A 30 year-old patient with no significant past medical history presents to the primary clinic with complaints of episodic headaches. The patient describes the headaches as non-throbbing, moderate in intensity, and located on both the left and right side of their forehead. Which type of headache is most likely based on the description of symptoms?
Cluster headaches
Migraine headaches
Tension headaches
Secondary headaches
The Correct Answer is C
A. Cluster headaches is incorrect because cluster headaches typically cause severe, unilateral pain, usually around the eye or temporal region, rather than across both sides of the forehead. They are often described as sharp, piercing, or burning, and are commonly associated with autonomic symptoms such as tearing, nasal congestion, eyelid drooping, or facial sweating. The pain occurs in recurrent clusters, often at the same time each day. The patient’s symptoms of bilateral, moderate, non-throbbing pain do not match this pattern.
B. Migraine headaches is incorrect because migraines are usually unilateral and throbbing or pulsating in nature, often described as moderate to severe pain that worsens with activity. Migraines are commonly associated with nausea, vomiting, photophobia, phonophobia, and sometimes aura. The patient’s headache is described as non-throbbing and bilateral, which is inconsistent with typical migraine characteristics.
C. Tension headaches is correct because tension-type headaches are the most common primary headache disorder and are characterized by bilateral, non-throbbing pain that is typically mild to moderate in intensity. Patients often describe the sensation as tightness or pressure across the forehead or around the head, sometimes described as a band-like sensation. These headaches usually lack associated symptoms such as nausea or visual disturbances and often occur with stress, fatigue, or muscle tension. The patient’s description of moderate, non-throbbing pain affecting both sides of the forehead is classic for a tension headache.
D. Secondary headaches is incorrect because secondary headaches occur due to an underlying medical condition, such as infection, trauma, tumors, vascular disorders, or medication effects. The scenario describes a patient with no significant medical history and typical primary headache features, making a primary headache disorder more likely than a secondary cause.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Whisper pectoriloquy is incorrect because this test involves asking the patient to whisper a phrase, such as “one-two-three,” while auscultating the lungs. In whispered pectoriloquy, increased clarity or loudness of the whispered sound suggests consolidation, but it does not involve the characteristic “E” to “A” change.
B. Egophony is correct because egophony is a change in the quality of the voice sound when auscultating the lungs. Normally, when a patient says “E,” it should sound like “E” through the stethoscope. In areas of lung consolidation, such as in pneumonia, the sound is transmitted differently, and “E” is heard as an “A,” which is a classic sign of alveolar consolidation.
C. Fremitus is incorrect because tactile fremitus is assessed by palpating the chest while the patient repeats a phrase like “ninety-nine.” Increased fremitus can indicate consolidation, but it is palpated, not auscultated, and does not involve hearing the “E” to “A” change.
D. Bronchophony is incorrect because bronchophony involves asking the patient to say a phrase in a normal voice, such as “ninety-nine,” and auscultating for increased clarity or loudness. While both bronchophony and egophony indicate consolidation, egophony is specifically the “E” to “A” change, which is a classic sign of pneumonia.
Correct Answer is A
Explanation
A. Wernicke aphasia is correct because it is characterized by fluent, rapid speech that is often nonsensical, includes neologisms (invented words), and the patient demonstrates impaired comprehension of both spoken and written language. The patient cannot follow simple commands or understand questions, which is consistent with a receptive language deficit caused by damage to Wernicke’s area in the posterior superior temporal gyrus of the dominant hemisphere (usually the left).
B. Dysphonia is incorrect because it refers to disorders of vocal quality, pitch, or volume, typically due to laryngeal or vocal cord pathology. Dysphonia affects speech production but does not impair language comprehension or content.
C. Dysarthria is incorrect because it refers to impaired articulation of speech due to motor deficits (e.g., weakness, incoordination, or paralysis of the speech muscles). Dysarthric speech is often slurred, slow, or effortful, but comprehension is preserved, unlike in Wernicke aphasia.
D. Broca aphasia is incorrect because it involves nonfluent, effortful speech with relatively preserved comprehension. Patients often speak in short, broken phrases and omit small words (agrammatism), which is the opposite of the fluent but meaningless speech described in this patient.
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