1
NR511 CEA Exam (2026–2027 Update) Practice
Questions with Verified Answers & Rationales
Chamberlain University | Advanced Practice Nursing | Graded
A+
QUESTION 1
A 45-year-old male presents with chest pain that is pressure-like, radiating to the left
arm, associated with diaphoresis and nausea. The pain started 30 minutes ago while
shoveling snow. What is the most appropriate initial action?
A) Obtain a detailed cardiac history
B) Administer aspirin 324 mg PO
C) Activate EMS for immediate transport
D) Perform an EKG in the office
Rationale: This patient has symptoms concerning for acute coronary syndrome (ACS). The
most appropriate initial action is to activate EMS for immediate transport to an emergency
department. While aspirin and EKG are important, they should not delay emergency
transport .
QUESTION 2
A 65-year-old female presents with acute onset of severe, tearing chest pain radiating to
the back. Blood pressure is 160/90 in the right arm and 100/60 in the left arm. What is
the most likely diagnosis?
Sure pass
,2
A) Acute myocardial infarction
B) Pulmonary embolism
C) Aortic dissection
D) Pericarditis
Rationale: Aortic dissection presents with severe, tearing chest pain that radiates to the
back and can cause discrepancies in blood pressure between arms. This clinical picture is
classic for aortic dissection, which is a medical emergency requiring immediate imaging
and surgical consultation .
QUESTION 3
What is the primary purpose of creating a differential diagnosis list?
A) To list all possible diseases that could explain a patient's symptoms, ranked
from most to least likely
B) To provide a definitive diagnosis before any testing is done
C) To satisfy insurance requirements for reimbursement
D) To document only the most serious condition regardless of likelihood
Rationale: A differential diagnosis list is a systematic method to identify and rank
potential causes of a patient's presenting symptoms. This process ensures comprehensive
clinical reasoning, prevents premature closure, and guides appropriate diagnostic testing .
QUESTION 4
A 55-year-old male presents with chest pain. Which finding on history most increases
the probability of acute coronary syndrome (ACS)?
Sure pass
,3
A) Sharp, positional pain reproducible with palpation
B) Pain that radiates to the left arm or jaw
C) Pain that worsens with deep inspiration
D) Pain that improves with leaning forward
Rationale: Pain radiating to the left arm or jaw is a classic symptom of cardiac ischemia
and is one of the key features that increases the probability of ACS. Positional pain, pain
with palpation, and pain worsening with inspiration are more consistent with
musculoskeletal or pericardial etiologies .
QUESTION 5
Your 22-year-old male patient states during his review of systems that his scrotum is
very enlarged and "feels like it is full of fluid." He is a powerlifter and works as a trash
collector. You suspect the patient likely has which diagnosis?
A) Varicocele
B) Meningocele
C) Rectocele
D) Hydrocele
Rationale: A varicocele is an abnormal enlargement of the pampiniform venous plexus in
the scrotum, often described as a "bag of worms." It is more common in men who perform
heavy lifting or prolonged standing due to increased intra-abdominal pressure, which
impedes venous return .
QUESTION 6
Sure pass
, 4
A 60-year-old male presents with dizziness described as "feeling like I might pass out."
He reports it occurs when standing up quickly. Which term best describes this
symptom?
A) Vertigo
B) Presyncope
C) Disequilibrium
D) Lightheadedness
Rationale: Presyncope is the sensation of feeling faint or about to pass out without actual
loss of consciousness. It often occurs with orthostatic hypotension. Vertigo is a false sense
of motion (room spinning). Disequilibrium refers to imbalance or unsteadiness .
QUESTION 7
The point of maximum impulse (PMI) is MOST often palpable in healthy adults when
positioned in the supine or left lateral decubitus position. Which one of the following
locations is most commonly described as the PMI in a healthy adult?
A) Left 2nd intercostal space, midaxillary line
B) Left 5th intercostal space, midclavicular line
C) Right 4th intercostal space, midaxillary line
D) Right 2nd intercostal space, midclavicular line
Rationale: The PMI is most commonly palpable in the left 5th intercostal space (ICS) at
the midclavicular line (MCL) because this location corresponds to the apex of the heart,
which is the area of maximum impulse generation .
