NR511 CEA Exam
Questions and Ansẉers with
Rationales 2026\2027 update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
Expert-Verified rationales
Verified ẉith trusted textbooks
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,A 55-year-old male presents with sudden onset severe chest pain
radiating to his back. Blood pressure is 180/110 in the right arm
and 140/80 in the left arm. What is the most likely diagnosis?
A) Acute myocardial infarction
B) Aortic dissection
C) Pulmonary embolism
D) Pericarditis
Answer: B
Rationale: Aortic dissection presents with severe tearing chest pain
radiating to the back and a pulse deficit (BP difference >20 mmHg
between arms). MI pain does not typically cause a pulse deficit.
A 65-year-old female with a history of hypertension presents with
shortness of breath, orthopnea, and bilateral lower extremity
edema. Auscultation reveals crackles at the lung bases and an S3
gallop. What is the most likely diagnosis?
A) Chronic obstructive pulmonary disease
B) Congestive heart failure
C) Pneumonia
D) Pulmonary fibrosis
Answer: B
Rationale: Orthopnea, S3 gallop, crackles, and peripheral edema are
classic signs of congestive heart failure (systolic dysfunction). COPD
typically has wheezing and a prolonged expiratory phase without an
S3.
A 72-year-old male presents with a new irregularly irregular pulse.
He reports mild fatigue but no chest pain or shortness of breath. An
ECG confirms atrial fibrillation. He has a CHA2DS2-VASc score of 3.
What is the most appropriate next step in management?
A) Immediate cardioversion
B) Initiate anticoagulation therapy
C) Prescribe a beta-blocker only
D) Refer for electrophysiology study
Answer: B
,Rationale: A CHA2DS2-VASc score of 3 in a male indicates a high
risk of stroke, necessitating anticoagulation (e.g., a DOAC or
warfarin). Cardioversion is not indicated without hemodynamic
instability or proper anticoagulation duration.
A 50-year-old male with a 40-pack-year smoking history presents
with calf pain that occurs while walking and is relieved by rest. What
is the most likely diagnosis?
A) Deep vein thrombosis
B) Peripheral arterial disease
C) Popliteal cyst
D) Muscular strain
Answer: B
Rationale: Intermittent claudication (pain with walking, relieved by
rest) is the classic presentation of peripheral arterial disease (PAD),
highly associated with smoking. DVT pain is usually constant and
not strictly relieved by rest.
A 45-year-old African American male presents with a blood pressure
of 165/100 mmHg on three separate visits. He has no other medical
conditions. Laboratory tests are normal. What is the most
appropriate initial pharmacologic treatment?
A) ACE inhibitor
B) Calcium channel blocker
C) Beta-blocker
D) Diuretic
Answer: B
Rationale: African American patients respond better to calcium
channel blockers and thiazide diuretics as initial monotherapy for
hypertension. ACE inhibitors are less effective as monotherapy in
this demographic and carry a higher risk of angioedema.
A 60-year-old female with a 30-pack-year smoking history presents
with progressive dyspnea and a chronic productive cough.
Spirometry shows an FEV1/FVC ratio of 0.60, which improves
minimally with bronchodilators. What is the most likely diagnosis?
A) Asthma
, B) Chronic obstructive pulmonary disease
C) Congestive heart failure
D) Pulmonary hypertension
Answer: B
Rationale: A smoking history, chronic productive cough, and an
FEV1/FVC ratio < 0.70 that does not significantly reverse with
bronchodilators is diagnostic for COPD. Asthma typically reverses
significantly with bronchodilators.
A 25-year-old female presents with episodic wheezing, coughing,
and chest tightness that worsens at night and early in the morning.
Symptoms are exacerbated by exercise and cold air. What is the
most likely diagnosis?
A) Acute bronchitis
B) Asthma
C) GERD
D) Anxiety
Answer: B
Rationale: Episodic wheezing, cough, and chest tightness triggered
by exercise, cold air, and nocturnal patterns are classic for asthma.
GERD can cause cough but typically not wheezing without
aspiration.
