ADVANCED PHYSICAL ASSESSMENT NR 509 WEEK 1-4
MIDTERM EXAM / NR509 ADVANCED PHYSICAL
ASSESSMENT MIDTERM WEEK 1-4 LATEST ACTUAL
EXAM REAL QUESTIONS AND CORRECT DETAILED
ANSWERS (CORRECT VERIFIED ANSWERS) A NEW
UPDATED VERSION |ALREADY GRADED A+
Secondary headache - ANSWER: Caused by underlying structural, systemic, or
infectious processes (infection, bleed, tumor, medication)
Tension headaches - ANSWER: Location: Bilateral
Characteristics: pressure or tightness which waxes and wanes
Pt appearance: Pt may remain active or may need to rest; squeezing tightening same
time every day
Duration: Variable
No associated symptoms
Acute Glaucoma - ANSWER: Headache related to eye disorder
- Sudden increase in intraocular pressure
- Pain in and around one eye
- Steady aching often severe
- Onset is rapid
- Associated with diminished vision
Central vertigo - ANSWER: Separate from peripheral vertigo
- Onset: often sudden
- Duration: Variable
- Hearing: not affected
- Tinnitus: Absent
- Associated features: Brainstem deficits (neuromuscular exam abnormal)
Primary headaches - ANSWER: Tension, migrane, cluster, general headache
Signs of a worrisome headache - ANSWER: SNOOPS
S - systemic symptoms (fever, wt loss)
N - neurologic symptoms or abnormals signs such as confusion, impaired
alertness/conciousness
O - onset sudden, abrupt, split second
O - Older, new onset or progressive headache, especially in patients > 50 (giant cell
arteritis)
P - previous headache history, first or new headache, change in attack, frequency, or
severity
, Migraine headaches - ANSWER: Location: unilateral in 60-70%, bilateral or global in
30%
Characteristics: gradual in onset, crescendo pattern, pulsating, throbbing, moderate
or severe intensity, aggravated by routine physical activity
Pt appearance: Pt prefers rest in a dark, quiet, room
Duration: 4-72 hours
Associated symptoms: N/V, photophobia, phonophobia, visual aura, may cause
speech or motor deficits
Cluster headache - ANSWER: Location: always unilateral, usually begins around eye
or temple
Characteristics: pain begins quickly, reaches a crescendo within minutes, pain is
deep, continuous, excruciating and explosive
Patient appearance: Patient remains active
Duration: 30 min to 3 hours
Associated symptoms: Ipsilateral lacrimation and redness of eye; stuffy nose,
rhinnorhea, pallor, sweating, Horner's syndrome, focal neurologic symptoms rare,
sensitivity to alcohol; temporal, orbital, rapid
Migraine criteria - ANSWER: 1st (need at least 2): Severe, UniLateral, Throbbing,
Activity worsens headache
2nd (need 1): Nausea, Sensitivity to light/sound
Mild traumatic brain injury/Concussion - ANSWER: Head Trauma
- Headache can present immediately, hours, days or weeks later
- Related to the cellular metabolic cascade that occurs right after an injury coupled
with the diminished energy supply
- Headache intensifies with increased mental or physical exertion
- Usually resolves within 10-14 days in adults but can last months to years
- Associated with cognitive impairment
Chronic Subdural Hematoma - ANSWER: Head trauma
- Caused by bleeding into the subdural space after trauma
Variable in location
Steady, aching
Gradual onset weeks to months after injury or Progressively severe but may be
obscured by clouded consciousness
Associated with changes in personality, hemiparesis.