Sure pass
NR511 CEA Exam (2026–2027 Update) Practice
Questions with Verified Answers & Rationales
Chamberlain University | Advanced Practice Nursing | Graded
A+
QUESTION 1
A 45-year-old male presents with chest pain that is pressure-like, radiating to the left
arm, associated with diaphoresis and nausea. The pain started 30 minutes ago while
shoveling snow. What is the most appropriate initial action?
A) Obtain a detailed cardiac history
B) Administer aspirin 324 mg PO
C) Activate EMS for immediate transport
D) Perform an EKG in the office
Rationale: This patient has symptoms concerning for acute coronary syndrome (ACS). The
most appropriate initial action is to activate EMS for immediate transport to an emergency
department. While aspirin and EKG are important, they should not delay emergency
transport .
QUESTION 2
A 65-year-old female presents with acute onset of severe, tearing chest pain radiating to
the back. Blood pressure is 160/90 in the right arm and 100/60 in the left arm. What is
the most likely diagnosis?
Sure pass
,2
A) Acute myocardial infarction
B) Pulmonary embolism
C) Aortic dissection
D) Pericarditis
Rationale: Aortic dissection presents with severe, tearing chest pain that radiates to the
back and can cause discrepancies in blood pressure between arms. This clinical picture is
classic for aortic dissection, which is a medical emergency requiring immediate imaging
and surgical consultation .
QUESTION 3
What is the primary purpose of creating a differential diagnosis list?
A) To list all possible diseases that could explain a patient's symptoms, ranked
from most to least likely
B) To provide a definitive diagnosis before any testing is done
C) To satisfy insurance requirements for reimbursement
D) To document only the most serious condition regardless of likelihood
Rationale: A differential diagnosis list is a systematic method to identify and rank
potential causes of a patient's presenting symptoms. This process ensures comprehensive
clinical reasoning, prevents premature closure, and guides appropriate diagnostic testing .
QUESTION 4
A 55-year-old male presents with chest pain. Which finding on history most increases
the probability of acute coronary syndrome (ACS)?
Sure pass
,3
A) Sharp, positional pain reproducible with palpation
B) Pain that radiates to the left arm or jaw
C) Pain that worsens with deep inspiration
D) Pain that improves with leaning forward
Rationale: Pain radiating to the left arm or jaw is a classic symptom of cardiac ischemia
and is one of the key features that increases the probability of ACS. Positional pain, pain
with palpation, and pain worsening with inspiration are more consistent with
musculoskeletal or pericardial etiologies .
QUESTION 5
Your 22-year-old male patient states during his review of systems that his scrotum is
very enlarged and "feels like it is full of fluid." He is a powerlifter and works as a trash
collector. You suspect the patient likely has which diagnosis?
A) Varicocele
B) Meningocele
C) Rectocele
D) Hydrocele
Rationale: A varicocele is an abnormal enlargement of the pampiniform venous plexus in
the scrotum, often described as a "bag of worms." It is more common in men who perform
heavy lifting or prolonged standing due to increased intra-abdominal pressure, which
impedes venous return .
QUESTION 6
Sure pass
, 4
A 60-year-old male presents with dizziness described as "feeling like I might pass out."
He reports it occurs when standing up quickly. Which term best describes this
symptom?
A) Vertigo
B) Presyncope
C) Disequilibrium
D) Lightheadedness
Rationale: Presyncope is the sensation of feeling faint or about to pass out without actual
loss of consciousness. It often occurs with orthostatic hypotension. Vertigo is a false sense
of motion (room spinning). Disequilibrium refers to imbalance or unsteadiness .
QUESTION 7
The point of maximum impulse (PMI) is MOST often palpable in healthy adults when
positioned in the supine or left lateral decubitus position. Which one of the following
locations is most commonly described as the PMI in a healthy adult?
A) Left 2nd intercostal space, midaxillary line
B) Left 5th intercostal space, midclavicular line
C) Right 4th intercostal space, midaxillary line
D) Right 2nd intercostal space, midclavicular line
Rationale: The PMI is most commonly palpable in the left 5th intercostal space (ICS) at
the midclavicular line (MCL) because this location corresponds to the apex of the heart,
which is the area of maximum impulse generation .
Sure pass
