NR 667 CEA EXAM 250 QUESTIONS & CORRECT
ANSWERS LATEST 2026/2027
Your patient has a history of moderate aortic stenosis. During which phase of
the cardiac contraction would you anticipate to hear this murmur?
Systole
Diastole
Both systole and diastole
Neither
Systole
Rationale: In aortic stenosis, the murmur is typically a systolic ejection
murmur. This is because the left ventricle must contract forcefully during
systole to eject blood through the narrowed aortic valve, producing the
characteristic murmur heard during this phase.
Which of the following locations is most commonly described as the best
location to identify the mitral valve in a healthy adult?
Left 2nd intercostal space, midaxillary line
4th intercostal space, right midaxillary line
Left 5th intercostal space, midclavicular line
2nd intercostal space, right sternal border
Left 5th intercostal space, midclavicular line
Rationale: The mitral valve is best auscultated at the cardiac apex, which is
typically located at the left 5th intercostal space along the midclavicular line.
Your patient is a 52-year-old post–MI patient in your clinic. What is the
recommended initial medication choice for dual antiplatelet therapy after a
myocardial infarction?
Aspirin plus prasugrel (Effient)
,Aspirin plus ticagrelor (Brilinta)
Aspirin alone twice a day
Aspirin plus clopidogrel (Plavix)
Asprin plus clopidogrel (Plavix)
Rationale:
After a myocardial infarction, dual antiplatelet therapy (DAPT) is essential to
reduce the risk of thrombotic events, particularly after percutaneous
coronary intervention (PCI). Although newer agents like ticagrelor and
prasugrel are alternatives in certain patient populations, the most common
and widely accepted initial regimen is aspirin plus clopidogrel, as it has been
proven effective and is supported by established guidelines.
Which of the following is a common cause of gram-negative bacterial
pneumonia?
Allergies
Aspiration
Community acquired pneumonia
Pleural effusion
Aspiration
Rationale:
Aspiration pneumonia frequently occurs when oropharyngeal or gastric
contents are inhaled into
the lungs, often introducing gram-negative bacteria such as Klebsiella and
Pseudomonas. Allergies do not cause bacterial pneumonia, community
acquired pneumonia is a broader category (with many cases caused by gram-
positive organisms like Streptococcus pneumoniae),
and pleural effusion is a complication rather than a cause of pneumonia.
While assessing the 15-year-old patient for a new onset cough, the nurse
practitioner may inspect, auscultate, palpate, and/or percuss. How does
performing percussion of the thorax assist the provider during the physical
examination?
,To identify if underlying tissues are air filled, fluid filled, or consolidated
To assess for deep-seated lesions and tumors
To assist with the confirmation of cardiac origin of angina
To assess for any pain or discomfort prior to palpation of the chest wall
To identify if underlying tissues are air filled, fluid filled or consolidated
Rationale: Percussion helps differentiate the density of tissues beneath the
chest wall. By tapping on the thorax, the practitioner can determine if the
lung tissue is normally air filled, if it contains fluid (as in a pleural effusion),
or if it is consolidated (as in pneumonia), which guides further diagnostic
evaluation.
Which of the following patients would you expect to have a less than expected
forced expiratory volume in the first second (FEV₁) on pulmonary function
testing?
Emphysema
Pleural effusion
Third trimester pregnancy
Severe interstitial lung disease
Emphysema
Rationale:
Emphysema, a form of chronic obstructive pulmonary disease (COPD), is
characterized by the destruction of alveolar walls and loss of elastic recoil.
This results in airway collapse during exhalation, which significantly reduces
the FEV₁. While severe interstitial lung disease also decreases lung volumes, it
does so in a restrictive pattern where both FEV₁ and forced vital capacity
(FVC) are reduced proportionally. In emphysema, however, the reduction in
FEV₁ is a hallmark finding and is often more pronounced relative to other
values, making it the expected cause of a low FEV₁.
Your patient has undergone a pulmonary function test with spirometry. In
explaining the study findings at a follow-up visit, the patient asks what the test
, was evaluating. Which decreased exam segment suggests a diagnosis of
restrictive lung disease?
Forced vital capacity (FVC)
Functional reserve capacity
Forced expiratory volume in 1 second (FEV₁)
Prolonged expiratory time"
Forced Vital Capacity (FVC)
Rationale:
In restrictive lung disease, the total lung volume is reduced due to decreased
lung compliance. This results in a decreased forced vital capacity (FVC) while
the FEV₁/FVC ratio often remains normal or even increased. Although
FEV₁ may also be reduced, the hallmark is the reduction in FVC, making it
the key measure in diagnosing restrictive patterns on spirometry.
Your newly established patient states that in the past year they have
progressively developed a noticeable enlargement of their anterior neck.
When asked about symptoms, they report feeling very anxious, developing a
tremor, and commonly feeling palpitations in their chest. On examination, you
identify an enlarged thyroid gland suspicious for a goiter. Which laboratory
finding is most likely to be elevated in this patient?
Anti–thyroid peroxidase (anti-TPO)
Prolactin
T4
TSH
T4
Rationale:
The patient’s symptoms—anxiety, tremor, palpitations—and the presence of a
goiter are consistent with hyperthyroidism, most commonly due to Graves'
disease. In hyperthyroidism, thyroid hormone levels, particularly T4, are
elevated while TSH is typically suppressed. Anti-TPO antibodies may be
ANSWERS LATEST 2026/2027
Your patient has a history of moderate aortic stenosis. During which phase of
the cardiac contraction would you anticipate to hear this murmur?
