NR 603 WEEK 1 |2025| complete exam test questions and verified answers (MULTIPLE CHOICES) AND RATIONALES REAL EXAM QUESTIONS & VERIFIED ANSWERS - PASS FIRST ATTEMPT GUARANTEED UPDATED QUESTIONS AND 100% ACCURATE ANSWERS | HIGH-LEVEL EXIT EXAM

. Complex Regional Pain Syndrome (CRPS) Question: A 40-year-old woman develops burning, throbbing pain, swelling, and marked sensitivity to touch in her right arm 2 months after a Colles’ fracture. What is the most appropriate initial treatment? Options: 1. Acetaminophen 2. Naproxen (Naprosyn) 3. Acyclovir 4. Colchicine 5. Cephalexin Correct Answer: 2. Naproxen (Naprosyn) Rationale: The patient has early-stage Complex Regional Pain Syndrome (CRPS type I) following trauma. CRPS presents with burning pain, allodynia, swelling, and vasomotor changes. First-line treatment in early disease includes NSAIDs (e.g., naproxen) and physical therapy. More severe cases may require steroids, gabapentin, or bisphosphonates. Antibiotics and antivirals are not indicated. 2. Duchenne Muscular Dystrophy Diagnosis Question: A 5-year-old boy presents with progressive waddling gait, calf pseudohypertrophy, and a positive Gower sign. What test is most diagnostic? Options: 1. Aldolase level 2. Creatine kinase level 3. Electromyography 4. Nerve conduction studies 5. Muscle biopsy Correct Answer: 5. Muscle biopsy Rationale: Findings suggest Duchenne muscular dystrophy (X-linked dystrophin mutation). While CK and aldolase are elevated, they are nonspecific. Muscle biopsy confirms diagnosis by showing muscle fiber degeneration with fatty replacement. 3. Essential Tremor Treatment Question: A woman with bilateral action tremor improves with alcohol and has a family history of tremor. What is the best treatment? Options: 1. Carbidopa/levodopa 2. Propranolol 3. Methylphenidate 4. Physical therapy 5. Diazepam Correct Answer: 2. Propranolol Rationale: This is essential tremor, characterized by action tremor improved by alcohol and familial pattern. First-line treatment is propranolol or primidone. Parkinson disease drugs (levodopa) are not indicated. 4. Sumatriptan for Migraine Question: Which statement about sumatriptan is correct? Options: 1. It is a serotonin antagonist 2. Main side effect is irritability 3. Oral dose is 6 mg 4. Used for prophylaxis 5. If effective initially, it often works for recurrence Correct Answer: 5. If effective initially, it often works for recurrence Rationale: Sumatriptan is a 5-HT1B/1D agonist used for acute migraine treatment only. It is not prophylactic. It has a 6 mg subcutaneous dose, and recurrence of headache may still respond to repeat dosing. 5. Amaurosis Fugax (TIA) Question: A man has transient right eye blindness (“curtain falling”) lasting 10 minutes. What is the diagnosis? Options: 1. Right ICA TIA 2. Basilar artery TIA 3. Left PCA TIA 4. Left ICA TIA 5. Ophthalmic migraine Correct Answer: 1. Right ICA TIA Rationale: Transient monocular blindness (amaurosis fugax) is due to ipsilateral internal carotid artery stenosis causing retinal ischemia. 6. Treatment of Primary Generalized Seizures Question: What is the best treatment for primary generalized seizures? Options: 1. Phenytoin 2. Phenobarbital 3. Valproic acid 4. Carbamazepine 5. Gabapentin Correct Answer: 3. Valproic acid Rationale: Primary generalized seizures (tonic-clonic, absence, myoclonic) are best treated with valproic acid, which is broad-spectrum and effective for generalized epilepsies. 7. Myasthenia Gravis Receptor Structure Question: What is the subunit ratio of the nicotinic acetylcholine receptor? Options: 1. 2:1:1:1 2. 3:1:1:1 3. 4:1:1:1 4. 5:1:1:1 5. 6:1:1:1 Correct Answer: 1. 2:1:1:1 Rationale: The nicotinic acetylcholine receptor consists of 5 subunits (2 alpha, 1 beta, 1 gamma, 1 delta) in a 2:1:1:1 ratio forming an ion channel. 8. Cluster Headache Diagnosis Question: A man has unilateral severe orbital pain with lacrimation, nasal congestion, and restlessness lasting 30–90 minutes. Diagnosis? Options: 1. Migraine 2. Tension headache 3. Cluster headache 4. Sinus headache 5. Temporal arteritis Correct Answer: 3. Cluster headache Rationale: Cluster headaches are trigeminal autonomic cephalalgias characterized by severe unilateral orbital pain with autonomic symptoms and restlessness. 9. Sumatriptan Mechanism Question: What is the correct mechanism of sumatriptan? Options: 1. Serotonin antagonist 2. Dopamine agonist 3. Beta blocker 4. Triptan causes cranial vasodilation 5. Triptans are 5-HT1 agonists causing vasoconstriction Correct Answer: 5. Triptans are 5-HT1 agonists causing vasoconstriction Rationale: Triptans are 5-HT1B/1D agonists, producing cranial vasoconstriction and reduced trigeminal inflammation. 10. Carotid TIA Workup Question: A patient with transient monocular vision loss should first undergo which test? Options: 1. MRI brain 2. EEG 3. Carotid ultrasound 4. CT brain 5. ESR Correct Answer: 3. Carotid ultrasound Rationale: Amaurosis fugax is most commonly due to carotid artery stenosis, so carotid duplex ultrasound is the best initial diagnostic test. 11. Post-Concussion Syndrome Question: A teenager has headaches, dizziness, and difficulty concentrating weeks after a mild head injury. Diagnosis? Options: 1. Traumatic brain injury 2. Depression Seizure disorder Post-concussion syndrome Subdural hematoma Correct Answer: 4. Post-concussion syndrome Rationale: Symptoms after head injury with normal imaging and exam are consistent with post-concussion syndrome, including headache, dizziness, and cognitive difficulty. 12. Epidural Hematoma Diagnosis Question: A patient with trauma, coma, and fixed dilated pupil requires what diagnostic test? Options: 1. MRI brain 2. Lumbar puncture 3. Burr hole 4. CT brain 5. Observation Correct Answer: 4. CT brain Rationale: Suspected epidural hematoma (lucid interval + herniation signs) requires immediate noncontrast CT brain for diagnosis.