NR 603 CEA Midterm Exam - Advanced Clinical Diagnosis 2026/2027
Chamberlain
1. According to the ACC/AHA guidelines, what blood pressure reading defines
Stage 2 Hypertension?
A. 120-129 / <80 mmHg
B. 130--89 mmHg
C. >=140 / >=90 mmHg
D. >=160 / >=100 mmHg
Answer: C
Rationale: Stage 2 Hypertension is defined as a systolic BP of 140 mmHg or higher OR a
diastolic BP of 90 mmHg or higher.
2. Which of the following is considered the ‘gold standard’ for diagnosing
Chronic Obstructive Pulmonary Disease (COPD)?
A. Chest X-ray
B. Spirometry (Post-bronchodilator FEV1/FVC < 0.70)
C. Arterial Blood Gas (ABG)
D. Peak Flow Meter reading
Answer: B
Rationale: Spirometry is required to make a clinical diagnosis of COPD; a post-
bronchodilator FEV1/FVC ratio of less than 0.70 confirms persistent airflow limitation.
,3. A 65-year-old patient presents with heart failure symptoms. Their
echocardiogram shows an Ejection Fraction (EF) of 35%. This is classified as:
A. HFpEF (Preserved)
B. HFrEF (Reduced)
C. HFmrEF (Mid-range)
D. Diastolic dysfunction only
Answer: B
Rationale: Heart Failure with Reduced Ejection Fraction (HFrEF) is defined as an LVEF of
40% or less.
4. Which medication class is recommended as first-line therapy for a 55-year-old
diabetic patient with hypertension and albuminuria?
A. Calcium Channel Blockers
B. Beta-Blockers
C. Thiazide Diuretics
D. ACE Inhibitors or ARBs
Answer: D
Rationale: ACE inhibitors or ARBs are first-line for patients with DM and CKD/albuminuria
due to their renal protective effects.
5. A patient presents with a TSH of 12.5 mIU/L and a low Free T4. What is the
most likely diagnosis?
A. Primary Hypothyroidism
B. Subclinical Hypothyroidism
C. Secondary Hypothyroidism
D. Hyperthyroidism
Answer: A
Rationale: Primary hypothyroidism is characterized by an elevated TSH and a low Free T4
level.
, 6. What is the primary screening tool used to assess the severity of depression
in primary care?
A. GAD-7
B. PHQ-9
C. CAGE Questionnaire
D. MMSE
Answer: B
Rationale: The Patient Health Questionnaire-9 (PHQ-9) is the standard tool for screening
and monitoring depression severity.
7. Which physical exam finding is most indicative of Community-Acquired
Pneumonia (CAP)?
A. Hyperresonance on percussion
B. Wheezing throughout all lung fields
C. Egophony (E to A change)
D. Decreased tactile fremitus
Answer: C
Rationale: Consolidation in pneumonia leads to increased tactile fremitus and positive
special tests like egophony.
8. A 70-year-old male has an Ankle-Brachial Index (ABI) of 0.65. This result is
consistent with:
A. Normal arterial flow
B. Venous Insufficiency
C. Severe Peripheral Artery Disease
D. Mild to moderate Peripheral Artery Disease
Answer: D
Rationale: An ABI between 0.41 and 0.90 indicates mild to moderate PAD.
Chamberlain
1. According to the ACC/AHA guidelines, what blood pressure reading defines
Stage 2 Hypertension?
A. 120-129 / <80 mmHg
B. 130--89 mmHg
C. >=140 / >=90 mmHg
D. >=160 / >=100 mmHg
Answer: C
Rationale: Stage 2 Hypertension is defined as a systolic BP of 140 mmHg or higher OR a
diastolic BP of 90 mmHg or higher.
2. Which of the following is considered the ‘gold standard’ for diagnosing
Chronic Obstructive Pulmonary Disease (COPD)?
A. Chest X-ray
B. Spirometry (Post-bronchodilator FEV1/FVC < 0.70)
C. Arterial Blood Gas (ABG)
D. Peak Flow Meter reading
Answer: B
Rationale: Spirometry is required to make a clinical diagnosis of COPD; a post-
bronchodilator FEV1/FVC ratio of less than 0.70 confirms persistent airflow limitation.
,3. A 65-year-old patient presents with heart failure symptoms. Their
echocardiogram shows an Ejection Fraction (EF) of 35%. This is classified as:
A. HFpEF (Preserved)
B. HFrEF (Reduced)
C. HFmrEF (Mid-range)
D. Diastolic dysfunction only
Answer: B
Rationale: Heart Failure with Reduced Ejection Fraction (HFrEF) is defined as an LVEF of
40% or less.
4. Which medication class is recommended as first-line therapy for a 55-year-old
diabetic patient with hypertension and albuminuria?
A. Calcium Channel Blockers
B. Beta-Blockers
C. Thiazide Diuretics
D. ACE Inhibitors or ARBs
Answer: D
Rationale: ACE inhibitors or ARBs are first-line for patients with DM and CKD/albuminuria
due to their renal protective effects.
5. A patient presents with a TSH of 12.5 mIU/L and a low Free T4. What is the
most likely diagnosis?
A. Primary Hypothyroidism
B. Subclinical Hypothyroidism
C. Secondary Hypothyroidism
D. Hyperthyroidism
Answer: A
Rationale: Primary hypothyroidism is characterized by an elevated TSH and a low Free T4
level.
, 6. What is the primary screening tool used to assess the severity of depression
in primary care?
A. GAD-7
B. PHQ-9
C. CAGE Questionnaire
D. MMSE
Answer: B
Rationale: The Patient Health Questionnaire-9 (PHQ-9) is the standard tool for screening
and monitoring depression severity.
7. Which physical exam finding is most indicative of Community-Acquired
Pneumonia (CAP)?
A. Hyperresonance on percussion
B. Wheezing throughout all lung fields
C. Egophony (E to A change)
D. Decreased tactile fremitus
Answer: C
Rationale: Consolidation in pneumonia leads to increased tactile fremitus and positive
special tests like egophony.
8. A 70-year-old male has an Ankle-Brachial Index (ABI) of 0.65. This result is
consistent with:
A. Normal arterial flow
B. Venous Insufficiency
C. Severe Peripheral Artery Disease
D. Mild to moderate Peripheral Artery Disease
Answer: D
Rationale: An ABI between 0.41 and 0.90 indicates mild to moderate PAD.
