NR 603 CEA Midterm Exam (2026) | Chamberlain Advanced Clinical
Diagnosis
1. A 65-year-old male with no history of chronic kidney disease or diabetes
presents with a blood pressure of 152/94. According to JNC 8 guidelines, what is
his blood pressure goal?
A. Less than 130/80 mmHg
B. Less than 140/90 mmHg
C. Less than 150/90 mmHg
D. Less than 160/100 mmHg
Answer: C
Rationale: Per JNC 8 guidelines, for patients aged 60 years or older without DM or CKD, the
blood pressure goal is less than 150/90 mmHg.
2. Which of the following is the first-line pharmacologic treatment for a patient
newly diagnosed with Type 2 Diabetes Mellitus and an A1C of 7.8%?
A. Glipizide
B. Metformin
C. Pioglitazone
D. Lantus (Insulin glargine)
Answer: B
Rationale: Metformin is recommended as the initial pharmacologic agent for the treatment
of type 2 diabetes unless contraindicated.
,3. An 18-year-old female presents with a sore throat, fever, and cervical
lymphadenopathy. A rapid strep test is negative. Which physical exam finding
would most strongly suggest Infectious Mononucleosis?
A. Posterior cervical lymphadenopathy
B. Sandpaper rash
C. Anterior cervical lymphadenopathy
D. Koplik spots
Answer: A
Rationale: While both can cause lymphadenopathy, posterior cervical lymphadenopathy is
more characteristic of Mononucleosis than Group A Strep.
4. A patient presents with sudden onset of ‘the worst headache of my life.’
What is the most likely diagnosis?
A. Cluster headache
B. Migraine with aura
C. Tension-type headache
D. Subarachnoid hemorrhage
Answer: D
Rationale: A ‘thunderclap’ headache or ‘the worst headache of my life’ is a classic
presentation of a subarachnoid hemorrhage and requires emergency imaging.
5. Which laboratory value is the most sensitive marker for diagnosing iron
deficiency anemia in its early stages?
A. Hemoglobin
B. Serum Ferritin
C. Total Iron Binding Capacity (TIBC)
D. Mean Corpuscular Volume (MCV)
Answer: B
, Rationale: Serum ferritin levels reflect iron stores and are the first to decrease in iron
deficiency anemia, often before hemoglobin or MCV changes.
6. What is the primary diagnostic test used to confirm a diagnosis of Chronic
Obstructive Pulmonary Disease (COPD)?
A. Spirometry
B. Chest X-ray
C. Arterial Blood Gas (ABG)
D. Peak flow meter
Answer: A
Rationale: Spirometry is required to make a clinical diagnosis of COPD; a post-
bronchodilator FEV1/FVC ratio < 0.70 confirms persistent airflow limitation.
7. A 55-year-old postmenopausal woman with a T-score of -2.8 on a DEXA scan
should be diagnosed with:
A. Osteopenia
B. Osteoporosis
C. Osteoarthritis
D. Normal bone density
Answer: B
Rationale: Osteoporosis is defined as a T-score of -2.5 or lower. Osteopenia is defined
between -1.0 and -2.5.
8. A patient with a history of heart failure (HFrEF) should typically be on which
combination of medications to reduce mortality?
A. CCB and Diuretic
B. Digoxin and Warfarin
C. ACE inhibitor/ARB and Beta-blocker
D. Statin and Aspirin
Answer: C
Diagnosis
1. A 65-year-old male with no history of chronic kidney disease or diabetes
presents with a blood pressure of 152/94. According to JNC 8 guidelines, what is
his blood pressure goal?
A. Less than 130/80 mmHg
B. Less than 140/90 mmHg
C. Less than 150/90 mmHg
D. Less than 160/100 mmHg
Answer: C
Rationale: Per JNC 8 guidelines, for patients aged 60 years or older without DM or CKD, the
blood pressure goal is less than 150/90 mmHg.
2. Which of the following is the first-line pharmacologic treatment for a patient
newly diagnosed with Type 2 Diabetes Mellitus and an A1C of 7.8%?
A. Glipizide
B. Metformin
C. Pioglitazone
D. Lantus (Insulin glargine)
Answer: B
Rationale: Metformin is recommended as the initial pharmacologic agent for the treatment
of type 2 diabetes unless contraindicated.
,3. An 18-year-old female presents with a sore throat, fever, and cervical
lymphadenopathy. A rapid strep test is negative. Which physical exam finding
would most strongly suggest Infectious Mononucleosis?
A. Posterior cervical lymphadenopathy
B. Sandpaper rash
C. Anterior cervical lymphadenopathy
D. Koplik spots
Answer: A
Rationale: While both can cause lymphadenopathy, posterior cervical lymphadenopathy is
more characteristic of Mononucleosis than Group A Strep.
4. A patient presents with sudden onset of ‘the worst headache of my life.’
What is the most likely diagnosis?
A. Cluster headache
B. Migraine with aura
C. Tension-type headache
D. Subarachnoid hemorrhage
Answer: D
Rationale: A ‘thunderclap’ headache or ‘the worst headache of my life’ is a classic
presentation of a subarachnoid hemorrhage and requires emergency imaging.
5. Which laboratory value is the most sensitive marker for diagnosing iron
deficiency anemia in its early stages?
A. Hemoglobin
B. Serum Ferritin
C. Total Iron Binding Capacity (TIBC)
D. Mean Corpuscular Volume (MCV)
Answer: B
, Rationale: Serum ferritin levels reflect iron stores and are the first to decrease in iron
deficiency anemia, often before hemoglobin or MCV changes.
6. What is the primary diagnostic test used to confirm a diagnosis of Chronic
Obstructive Pulmonary Disease (COPD)?
A. Spirometry
B. Chest X-ray
C. Arterial Blood Gas (ABG)
D. Peak flow meter
Answer: A
Rationale: Spirometry is required to make a clinical diagnosis of COPD; a post-
bronchodilator FEV1/FVC ratio < 0.70 confirms persistent airflow limitation.
7. A 55-year-old postmenopausal woman with a T-score of -2.8 on a DEXA scan
should be diagnosed with:
A. Osteopenia
B. Osteoporosis
C. Osteoarthritis
D. Normal bone density
Answer: B
Rationale: Osteoporosis is defined as a T-score of -2.5 or lower. Osteopenia is defined
between -1.0 and -2.5.
8. A patient with a history of heart failure (HFrEF) should typically be on which
combination of medications to reduce mortality?
A. CCB and Diuretic
B. Digoxin and Warfarin
C. ACE inhibitor/ARB and Beta-blocker
D. Statin and Aspirin
Answer: C
