NR 603 CEA EXAM AND PRACTICE EXAM BANK COMPLETE REAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) GRADED A+ | NR603 FINAL EXAM PREP

NR 603 CEA EXAM AND PRACTICE EXAM BANK COMPLETE REAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) GRADED A+ | NR603 FINAL EXAM PREP 1. A 68-year-old male with a history of hypertension presents with sudden onset of severe, tearing chest pain radiating to his back. His blood pressure is 180/100 mmHg in the right arm and 140/85 mmHg in the left arm. What is the most likely diagnosis? A. Myocardial infarction B. Acute aortic dissection C. Pulmonary embolism D. Esophageal rupture Correct Answer: B. Acute aortic dissection Rationale: The classic presentation of aortic dissection includes sudden severe tearing chest pain that radiates to the back, with blood pressure differential between arms. This condition requires immediate imaging and surgical consultation. Myocardial infarction typically presents with crushing chest pain without arm blood pressure differential. ________________________________________ 2. A 55-year-old diabetic patient presents with a foot ulcer that has been present for 3 months. The wound is deep, with exposed tendon, and has a foul odor. Which classification would this wound fall under? A. Stage 1 pressure ulcer B. Stage 2 pressure ulcer C. Stage 3 pressure ulcer D. Stage 4 pressure ulcer Correct Answer: D. Stage 4 pressure ulcer Rationale: Stage 4 pressure ulcers involve full-thickness tissue loss with exposed bone, tendon, or muscle. They often have slough or eschar and may have undermining or tunneling. This wound's description of exposed tendon and foul odor indicates a Stage 4 ulcer with possible infection. ________________________________________ 3. Which medication is considered first-line therapy for stable angina in patients with no contraindications? A. Amlodipine B. Metoprolol C. Isosorbide mononitrate D. Ranolazine Correct Answer: B. Metoprolol Rationale: Beta-blockers (metoprolol, atenolol) are first-line therapy for stable angina as they reduce myocardial oxygen demand by decreasing heart rate and contractility. They also improve survival post-MI. Calcium channel blockers and nitrates are alternative or adjunctive therapies. ________________________________________ 4. A 72-year-old female presents with progressive dyspnea on exertion and orthopnea. On examination, you note jugular venous distension, lower extremity edema, and an S3 gallop. What is the most appropriate diagnostic test to confirm your suspicion? A. Chest X-ray B. B-type natriuretic peptide (BNP) C. Echocardiogram D. Cardiac catheterization Correct Answer: C. Echocardiogram Rationale: An echocardiogram is the gold standard for diagnosing heart failure, providing information on ejection fraction, valve function, and chamber sizes. While BNP and CXR support the diagnosis, echocardiography confirms it and guides treatment decisions. ________________________________________ 5. A 45-year-old male presents with acute onset of right lower quadrant pain, nausea, and fever. On examination, you note rebound tenderness at McBurney's point. What is the most likely diagnosis? A. Diverticulitis B. Acute appendicitis C. Cholecystitis D. Renal colic Correct Answer: B. Acute appendicitis Rationale: Acute appendicitis typically presents with periumbilical pain migrating to the right lower quadrant, associated with anorexia, nausea, fever, and rebound tenderness at McBurney's point (one-third the distance from the anterior superior iliac spine to the umbilicus). ________________________________________ 6. A 60-year-old patient with COPD is prescribed theophylline. Which side effect should you monitor for? A. Bradycardia B. Seizures C. Hyperkalemia D. Hypoglycemia Correct Answer: B. Seizures Rationale: Theophylline has a narrow therapeutic index and can cause significant toxicity including seizures, cardiac arrhythmias, nausea, vomiting, and tachycardia. Serum levels should be monitored regularly to maintain therapeutic range (5-15 mcg/mL). ________________________________________ 7. A patient with chronic kidney disease presents with fatigue, weakness, and bone pain. Lab results show calcium 8.2 mg/dL (8.5-10.2), phosphorus 5.8 mg/dL (2.5-4.5), and PTH 250 pg/mL (10-65). What is the most appropriate treatment? A. Calcium carbonate B. Sevelamer C. Calcitriol D. Cinacalcet Correct Answer: B. Sevelamer Rationale: This patient has hyperphosphatemia with secondary hyperparathyroidism. Sevelamer is a phosphate binder that does not contain calcium, making it preferred in CKD patients with elevated calcium levels. Calcium carbonate would further increase calcium levels. Calcitriol and cinacalcet would be considered after phosphorus control. ________________________________________ 8. A 28-year-old female presents with palpitations, heat intolerance, and weight loss despite increased appetite. Her TSH is 0.01 mIU/L and free T4 is elevated. Which of the following would you expect on physical examination? A. Bradycardia B. Hyporeflexia C. Lid lag D. Cold intolerance Correct Answer: C. Lid lag Rationale: This presentation is consistent with hyperthyroidism. Lid lag (upper eyelid retraction) is a classic sign of hyperthyroidism, along with tachycardia, hyperreflexia, warm moist skin, tremor, and exophthalmos. Bradycardia, hyporeflexia, and cold intolerance are signs of hypothyroidism. ________________________________________ 9. A patient with atrial fibrillation is started on warfarin. Which laboratory value should be monitored to guide dosing? A. PT/INR B. PTT C. Platelet count D. Thrombin time Correct Answer: A. PT/INR