NUR 5461 Module 4 Quiz – Advanced
Pathophysiology – (2026) Actual Questions &
Answers (William Paterson University)
Question 1
A 23-year-old reports bilateral pain with a sensation of a tight band around the
head. Which type of headache fits this description?
A) Migraine with aura
B) Migraine without aura
C) Tension headache
D) Cluster headache
Correct Answer: C
Rationale: A tension-type headache is characterized by bilateral, band-like, or
“vice-like” sensation around the head, with mild to moderate pain.
Question 2
A patient is experiencing a headache. Which of the following is NOT a possible
cause of this type of headache?
A) Stress
B) Dehydration
C) Sinusitis
D) Migraine
Correct Answer: D
Rationale: Migraine is a primary headache disorder, not a cause of another
headache type.)
Question 3
When do migraines occur most frequently in women of reproductive age?
A) During sleep
B) Before and during menses
,C) After meals
D) During exercise
Correct Answer: B
Rationale: Migraines occur most frequently before and during menstruation due to
estrogen withdrawal, a well-established trigger.
Question 4
An electroencephalogram (EEG) can be used to confirm a diagnosis of which
condition?
A) Tension headache
B) Cluster headache
C) Migraine headache
D) Seizure disorder
Correct Answer: D
Rationale: EEG records electrical activity in the brain and is particularly useful for
diagnosing seizure disorders (epilepsy) by identifying abnormal patterns.
Question 5
A patient presents with recurrent, severe unilateral headaches accompanied by
ipsilateral lacrimation, nasal congestion, and ptosis. Each episode lasts 15-30
minutes and occurs at the same time of day for several weeks. This describes:
A) Migraine with aura
B) Tension headache
C) Cluster headache
D) Medication overuse headache
Correct Answer: C
Rationale: Cluster headaches are strictly unilateral, associated with autonomic
symptoms (lacrimation, rhinorrhea, ptosis), are short-lasting (15-180 min), and
occur in clusters.
Question 6
,Which of the following is a characteristic of a migraine with aura?
A) Bilateral, band-like pressure
B) Gradual onset of visual disturbances (flashing lights, scotoma) followed by
headache
C) Headache that occurs only at night
D) Absence of any prodromal symptoms
Correct Answer: B
Rationale: Migraine with aura includes fully reversible visual, sensory, or speech
symptoms that typically precede the headache phase.
Question 7
The pathophysiology of tension-type headaches is most closely related to:
A) Cortical spreading depression
B) Vasodilation of cerebral arteries
C) Activation of peripheral and central pain pathways, often associated with
pericranial muscle tenderness
D) Autonomic dysregulation in the hypothalamus
Correct Answer: C
Rationale: Tension headaches involve increased pericranial muscle tension and
sensitization of central pain pathways, not cortical spreading depression (migraine)
or hypothalamic activation (cluster).
Question 8
A patient reports a “thunderclap” headache that reached maximum intensity within
seconds. This type of headache warrants immediate evaluation for:
A) Subarachnoid hemorrhage
B) Migraine with aura
C) Cluster headache
D) Tension headache
Correct Answer: A
Rationale: Thunderclap headache (sudden, severe) is a red flag for subarachnoid
hemorrhage, sentinel bleed, or reversible cerebral vasoconstriction syndrome.
, Question 9
Which statement about the trigeminal autonomic cephalalgias (TACs) is correct?
A) They always present with bilateral symptoms
B) They include cluster headache, paroxysmal hemicrania, and SUNCT
C) They are not responsive to indomethacin
D) They occur exclusively in men
Correct Answer: B
Rationale: TACs include cluster headache, paroxysmal hemicrania, SUNCT
(short-lasting unilateral neuralgiform headache with conjunctival injection and
tearing), and hemicrania continua. Paroxysmal hemicrania is
indomethacin-responsive.
Question 10
Indomethacin is the treatment of choice for which headache disorder?
A) Migraine
B) Cluster headache
C) Paroxysmal hemicrania
D) Tension headache
Correct Answer: C
Rationale: Paroxysmal hemicrania is characterized by multiple short-lasting
attacks and shows an absolute response to indomethacin.
Question 11
A 45-year-old presents with a new daily persistent headache that started abruptly
three weeks ago and has been constant since. There is no autonomic feature or
aura. Which diagnosis is most likely?
