CEA Prep Exam: 2025/ 2026 Update Full
Practice Exam The inability to fully relax the myocardium during relaxation is a trademark
of which of the following diagnoses?
Diastolic dysfunction
Rationale: The inability for the heart to relax is a trademark of the diagnosis
of diastolic dysfunction and is common in patients with thickened
The patient is exhibiting a productive cough and a low-grade fever. Chest hypertrophic myocardium.
X-ray on PA view shows a left lower chest area of consolidation adjacent to
the left border of the heart approximately 2 rib spaces above the
costophrenic angle. The lateral x-ray view shows this lesion absent of the
window posterior to the cardiac silhouette. Which is the most likely location
of this area of focal consolidation? An otherwise healthy African American adult male has been diagnosed with
*Left upper lobe apex hypertension. He has been restricting his salt intake, eating a DASH
(Dietary Approaches to Stop Hypertension) diet, and exercising more, but
*Right middle lobe
his blood pressure is still elevated. Which is the BEST medication to
*Left upper lobe lingula
prescribe him?
*Left lower lobe
Calcium channel blocker
Left upper lobe lingula
Rationale: African American patients per JNC8 Hypertension Guidelines
Ratonale: Lingular consolidation is described in this question precisely. If should be managed with a dihydropyridine calcium channel blocker such as
the cardiac margin/silhouette is obliterated by the mass, the lesion is either amlodipine (Norvasc) as first line management therapy for hypertension not
right middle lobe or left upper lobe lingula. at goal with DASH and lifestyle modifications.
pg. 1 pg. 2
, A 50-year-old woman with a history of hypertension presents with dyspnea
on exertion and orthopnea. On examination, she has jugular venous
Your patient has been diagnosed with a 4.5cm ascending aortic aneurysm.
distention and bilateral crackles on lung auscultation. What is the most
Which medical imaging is considered standard of care for serial
likely diagnosis?
surveillance?
Congestive heart failure
CT angiography of the chest
Rationale: Of the available options, the most accurate response is
Rationale: CT angiography is considered the standard of care for
congestive heart failure as it is signifying both a right ventricular back up
measuring vascular luminal dimensions with contrast. CT PE protocol is not
with jugular venous extension and crackles on lung assault, which are
timed properly for the aorta (it's timed for the pulmonary artery). Although a
suggestive of left ventricular back up. it is possible the patient may have an
plain film is able to catch large aneurysms at times, they are not able to
acute myocardial infarction that precipitated this, however, a patient has not
provide multi-axis reconstruction needed to accurately measure the size.
described that, rather is only describing dyspnea on exertion and
Transesophageal echo is not needed to accurately measure the aorta and
orthopnea, which both speak to a state of fluid overload. The only
requires the patient to undergo sedation which is unnecessary.
appropriate response of these available is congestive heart failure.
Which of the following medications does not cause beta 1 stimulation?
Your patient with a history of HFrEF (heart failure with reduced ejection
phenylephrine
fraction) with an ejection fraction of 40% who is also not on optimal medical
Rationale: Phenylephrine only stimulates alpha 1 receptors. The remaining therapy has been diagnosed with a myocardial infarction this admission
three all have beta receptor activity. and received emergent placement of a drug-eluting stent to the left anterior
descending artery. As the medical home who will manage this patient after
discharge, which medication strategy would you expect to be a priority in
the patient's care?
pg. 3 pg. 4
,Ordering a transthoracic echocardiogram and order a Lifevest if EF is less
than 35%
Rationale: The patient should have a protective mechanism such as an
A 65-year-old woman presents for a follow-up examination. She is a
implantable automated cardioverter defibrillator (AICD) or a Lifevest if the
smoker, and her hypertension is now adequately controlled with
EF is less than 35% due to the increased risk of sudden cardiac death with
medication. Her mother died at age 40 from a heart attack. The fasting lipid
low EF states. Since most patients are not eligible for 90 days for an AICD
profile shows cholesterol = 240 mg/dL, HDL = 30, and LDL = 200. In
in this state, optimizing their medication regimen and repeating an echo in
addition to starting therapeutic lifestyle changes, the nurse practitioner
2-3 months to re-evaluate for improvement in their EF is required by most
should start the patient on:
insurance companies. A baseline echo is needed at discharge to provide a
a statin drug.
baseline for improvement vs their repeat echo in 2-3 months.
Rationale: Bile acid sequestrants and cholesterol absorption inhibitors may
Dual anti-platelet therapy is required for 12 months minimum post-MI.
be useful in reducing ASVD risk, but for a patient who is an active smoker
A Holter monitor does not provide any conceivable benefit for this patient
with premature coronary disease history (less than age 65 for women), has
as presented.
hypertension and is far from an LDL goal, this patient is most certainly a
candidate for statin therapy, which represents the most aggressive therapy
option of these four listed.
