NR 603 CEA Final Exam (2026) - Advanced Clinical Diagnosis
Chamberlain College
1. A 65-year-old African American male presents with a blood pressure of
152/94 mmHg. According to current guidelines, which is the most appropriate
initial treatment?
A. Lisinopril
B. Losartan
C. Metoprolol
D. Amlodipine
Answer: D
Rationale: For African American patients without chronic kidney disease, initial
antihypertensive treatment should include a thiazide-type diuretic or a calcium channel
blocker (like Amlodipine).
2. Which physical exam finding is most suggestive of Acute Cholecystitis?
A. McBurney’s sign
B. Rovsing’s sign
C. Psoas sign
D. Murphy’s sign
Answer: D
Rationale: Murphy’s sign is specific for gallbladder inflammation; it involves inspiratory
arrest upon deep palpation of the right upper quadrant.
,3. A patient presents with a TSH of 0.1 mIU/L and an elevated Free T4. Which
diagnosis is most likely?
A. Primary Hypothyroidism
B. Hyperthyroidism
C. Secondary Hypothyroidism
D. Subclinical Hypothyroidism
Answer: B
Rationale: A low TSH combined with an elevated Free T4 indicates primary
hyperthyroidism.
4. In the management of COPD, which class of medication is the mainstay for
reducing exacerbations?
A. Long-acting muscarinic antagonists (LAMA)
B. Inhaled corticosteroids (ICS) alone
C. Short-acting beta-agonists (SABA)
D. Oral Leukotriene modifiers
Answer: A
Rationale: LAMAs are first-line for reducing COPD exacerbations and improving lung
function compared to LABAs or ICS alone.
5. Which heart murmur is typically described as a holosystolic murmur heard
best at the apex, radiating to the axilla?
A. Aortic Stenosis
B. Mitral Regurgitation
C. Mitral Stenosis
D. Aortic Regurgitation
Answer: B
Rationale: Mitral Regurgitation occurs during systole and is loudest at the apex with
radiation to the left axilla.
, 6. A 45-year-old male has a fasting glucose of 130 mg/dL on two separate
occasions. What is the diagnosis?
A. Prediabetes
B. Normal glucose tolerance
C. Type 2 Diabetes Mellitus
D. Metabolic Syndrome
Answer: C
Rationale: A fasting plasma glucose of 126 mg/dL or higher on two separate tests is
diagnostic for Diabetes Mellitus.
7. What is the first-line antibiotic treatment for an adult with uncomplicated
Community-Acquired Pneumonia and no comorbidities?
A. Metronidazole
B. Ciprofloxacin
C. Vancomycin
D. Amoxicillin
Answer: D
Rationale: Recent guidelines recommend High-dose Amoxicillin or Doxycycline as
monotherapy for healthy adults with CAP.
8. A patient with heart failure with reduced ejection fraction (HFrEF) is already
on an ACE inhibitor and a Beta-blocker. What is the next recommended class to
add?
A. Nitrate monotherapy
B. Calcium Channel Blocker
C. Mineraloid Receptor Antagonist (MRA)
D. Alpha-blocker
Answer: C
Chamberlain College
1. A 65-year-old African American male presents with a blood pressure of
152/94 mmHg. According to current guidelines, which is the most appropriate
initial treatment?
A. Lisinopril
B. Losartan
C. Metoprolol
D. Amlodipine
Answer: D
Rationale: For African American patients without chronic kidney disease, initial
antihypertensive treatment should include a thiazide-type diuretic or a calcium channel
blocker (like Amlodipine).
2. Which physical exam finding is most suggestive of Acute Cholecystitis?
A. McBurney’s sign
B. Rovsing’s sign
C. Psoas sign
D. Murphy’s sign
Answer: D
Rationale: Murphy’s sign is specific for gallbladder inflammation; it involves inspiratory
arrest upon deep palpation of the right upper quadrant.
,3. A patient presents with a TSH of 0.1 mIU/L and an elevated Free T4. Which
diagnosis is most likely?
A. Primary Hypothyroidism
B. Hyperthyroidism
C. Secondary Hypothyroidism
D. Subclinical Hypothyroidism
Answer: B
Rationale: A low TSH combined with an elevated Free T4 indicates primary
hyperthyroidism.
4. In the management of COPD, which class of medication is the mainstay for
reducing exacerbations?
A. Long-acting muscarinic antagonists (LAMA)
B. Inhaled corticosteroids (ICS) alone
C. Short-acting beta-agonists (SABA)
D. Oral Leukotriene modifiers
Answer: A
Rationale: LAMAs are first-line for reducing COPD exacerbations and improving lung
function compared to LABAs or ICS alone.
5. Which heart murmur is typically described as a holosystolic murmur heard
best at the apex, radiating to the axilla?
A. Aortic Stenosis
B. Mitral Regurgitation
C. Mitral Stenosis
D. Aortic Regurgitation
Answer: B
Rationale: Mitral Regurgitation occurs during systole and is loudest at the apex with
radiation to the left axilla.
, 6. A 45-year-old male has a fasting glucose of 130 mg/dL on two separate
occasions. What is the diagnosis?
A. Prediabetes
B. Normal glucose tolerance
C. Type 2 Diabetes Mellitus
D. Metabolic Syndrome
Answer: C
Rationale: A fasting plasma glucose of 126 mg/dL or higher on two separate tests is
diagnostic for Diabetes Mellitus.
7. What is the first-line antibiotic treatment for an adult with uncomplicated
Community-Acquired Pneumonia and no comorbidities?
A. Metronidazole
B. Ciprofloxacin
C. Vancomycin
D. Amoxicillin
Answer: D
Rationale: Recent guidelines recommend High-dose Amoxicillin or Doxycycline as
monotherapy for healthy adults with CAP.
8. A patient with heart failure with reduced ejection fraction (HFrEF) is already
on an ACE inhibitor and a Beta-blocker. What is the next recommended class to
add?
A. Nitrate monotherapy
B. Calcium Channel Blocker
C. Mineraloid Receptor Antagonist (MRA)
D. Alpha-blocker
Answer: C
