NBCE PART 3 EXAM LATEST 2024 ACTUAL EXAM QUESTIONS
AND CORRECT DETAILED ANSWERS
*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
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
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
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
Hangman's fracture
Posterior spinal artery syndrome
Unstable fracture
Whiplash associated disorder
Stable fracture - ANSWER: Anterior spinal artery syndrome
Unstable fracture
Whiplash associated disorder
*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.*
*What additional findings are most likely to be present in this patient?*
Numbness in both hands
Shoulder weakness
Decreased C7 tendon reflex
Headache
Pain with head movement
, Weak ankle flexors
Lower extremity flaccid paralysis
Weak wrist extensors
Inability to recognize temperature in the hands - ANSWER: Shoulder weakness
Pain with head movement
Inability to recognize temperature in the hands
*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 should be included in the management of this patient?*
Hot packs
Full Davis series of x-ray
Soft collar
Hard collar
Surgical consultation
Adjust the cervical spine
Prolotherapy
Spray & stretch
Refer to the ER - ANSWER: Hard collar
Surgical consultation
Refer to the ER
*A 35-year-old mechanic complains of low back pain which started when he lifted a
barrel of hay. The pain is better when he lies on his stomach with ice on his back. The
pain radiates to the dorsum of the left foot. There is decreased sensation over the
dorsum of the left foot and the Bechterew's test is positive.*
*Which structures are likely to be affected?*
AND CORRECT DETAILED ANSWERS
*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
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
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
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
Hangman's fracture
Posterior spinal artery syndrome
Unstable fracture
Whiplash associated disorder
Stable fracture - ANSWER: Anterior spinal artery syndrome
Unstable fracture
Whiplash associated disorder
*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.*
*What additional findings are most likely to be present in this patient?*
Numbness in both hands
Shoulder weakness
Decreased C7 tendon reflex
Headache
Pain with head movement
, Weak ankle flexors
Lower extremity flaccid paralysis
Weak wrist extensors
Inability to recognize temperature in the hands - ANSWER: Shoulder weakness
Pain with head movement
Inability to recognize temperature in the hands
*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 should be included in the management of this patient?*
Hot packs
Full Davis series of x-ray
Soft collar
Hard collar
Surgical consultation
Adjust the cervical spine
Prolotherapy
Spray & stretch
Refer to the ER - ANSWER: Hard collar
Surgical consultation
Refer to the ER
*A 35-year-old mechanic complains of low back pain which started when he lifted a
barrel of hay. The pain is better when he lies on his stomach with ice on his back. The
pain radiates to the dorsum of the left foot. There is decreased sensation over the
dorsum of the left foot and the Bechterew's test is positive.*
*Which structures are likely to be affected?*