Systole
Diastole
Both systole and diastole
Neither
Systole
Rationale: In aortic stenosis, the murmur is typically a systolic ejection
murmur. This is because the left ventricle must contract forcefully during
systole to eject blood through the narrowed aortic valve, producing the
characteristic murmur heard during this phase.
Which of the following locations is most commonly described as the best
location to identify the mitral valve in a healthy adult?
Left 2nd intercostal space, midaxillary line
4th intercostal space, right midaxillary line
Left 5th intercostal space, midclavicular line
2nd intercostal space, right sternal border
Left 5th intercostal space, midclavicular line
Rationale: The mitral valve is best auscultated at the cardiac apex, which is
typically located at the left 5th intercostal space along the midclavicular line.
Your patient is a 52-year-old post–MI patient in your clinic. What is the
recommended initial medication choice for dual antiplatelet therapy after a
myocardial infarction?
Aspirin plus prasugrel (Effient)
,Aspirin plus ticagrelor (Brilinta)
Aspirin alone twice a day
Aspirin plus clopidogrel (Plavix)
Asprin plus clopidogrel (Plavix)
Rationale:
After a myocardial infarction, dual antiplatelet therapy (DAPT) is essential to
reduce the risk of thrombotic events, particularly after percutaneous
coronary intervention (PCI). Although newer agents like ticagrelor and
prasugrel are alternatives in certain patient populations, the most common
and widely accepted initial regimen is aspirin plus clopidogrel, as it has been
proven effective and is supported by established guidelines.
Which of the following is a common cause of gram-negative bacterial
pneumonia?
Allergies
Aspiration
Community acquired pneumonia
Pleural effusion
Aspiration
Rationale:
Aspiration pneumonia frequently occurs when oropharyngeal or gastric
contents are inhaled into
the lungs, often introducing gram-negative bacteria such as Klebsiella and
Pseudomonas. Allergies do not cause bacterial pneumonia, community
acquired pneumonia is a broader category (with many cases caused by gram-
positive organisms like Streptococcus pneumoniae),
and pleural effusion is a complication rather than a cause of pneumonia.
While assessing the 15-year-old patient for a new onset cough, the nurse
practitioner may inspect, auscultate, palpate, and/or percuss. How does
performing percussion of the thorax assist the provider during the physical
examination?
,To identify if underlying tissues are air filled, fluid filled, or consolidated
To assess for deep-seated lesions and tumors
To assist with the confirmation of cardiac origin of angina
To assess for any pain or discomfort prior to palpation of the chest wall
To identify if underlying tissues are air filled, fluid filled or consolidated
Rationale: Percussion helps differentiate the density of tissues beneath the
chest wall. By tapping on the thorax, the practitioner can determine if the
lung tissue is normally air filled, if it contains fluid (as in a pleural effusion),
or if it is consolidated (as in pneumonia), which guides further diagnostic
evaluation.
Which of the following patients would you expect to have a less than expected
forced expiratory volume in the first second (FEV₁) on pulmonary function
testing?
Emphysema
Pleural effusion
Third trimester pregnancy
Severe interstitial lung disease
Emphysema
Rationale:
Emphysema, a form of chronic obstructive pulmonary disease (COPD), is
characterized by the destruction of alveolar walls and loss of elastic recoil.
This results in airway collapse during exhalation, which significantly reduces
the FEV₁. While severe interstitial lung disease also decreases lung volumes, it
does so in a restrictive pattern where both FEV₁ and forced vital capacity
(FVC) are reduced proportionally. In emphysema, however, the reduction in
FEV₁ is a hallmark finding and is often more pronounced relative to other
values, making it the expected cause of a low FEV₁.
Your patient has undergone a pulmonary function test with spirometry. In
explaining the study findings at a follow-up visit, the patient asks what the test
, was evaluating. Which decreased exam segment suggests a diagnosis of
restrictive lung disease?
Forced vital capacity (FVC)
Functional reserve capacity
Forced expiratory volume in 1 second (FEV₁)
Prolonged expiratory time"
Forced Vital Capacity (FVC)
Rationale:
In restrictive lung disease, the total lung volume is reduced due to decreased
lung compliance. This results in a decreased forced vital capacity (FVC) while
the FEV₁/FVC ratio often remains normal or even increased. Although
FEV₁ may also be reduced, the hallmark is the reduction in FVC, making it
the key measure in diagnosing restrictive patterns on spirometry.
Your newly established patient states that in the past year they have
progressively developed a noticeable enlargement of their anterior neck.
When asked about symptoms, they report feeling very anxious, developing a
tremor, and commonly feeling palpitations in their chest. On examination, you
identify an enlarged thyroid gland suspicious for a goiter. Which laboratory
finding is most likely to be elevated in this patient?
Anti–thyroid peroxidase (anti-TPO)
Prolactin
T4
TSH
T4
Rationale:
The patient’s symptoms—anxiety, tremor, palpitations—and the presence of a
goiter are consistent with hyperthyroidism, most commonly due to Graves'
disease. In hyperthyroidism, thyroid hormone levels, particularly T4, are
elevated while TSH is typically suppressed. Anti-TPO antibodies may be