A) Chronic migraine
B) New daily persistent headache (NDPH)
C) Hemicrania continua
D) Cluster headache
Pathophysiology – (2026) Actual Questions &
Answers (William Paterson University)
Question 1
A 23-year-old reports bilateral pain with a sensation of a tight band around the
head. Which type of headache fits this description?
A) Migraine with aura
B) Migraine without aura
C) Tension headache
D) Cluster headache
Correct Answer: C
Rationale: A tension-type headache is characterized by bilateral, band-like, or
“vice-like” sensation around the head, with mild to moderate pain.
Question 2
A patient is experiencing a headache. Which of the following is NOT a possible
cause of this type of headache?
A) Stress
B) Dehydration
C) Sinusitis
D) Migraine
Correct Answer: D
Rationale: Migraine is a primary headache disorder, not a cause of another
headache type.)
Question 3
When do migraines occur most frequently in women of reproductive age?
A) During sleep
B) Before and during menses
,C) After meals
D) During exercise
Correct Answer: B
Rationale: Migraines occur most frequently before and during menstruation due to
estrogen withdrawal, a well-established trigger.
Question 4
An electroencephalogram (EEG) can be used to confirm a diagnosis of which
condition?
A) Tension headache
B) Cluster headache
C) Migraine headache
D) Seizure disorder
Correct Answer: D
Rationale: EEG records electrical activity in the brain and is particularly useful for
diagnosing seizure disorders (epilepsy) by identifying abnormal patterns.
Question 5
A patient presents with recurrent, severe unilateral headaches accompanied by
ipsilateral lacrimation, nasal congestion, and ptosis. Each episode lasts 15-30
minutes and occurs at the same time of day for several weeks. This describes:
A) Migraine with aura
B) Tension headache
C) Cluster headache
D) Medication overuse headache
Correct Answer: C
Rationale: Cluster headaches are strictly unilateral, associated with autonomic
symptoms (lacrimation, rhinorrhea, ptosis), are short-lasting (15-180 min), and
occur in clusters.
Question 6
,Which of the following is a characteristic of a migraine with aura?
A) Bilateral, band-like pressure
B) Gradual onset of visual disturbances (flashing lights, scotoma) followed by
headache
C) Headache that occurs only at night
D) Absence of any prodromal symptoms
Correct Answer: B
Rationale: Migraine with aura includes fully reversible visual, sensory, or speech
symptoms that typically precede the headache phase.
Question 7
The pathophysiology of tension-type headaches is most closely related to:
A) Cortical spreading depression
B) Vasodilation of cerebral arteries
C) Activation of peripheral and central pain pathways, often associated with
pericranial muscle tenderness
D) Autonomic dysregulation in the hypothalamus
Correct Answer: C
Rationale: Tension headaches involve increased pericranial muscle tension and
sensitization of central pain pathways, not cortical spreading depression (migraine)
or hypothalamic activation (cluster).
Question 8
A patient reports a “thunderclap” headache that reached maximum intensity within
seconds. This type of headache warrants immediate evaluation for:
A) Subarachnoid hemorrhage
B) Migraine with aura
C) Cluster headache
D) Tension headache
Correct Answer: A
Rationale: Thunderclap headache (sudden, severe) is a red flag for subarachnoid
hemorrhage, sentinel bleed, or reversible cerebral vasoconstriction syndrome.
, Question 9
Which statement about the trigeminal autonomic cephalalgias (TACs) is correct?
A) They always present with bilateral symptoms
B) They include cluster headache, paroxysmal hemicrania, and SUNCT
C) They are not responsive to indomethacin
D) They occur exclusively in men
Correct Answer: B
Rationale: TACs include cluster headache, paroxysmal hemicrania, SUNCT
(short-lasting unilateral neuralgiform headache with conjunctival injection and
tearing), and hemicrania continua. Paroxysmal hemicrania is
indomethacin-responsive.
Question 10
Indomethacin is the treatment of choice for which headache disorder?
A) Migraine
B) Cluster headache
C) Paroxysmal hemicrania
D) Tension headache
Correct Answer: C
Rationale: Paroxysmal hemicrania is characterized by multiple short-lasting
attacks and shows an absolute response to indomethacin.
Question 11
A 45-year-old presents with a new daily persistent headache that started abruptly
three weeks ago and has been constant since. There is no autonomic feature or
aura. Which diagnosis is most likely?
A) Chronic migraine
B) New daily persistent headache (NDPH)
C) Hemicrania continua
D) Cluster headache