Which of the following people groups represent the least risk of cardiac
disease?
Caucasians Which of the following end-organ sequelae is not directly caused by
uncontrolled hypertension?
Rationale: Statistically African Americans, Native Hawaiians, and American
Indians are at at increased risk of cardiac disease due to higher rates of Peripheral neuropathy
hypertension, diabetes, and obesity than Caucasians.
pg. 5 pg. 6
, Ratioanle: Although patients with hypertension frequently have peripheral Rationale: These are classic symptoms of polycystic ovarian syndrome and
neuropathy, it is only directly attributed to patients who are also diabetic the patient should be treated with oral contraceptives to help stabilize their
and is commonly found in non-hypertensive diabetic patients. Proteinuria, estrogen and progesterone. Additionally, they may be managed on
AV nicking, and hemorrhagic stroke are all caused by uncontrolled metformin and/or spironolactone for their PCOS.
hypertension.
Oral contraceptive pills (OCPs) are often the first pharmacological
treatment for polycystic ovary syndrome (PCOS) because they help
manage in several ways:
Menstrual irregularities: OCPs can help regulate menstrual cycles, making
Preventive cardiac care should focus primarily on addressing all the
periods lighter and more regular. This is important because irregular
following except?
ovulation can lead to endometrial hyperplasia, which is a buildup of uterine
Genetic predisposition
tissue that can increase the risk of uterine cancer.
Rationale: Smoking cessation, exercise, and medication compliance all
Androgen excess: OCPs can reduce androgen production and increase
represent modifiable risk factors and should be the focus of preventive
sex hormone-binding globulin (SHBG), which binds androgens. This can
care. Non-modifiable risk factors such as age, gender, genetic/family
help reduce symptoms like acne, hirsutism (unwanted body and facial hair),
history should not be the primary focus of prevention.
and androgenic alopecia (male pattern baldness).
Endometrium protection: OCPs can protect the endometrium by ensuring
regular ovulation
A 33-year-old woman presents with irregular menstrual cycles, hirsutism,
and obesity. Laboratory tests reveal elevated serum testosterone and LH
ratio > 2:1. What is the most appropriate initial treatment?
A 50-year-old woman with hypertension and diabetes comes in for a
Oral contraceptives
routine check-up. What screening test should be regularly performed to
monitor for early signs of diabetic nephropathy?
pg. 7 pg. 8
Practice Exam The inability to fully relax the myocardium during relaxation is a trademark
of which of the following diagnoses?
Diastolic dysfunction
Rationale: The inability for the heart to relax is a trademark of the diagnosis
of diastolic dysfunction and is common in patients with thickened
The patient is exhibiting a productive cough and a low-grade fever. Chest hypertrophic myocardium.
X-ray on PA view shows a left lower chest area of consolidation adjacent to
the left border of the heart approximately 2 rib spaces above the
costophrenic angle. The lateral x-ray view shows this lesion absent of the
window posterior to the cardiac silhouette. Which is the most likely location
of this area of focal consolidation? An otherwise healthy African American adult male has been diagnosed with
*Left upper lobe apex hypertension. He has been restricting his salt intake, eating a DASH
(Dietary Approaches to Stop Hypertension) diet, and exercising more, but
*Right middle lobe
his blood pressure is still elevated. Which is the BEST medication to
*Left upper lobe lingula
prescribe him?
*Left lower lobe
Calcium channel blocker
Left upper lobe lingula
Rationale: African American patients per JNC8 Hypertension Guidelines
Ratonale: Lingular consolidation is described in this question precisely. If should be managed with a dihydropyridine calcium channel blocker such as
the cardiac margin/silhouette is obliterated by the mass, the lesion is either amlodipine (Norvasc) as first line management therapy for hypertension not
right middle lobe or left upper lobe lingula. at goal with DASH and lifestyle modifications.
pg. 1 pg. 2
, A 50-year-old woman with a history of hypertension presents with dyspnea
on exertion and orthopnea. On examination, she has jugular venous
Your patient has been diagnosed with a 4.5cm ascending aortic aneurysm.
distention and bilateral crackles on lung auscultation. What is the most
Which medical imaging is considered standard of care for serial
likely diagnosis?
surveillance?
Congestive heart failure
CT angiography of the chest
Rationale: Of the available options, the most accurate response is
Rationale: CT angiography is considered the standard of care for
congestive heart failure as it is signifying both a right ventricular back up
measuring vascular luminal dimensions with contrast. CT PE protocol is not
with jugular venous extension and crackles on lung assault, which are
timed properly for the aorta (it's timed for the pulmonary artery). Although a
suggestive of left ventricular back up. it is possible the patient may have an
plain film is able to catch large aneurysms at times, they are not able to
acute myocardial infarction that precipitated this, however, a patient has not
provide multi-axis reconstruction needed to accurately measure the size.
described that, rather is only describing dyspnea on exertion and
Transesophageal echo is not needed to accurately measure the aorta and
orthopnea, which both speak to a state of fluid overload. The only
requires the patient to undergo sedation which is unnecessary.
appropriate response of these available is congestive heart failure.
