Written after an NU566 Unit 5 seminar split over scanning one composite adult's tension-type headaches, this reflection traces its author's move from imaging to a diary and a return date. Searches like "nu 566 unit 5 assignment example", "nu566 unit 5 sample" and "nu566 unit 5 example" land here.
I Came In Wanting the Scan: A Reflection on Defending a Plan That Orders Nothing for Pressing Headaches
[Student Name]
Purdue University Global
NU566: NP I - Introduction to Primary Care for the Nurse Practitioner
Unit 5 Seminar Reflection
[Instructor Name]
[Date]
The patient is a composite used in the seminar; no real person is described.
The Case
Ms. [J.], 31, is a paralegal. For two months she has had headaches about four days a month, a band-like pressure on both sides of her head, without aura or nausea, worse after long days at her desk and eased by rest. They never wake her. Her fundi and neurological examination are normal. She is worried because a coworker's sister was recently found to have a brain tumor.
Where I Started
I arrived convinced a CT scan was prudent. My reasoning felt kind: a normal image would settle her worry, and a scan is quick. I also admit to a second reason I did not say aloud. If something were ever found, I wanted to have looked.
The Counterargument
A classmate who had worked in radiology put the other side plainly. Imaging a patient with a typical primary headache and a normal examination rarely finds a cause. In an early review of patients with headache and normal neurological examinations, significant abnormalities on imaging were uncommon (Frishberg, 1994). What imaging finds more often are incidental results. In a population study of brain MRI in adults, incidental findings such as small aneurysms, benign tumors and silent infarcts were common (Vernooij et al., 2007). Each can lead to more scans, specialist visits and anxiety, sometimes to procedures with their own risks.
A normal scan might reassure her for a week; an incidental finding might worry her for years. Another classmate added that reassurance from a test tends not to last when the symptoms continue, and that the patient may simply ask for the next test.
The Red-Flag Check
Our facilitator then asked us to run the red-flag checklist for secondary headache together, aloud, item by item. The SNNOOP10 list gathers the features that raise concern: systemic symptoms, neoplasm history, neurological deficits, sudden or thunderclap onset, onset after age 50, pattern change or new onset, positional or exertional headache, papilledema, progression, pregnancy, and headache with painful eye or post-traumatic onset, among others (Do et al., 2019). We went through each for Ms. [J.]. None was present. Her headaches were new in the sense of two months old, but they were stable, not progressive, and they fit the pattern of tension-type headache.
Our facilitator also cited the American College of Radiology's Choosing Wisely recommendation against imaging for uncomplicated headache (American College of Radiology, 2012). Studies show that neuroimaging for headache remains common despite recommendations against it, at considerable cost (Callaghan et al., 2014).
Why I Changed Sides
By the end of the session I had changed my mind, and not because I was outnumbered. The red-flag check gave me a way to decide that I could defend and document. My fear of missing something was not irrational, but a scan would not have answered it; the checklist did, and it told me when a scan would become necessary. The second reason I had not said aloud, wanting to have looked, was about protecting myself rather than helping her. A documented red-flag check, with a plan and a return visit, protects both of us better.
I also realized that her worry deserved an answer, just not a scan. Explaining why her headaches do not look like a tumor, and what would make us look, is itself a treatment for the fear.
The Plan I Would Now Document
1. Explanation: her headaches have the features of tension-type headache; none of the warning signs for a serious cause is present; imaging is not needed now.
2. A headache diary for one month: days, triggers, analgesic use.
3. Analgesic limit: [composite analgesic] on no more than [a set number of] days a month, since frequent analgesic use can itself sustain daily headache.
4. Desk ergonomics and regular breaks.
5. Return visit in [one month] with the diary.
6. Return sooner for any change: a sudden severe headache, headache waking her, new neurological symptoms, a change in pattern or progression.
What surprised me most was how much of the plan is conversation. The diary gives her a job and gives us both data. The analgesic limit prevents a common trap, since taking pain relievers on many days a month can turn occasional headaches into daily ones. And the return visit tells her that ordering nothing today is not the same as doing nothing: we are watching, on a date, with a list of what would change our minds. When I described the plan to the group in the closing minutes, a classmate who had argued for the scan said the return visit was what made her comfortable. That seemed right to me. The follow-up carries the weight the scan was supposed to carry.
I would document the red-flag check in the note, item by item, so that the reasoning behind ordering nothing is as visible as any test result.
References
American College of Radiology. (2012). Ten things physicians and patients should question. Choosing Wisely, ABIM Foundation. https://www.choosingwisely.org
Callaghan, B. C., Kerber, K. A., Pace, R. J., Skolarus, L. E., & Burke, J. F. (2014). Headaches and neuroimaging: High utilization and costs despite guidelines. JAMA Internal Medicine, 174(5), 819-821. https://doi.org/10.1001/jamainternmed.2014.173
Do, T. P., Remmers, A., Schytz, H. W., Schankin, C., Nelson, S. E., Obermann, M., Hansen, J. M., Sinclair, A. J., Gantenbein, A. R., & Schoonman, G. G. (2019). Red and orange flags for secondary headaches in clinical practice: SNNOOP10 list. Neurology, 92(3), 134-144. https://doi.org/10.1212/WNL.0000000000006697
Frishberg, B. M. (1994). The utility of neuroimaging in the evaluation of headache in patients with normal neurologic examinations. Neurology, 44(7), 1191-1197. https://doi.org/10.1212/WNL.44.7.1191
Vernooij, M. W., Ikram, M. A., Tanghe, H. L., Vincent, A. J. P. E., Hofman, A., Krestin, G. P., Niessen, W. J., Breteler, M. M. B., & van der Lugt, A. (2007). Incidental findings on brain MRI in the general population. New England Journal of Medicine, 357(18), 1821-1828. https://doi.org/10.1056/NEJMoa070972
How this NU566 Unit 5 example is structured
The piece opens with the seminar's question in one line: did this presentation need any test at all? The case follows as the group received it. Where the author stood at the start is reported honestly, because the reflection turns on why the reassurance argument weakened. The central section sets each red flag against the case and finds it absent, then weighs the counterweight: an incidental finding can create more worry and more testing than it resolves. One short paragraph gives the opposing view its due, attributed to a peer rather than a name. The plan paragraph describes the revised documentation, in which a diary and a booked return take over the job a scan was meant to do. It closes by stating when the author would still order imaging, so the new position has a limit.
Get an NU566 Unit 5 example written to your instructions
Send what your Unit 5 seminar debated, or, if you missed it, the prompt for the written option, along with the NU566 grading rubric. A first reflection is prepared at no cost within 24-48h, stating where you started on the testing question, what moved you, and the plan you would now document. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
NU566 Unit 5 questions, answered
Is it a problem to admit I changed my mind?
Usually the opposite. A reflection exists to record how thinking developed, and a clearly explained change shows exactly that. Set out the belief you started with, the argument that shifted it, and the position you reached. The only weak version is a change with no reason attached, which reads as agreeing with whoever spoke last.
Should the reflection include guideline citations?
One or two, attached to the specific claims that need them. A recommendation against imaging uncomplicated headache, or a red-flag framework for secondary causes, supports the testing argument directly. Skip long background; the piece reflects on one session and does not survey the field. Use sources to anchor the turning points, not to fill space.
What if the seminar never reached agreement?
Say so and state your own conclusion. Seminars often end with the group still divided, and a reflection that reports an unresolved debate honestly, then explains which side the author finds stronger and why, meets the purpose well. Graders are assessing your reasoning, not whether the room reached consensus.