimaging? - ANSWER-
SNOOP4: Systemic symptoms/neoplasm, Neurological deficits, Onset sudden
(thunderclap), Older age onset (>50), Pattern change, Papilledema, Precipitated by
Valsalva, Positional.
What is a thunderclap headache and what is its primary differential? - ANSWER-A
severe headache reaching maximal intensity within seconds to minutes; the
primary critical differential is subarachnoid hemorrhage.
What is temporal arteritis (giant cell arteritis) and its hallmark symptoms? -
ANSWER-A systemic inflammatory vasculitis of medium and large vessels
characterized by new-onset temporal headache, jaw claudication, visual
disturbances, and scalp tenderness.
What diagnostic tests are used to evaluate suspected giant cell arteritis? -
ANSWER-Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and
temporal artery biopsy.
What is the immediate treatment for suspected giant cell arteritis to prevent
blindness? - ANSWER-High-dose systemic corticosteroids (e.g., prednisone)
initiated immediately without waiting for biopsy results.
What is a cervicogenic headache? - ANSWER-A secondary headache caused by a
disorder of the cervical spine and its component structures, typically aggravated by
neck movement or sustained postures.
Advanced Health Assessment Final Exam
High-yield clinical knowledge Topics Covered
Neurological & Headache Differentials
Epilepsy & Seizure Management
Pediatric Assessment & Development
Clinical Primary Care Foundations
Musculoskeletal & Radiculopathy
150 Questions and Answers
What are the classic clinical features of a migraine headache? - ANSWER-Unilateral,
throbbing or pulsatile pain lasting 4 to 72 hours, aggravated by routine physical
activity, and accompanied by nausea, vomiting, photophobia, and phonophobia.
What is a migraine aura? - ANSWER-Transient focal neurological symptoms that
precede a migraine, most commonly visual (scintillating scotomas, zigzag lines),
lasting less than 60 minutes.
What are common triggers for migraine headaches? - ANSWER-Stress, hormonal
changes (menstruation), certain foods (aged cheeses, red wine, MSG), lack of
sleep, bright lights, and weather changes.
What is first-line acute treatment for mild to moderate migraines? - ANSWER-
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, or combination
analgesics containing acetaminophen, aspirin, and caffeine.
What is the mechanism of action and primary use of triptans in migraines? -
ANSWER-Serotonin 5-HT 1B/1D agonists that cause vasoconstriction and inhibit
pro-inflammatory neuropeptide release; used for acute moderate-to-severe
migraine attacks.
What are major contraindications for prescribing triptans? - ANSWER-Ischemic
heart disease, cerebrovascular disease, uncontrolled hypertension, peripheral
vascular disease, and familial hemiplegic migraine.
What are preventative pharmacological options for chronic migraines? - ANSWER-
Beta-blockers (propranolol), tricyclic antidepressants (amitriptyline),
anticonvulsants (topiramate, divalproex sodium), and CGRP monoclonal antibodies.
What are the clinical characteristics of a cluster headache? - ANSWER-Severe,
strictly unilateral retro-orbital or temporal pain lasting 15 to 180 minutes, occurring
in daily clusters, accompanied by ipsilateral autonomic symptoms.
What ipsilateral autonomic symptoms are associated with cluster headaches? -
, ANSWER-Conjunctival injection, lacrimation, nasal congestion, rhinorrhea,
forehead/facial sweating, miosis, and ptosis (Horner syndrome).
What is the acute treatment of choice for cluster headaches? - ANSWER-High-flow
oxygen at 12 to 15 liters per minute via non-rebreather mask and subcutaneous or
intranasal sumatriptan.
What is the primary preventative medication for cluster headaches? - ANSWER-
Verapamil is the first-line prophylactic agent used to suppress cluster periods.
What are the clinical features of a tension-type headache? - ANSWER-Bilateral,
band-like tightening or pressure sensation of mild to moderate intensity, lasting
from 30 minutes to 7 days, without nausea or vomiting.
What is the mainstay acute treatment for tension-type headaches? - ANSWER-
Simple analgesics such as acetaminophen, ibuprofen, or naproxen sodium.
What is medication overuse headache (rebound headache)? - ANSWER-Headaches
occurring 15 or more days per month in patients with preexisting primary
headaches due to regular overuse of acute headache medications for more than 3
months.
What clinical red flags in headache presentation require neuroimaging? - ANSWER-
SNOOP4: Systemic symptoms/neoplasm, Neurological deficits, Onset sudden
(thunderclap), Older age onset (>50), Pattern change, Papilledema, Precipitated by
Valsalva, Positional.
What is a thunderclap headache and what is its primary differential? - ANSWER-A
severe headache reaching maximal intensity within seconds to minutes; the
primary critical differential is subarachnoid hemorrhage.
What is temporal arteritis (giant cell arteritis) and its hallmark symptoms? -
ANSWER-A systemic inflammatory vasculitis of medium and large vessels
characterized by new-onset temporal headache, jaw claudication, visual
disturbances, and scalp tenderness.
What diagnostic tests are used to evaluate suspected giant cell arteritis? -
ANSWER-Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and
temporal artery biopsy.
What is the immediate treatment for suspected giant cell arteritis to prevent
blindness? - ANSWER-High-dose systemic corticosteroids (e.g., prednisone)
initiated immediately without waiting for biopsy results.
What is a cervicogenic headache? - ANSWER-A secondary headache caused by a
disorder of the cervical spine and its component structures, typically aggravated by
neck movement or sustained postures.