Which of the following medications does not cause beta 1 stimulation?
Your patient with a history of HFrEF (heart failure with reduced ejection
phenylephrine
fraction) with an ejection fraction of 40% who is also not on optimal medical
Rationale: Phenylephrine only stimulates alpha 1 receptors. The remaining therapy has been diagnosed with a myocardial infarction this admission
three all have beta receptor activity. and received emergent placement of a drug-eluting stent to the left anterior
descending artery. As the medical home who will manage this patient after
discharge, which medication strategy would you expect to be a priority in
the patient's care?
pg. 3 pg. 4
,Ordering a transthoracic echocardiogram and order a Lifevest if EF is less
than 35%
Rationale: The patient should have a protective mechanism such as an
A 65-year-old woman presents for a follow-up examination. She is a
implantable automated cardioverter defibrillator (AICD) or a Lifevest if the
smoker, and her hypertension is now adequately controlled with
EF is less than 35% due to the increased risk of sudden cardiac death with
medication. Her mother died at age 40 from a heart attack. The fasting lipid
low EF states. Since most patients are not eligible for 90 days for an AICD
profile shows cholesterol = 240 mg/dL, HDL = 30, and LDL = 200. In
in this state, optimizing their medication regimen and repeating an echo in
addition to starting therapeutic lifestyle changes, the nurse practitioner
2-3 months to re-evaluate for improvement in their EF is required by most
should start the patient on:
insurance companies. A baseline echo is needed at discharge to provide a
a statin drug.
baseline for improvement vs their repeat echo in 2-3 months.
Rationale: Bile acid sequestrants and cholesterol absorption inhibitors may
Dual anti-platelet therapy is required for 12 months minimum post-MI.
be useful in reducing ASVD risk, but for a patient who is an active smoker
A Holter monitor does not provide any conceivable benefit for this patient
with premature coronary disease history (less than age 65 for women), has
as presented.
hypertension and is far from an LDL goal, this patient is most certainly a
candidate for statin therapy, which represents the most aggressive therapy
option of these four listed.
Which of the following people groups represent the least risk of cardiac
disease?
Caucasians Which of the following end-organ sequelae is not directly caused by
uncontrolled hypertension?
Rationale: Statistically African Americans, Native Hawaiians, and American
Indians are at at increased risk of cardiac disease due to higher rates of Peripheral neuropathy
hypertension, diabetes, and obesity than Caucasians.
pg. 5 pg. 6
, Ratioanle: Although patients with hypertension frequently have peripheral Rationale: These are classic symptoms of polycystic ovarian syndrome and
neuropathy, it is only directly attributed to patients who are also diabetic the patient should be treated with oral contraceptives to help stabilize their
and is commonly found in non-hypertensive diabetic patients. Proteinuria, estrogen and progesterone. Additionally, they may be managed on
AV nicking, and hemorrhagic stroke are all caused by uncontrolled metformin and/or spironolactone for their PCOS.
hypertension.
Oral contraceptive pills (OCPs) are often the first pharmacological
treatment for polycystic ovary syndrome (PCOS) because they help
manage in several ways:
Menstrual irregularities: OCPs can help regulate menstrual cycles, making
Preventive cardiac care should focus primarily on addressing all the
periods lighter and more regular. This is important because irregular
following except?
ovulation can lead to endometrial hyperplasia, which is a buildup of uterine
Genetic predisposition
tissue that can increase the risk of uterine cancer.
Rationale: Smoking cessation, exercise, and medication compliance all
Androgen excess: OCPs can reduce androgen production and increase
represent modifiable risk factors and should be the focus of preventive
sex hormone-binding globulin (SHBG), which binds androgens. This can
care. Non-modifiable risk factors such as age, gender, genetic/family
help reduce symptoms like acne, hirsutism (unwanted body and facial hair),
history should not be the primary focus of prevention.
and androgenic alopecia (male pattern baldness).
Endometrium protection: OCPs can protect the endometrium by ensuring
regular ovulation
A 33-year-old woman presents with irregular menstrual cycles, hirsutism,
and obesity. Laboratory tests reveal elevated serum testosterone and LH
ratio > 2:1. What is the most appropriate initial treatment?
A 50-year-old woman with hypertension and diabetes comes in for a
Oral contraceptives
routine check-up. What screening test should be regularly performed to
monitor for early signs of diabetic nephropathy?
pg. 7 pg. 8
