NR509 Final Exam 88 QUESTIONS AND ANSWERS

NR509 Final Exam 88 QUESTIONS AND ANSWERS
A 35-year-old female with a history of migraines presents to the
clinic with worsening symptoms for the past few weeks. She
reports waking up at night with headaches and nausea. Her only
medication history is oral contraceptive pills (OCPs). Otherwise,
she states she is healthy. Which of the following actions if taken
by the NP is the best next step?
Options:
a) Order a brain MRI immediately
b) Prescribe a triptan for acute migraine relief
c) Take a further history and perform a very careful neurological
exam
d) Recommend discontinuing OCPs and follow up in 1 month
ANSWER: c) Take a further history and perform a very careful
neurological exam
Correct; worsening headaches with nocturnal symptoms and
OCP use (a stroke risk factor) necessitate a detailed history and
neurological exam to rule out serious causes (e.g., stroke, tumor)
before imaging or treatment changes.
---
A grandmother is accompanying her 9-year-old granddaughter
during a routine physical examination. She asks you privately if
her granddaughter has started puberty yet. During the 

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