Injury is often forgotten
Vertigo (General) - ANSWER: - Feels like the room is spinning but you are actually still
- Usually caused by a peripheral vestibular dysfunction (40%)
- Or caused by central brain lesion (10%), MS, TIA, Tumor, migrane
Presyncope (lightheadedness) - ANSWER: - Complain of feeling faint or lightheaded
- Cause: orthostatic hypotension, arrhythmias, vasovagal attack
MIDTERM EXAM / NR509 ADVANCED PHYSICAL
ASSESSMENT MIDTERM WEEK 1-4 LATEST ACTUAL
EXAM REAL QUESTIONS AND CORRECT DETAILED
ANSWERS (CORRECT VERIFIED ANSWERS) A NEW
UPDATED VERSION |ALREADY GRADED A+
Secondary headache - ANSWER: Caused by underlying structural, systemic, or
infectious processes (infection, bleed, tumor, medication)
Tension headaches - ANSWER: Location: Bilateral
Characteristics: pressure or tightness which waxes and wanes
Pt appearance: Pt may remain active or may need to rest; squeezing tightening same
time every day
Duration: Variable
No associated symptoms
Acute Glaucoma - ANSWER: Headache related to eye disorder
- Sudden increase in intraocular pressure
- Pain in and around one eye
- Steady aching often severe
- Onset is rapid
- Associated with diminished vision
Central vertigo - ANSWER: Separate from peripheral vertigo
- Onset: often sudden
- Duration: Variable
- Hearing: not affected
- Tinnitus: Absent
- Associated features: Brainstem deficits (neuromuscular exam abnormal)
Primary headaches - ANSWER: Tension, migrane, cluster, general headache
Signs of a worrisome headache - ANSWER: SNOOPS
S - systemic symptoms (fever, wt loss)
N - neurologic symptoms or abnormals signs such as confusion, impaired
alertness/conciousness
O - onset sudden, abrupt, split second
O - Older, new onset or progressive headache, especially in patients > 50 (giant cell
arteritis)
P - previous headache history, first or new headache, change in attack, frequency, or
severity
, Migraine headaches - ANSWER: Location: unilateral in 60-70%, bilateral or global in
30%
Characteristics: gradual in onset, crescendo pattern, pulsating, throbbing, moderate
or severe intensity, aggravated by routine physical activity
Pt appearance: Pt prefers rest in a dark, quiet, room
Duration: 4-72 hours
Associated symptoms: N/V, photophobia, phonophobia, visual aura, may cause
speech or motor deficits
Cluster headache - ANSWER: Location: always unilateral, usually begins around eye
or temple
Characteristics: pain begins quickly, reaches a crescendo within minutes, pain is
deep, continuous, excruciating and explosive
Patient appearance: Patient remains active
Duration: 30 min to 3 hours
Associated symptoms: Ipsilateral lacrimation and redness of eye; stuffy nose,
rhinnorhea, pallor, sweating, Horner's syndrome, focal neurologic symptoms rare,
sensitivity to alcohol; temporal, orbital, rapid
Migraine criteria - ANSWER: 1st (need at least 2): Severe, UniLateral, Throbbing,
Activity worsens headache
2nd (need 1): Nausea, Sensitivity to light/sound
Mild traumatic brain injury/Concussion - ANSWER: Head Trauma
- Headache can present immediately, hours, days or weeks later
- Related to the cellular metabolic cascade that occurs right after an injury coupled
with the diminished energy supply
- Headache intensifies with increased mental or physical exertion
- Usually resolves within 10-14 days in adults but can last months to years
- Associated with cognitive impairment
Chronic Subdural Hematoma - ANSWER: Head trauma
- Caused by bleeding into the subdural space after trauma
Variable in location
Steady, aching
Gradual onset weeks to months after injury or Progressively severe but may be
obscured by clouded consciousness
Associated with changes in personality, hemiparesis.
Injury is often forgotten
Vertigo (General) - ANSWER: - Feels like the room is spinning but you are actually still
- Usually caused by a peripheral vestibular dysfunction (40%)
- Or caused by central brain lesion (10%), MS, TIA, Tumor, migrane
Presyncope (lightheadedness) - ANSWER: - Complain of feeling faint or lightheaded
- Cause: orthostatic hypotension, arrhythmias, vasovagal attack
