Page 1 of 66
NBCE PART 3 VIGNETTES 2025-2026 REAL EXAM QUESTIONS
AND CORRECT DETAILED ANSWERS
TERMS IN THIS SET (60) Q & A
>> A 23-year-old female woke up this morning with neck pain and stiffness. She rates her
pain as being 7/10. On examination her head is tilted to one side, Cervical compression and
distraction produce local pain. Kernig's and Brudzinski tests are negative. Muscle and sensory
tests are all normal. Right lateral flexion and left rotation are significantly restricted.
Which three diagnoses might be present in this patient?
Paraspinal muscle contraction
Sprained neck
Torticollis
Cervical disc
Rheumatoid arthritis
Sternocleidomastoid spasm
Trapezius spasm
Meningitis
, Page 2 of 66
Spinous fracture
- answer- Torticollis
Sternocleidomastoid spasm
Trapezius spasm
>> A 23-year-old female woke up this morning with neck pain and stiffness. She rates her
pain as being 7/10. On examination her head is tilted to one side, Cervical compression and
distraction produce local pain. Kernig's and Brudzinski tests are negative. Muscle and sensory
tests are all normal. Right lateral flexion and left rotation are significantly restricted.
Which should NOT be included in the management plan for this patient?
Heat for Pain
Ice for Pain
Spray and Stretch
Adjust
AROM exercises
Trigger Point
, Page 3 of 66
Cervical Fusion
Hard Cervical Collar
Soft Cervical Collar
- answer- Heat for Pain
Cervical Fusion
Hard Cervical Collar
>> A 23-year-old female woke up this morning with neck pain and stiffness. She rates her
pain as being 7/10. On examination her head is tilted to one side, Cervical compression and
distraction produce local pain. Kernig's and Brudzinski tests are negative. Muscle and sensory
tests are all normal. Right lateral flexion and left rotation are significantly restricted.
Which additional instructions should be given to this patient to perform at home?
Continue to wear soft collar
Isotonic strengthening exercises
TENS unit for pain
Continue to wear hard collar
Massage the sore muscles
, Page 4 of 66
Cold packs for the pain
ROM exercises to patient's tolerance
NSAIDs if needed
Thermotherapy
- answer- Massage the sore muscles
Cold packs for the pain
ROM exercises to patient's tolerance
>> A 31-year-old female presents with severe neck pain and weakness in the upper
extremities following a MVA. She is unable to perceive pain in the region of her shoulders
when tested with the pinwheel. Jackson's and Shoulder depression tests are positive.
Which are the most likely diagnoses?
Osteoporotic fracture
Clay shoveler's fracture
Anterior spinal artery syndrome
Facet dislocation
NBCE PART 3 VIGNETTES 2025-2026 REAL EXAM QUESTIONS
AND CORRECT DETAILED ANSWERS
TERMS IN THIS SET (60) Q & A
>> A 23-year-old female woke up this morning with neck pain and stiffness. She rates her
pain as being 7/10. On examination her head is tilted to one side, Cervical compression and
distraction produce local pain. Kernig's and Brudzinski tests are negative. Muscle and sensory
tests are all normal. Right lateral flexion and left rotation are significantly restricted.
Which three diagnoses might be present in this patient?
Paraspinal muscle contraction
Sprained neck
Torticollis
Cervical disc
Rheumatoid arthritis
Sternocleidomastoid spasm
Trapezius spasm
Meningitis
, Page 2 of 66
Spinous fracture
- answer- Torticollis
Sternocleidomastoid spasm
Trapezius spasm
>> A 23-year-old female woke up this morning with neck pain and stiffness. She rates her
pain as being 7/10. On examination her head is tilted to one side, Cervical compression and
distraction produce local pain. Kernig's and Brudzinski tests are negative. Muscle and sensory
tests are all normal. Right lateral flexion and left rotation are significantly restricted.
Which should NOT be included in the management plan for this patient?
Heat for Pain
Ice for Pain
Spray and Stretch
Adjust
AROM exercises
Trigger Point
, Page 3 of 66
Cervical Fusion
Hard Cervical Collar
Soft Cervical Collar
- answer- Heat for Pain
Cervical Fusion
Hard Cervical Collar
>> A 23-year-old female woke up this morning with neck pain and stiffness. She rates her
pain as being 7/10. On examination her head is tilted to one side, Cervical compression and
distraction produce local pain. Kernig's and Brudzinski tests are negative. Muscle and sensory
tests are all normal. Right lateral flexion and left rotation are significantly restricted.
Which additional instructions should be given to this patient to perform at home?
Continue to wear soft collar
Isotonic strengthening exercises
TENS unit for pain
Continue to wear hard collar
Massage the sore muscles
, Page 4 of 66
Cold packs for the pain
ROM exercises to patient's tolerance
NSAIDs if needed
Thermotherapy
- answer- Massage the sore muscles
Cold packs for the pain
ROM exercises to patient's tolerance
>> A 31-year-old female presents with severe neck pain and weakness in the upper
extremities following a MVA. She is unable to perceive pain in the region of her shoulders
when tested with the pinwheel. Jackson's and Shoulder depression tests are positive.
Which are the most likely diagnoses?
Osteoporotic fracture
Clay shoveler's fracture
Anterior spinal artery syndrome
Facet dislocation