A 70-year-old male presents with a fever, productive cough with
rust-colored sputum, and pleuritic chest pain. Auscultation reveals
bronchial breath sounds in the right lower lobe. Chest X-ray shows a
lobar consolidation. What is the most likely diagnosis?
A) Viral pneumonia
B) Bacterial pneumonia
C) Pulmonary embolism
D) Lung abscess
Answer: B
Rationale: Acute onset fever, productive cough with rust-colored
sputum, pleuritic pain, and lobar consolidation on X-ray are classic
for typical bacterial pneumonia (e.g., Streptococcus pneumoniae).
Viral pneumonia usually presents with diffuse infiltrates.
Questions and Ansẉers with
Rationales 2026\2027 update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
Expert-Verified rationales
Verified ẉith trusted textbooks
───────────────────────────────────────────────────────
─
,A 55-year-old male presents with sudden onset severe chest pain
radiating to his back. Blood pressure is 180/110 in the right arm
and 140/80 in the left arm. What is the most likely diagnosis?
A) Acute myocardial infarction
B) Aortic dissection
C) Pulmonary embolism
D) Pericarditis
Answer: B
Rationale: Aortic dissection presents with severe tearing chest pain
radiating to the back and a pulse deficit (BP difference >20 mmHg
between arms). MI pain does not typically cause a pulse deficit.
A 65-year-old female with a history of hypertension presents with
shortness of breath, orthopnea, and bilateral lower extremity
edema. Auscultation reveals crackles at the lung bases and an S3
gallop. What is the most likely diagnosis?
A) Chronic obstructive pulmonary disease
B) Congestive heart failure
C) Pneumonia
D) Pulmonary fibrosis
Answer: B
Rationale: Orthopnea, S3 gallop, crackles, and peripheral edema are
classic signs of congestive heart failure (systolic dysfunction). COPD
typically has wheezing and a prolonged expiratory phase without an
S3.
A 72-year-old male presents with a new irregularly irregular pulse.
He reports mild fatigue but no chest pain or shortness of breath. An
ECG confirms atrial fibrillation. He has a CHA2DS2-VASc score of 3.
What is the most appropriate next step in management?
A) Immediate cardioversion
B) Initiate anticoagulation therapy
C) Prescribe a beta-blocker only
D) Refer for electrophysiology study
Answer: B
,Rationale: A CHA2DS2-VASc score of 3 in a male indicates a high
risk of stroke, necessitating anticoagulation (e.g., a DOAC or
warfarin). Cardioversion is not indicated without hemodynamic
instability or proper anticoagulation duration.
A 50-year-old male with a 40-pack-year smoking history presents
with calf pain that occurs while walking and is relieved by rest. What
is the most likely diagnosis?
A) Deep vein thrombosis
B) Peripheral arterial disease
C) Popliteal cyst
D) Muscular strain
Answer: B
Rationale: Intermittent claudication (pain with walking, relieved by
rest) is the classic presentation of peripheral arterial disease (PAD),
highly associated with smoking. DVT pain is usually constant and
not strictly relieved by rest.
A 45-year-old African American male presents with a blood pressure
of 165/100 mmHg on three separate visits. He has no other medical
conditions. Laboratory tests are normal. What is the most
appropriate initial pharmacologic treatment?
A) ACE inhibitor
B) Calcium channel blocker
C) Beta-blocker
D) Diuretic
Answer: B
Rationale: African American patients respond better to calcium
channel blockers and thiazide diuretics as initial monotherapy for
hypertension. ACE inhibitors are less effective as monotherapy in
this demographic and carry a higher risk of angioedema.
A 60-year-old female with a 30-pack-year smoking history presents
with progressive dyspnea and a chronic productive cough.
Spirometry shows an FEV1/FVC ratio of 0.60, which improves
minimally with bronchodilators. What is the most likely diagnosis?
A) Asthma
, B) Chronic obstructive pulmonary disease
C) Congestive heart failure
D) Pulmonary hypertension
Answer: B
Rationale: A smoking history, chronic productive cough, and an
FEV1/FVC ratio < 0.70 that does not significantly reverse with
bronchodilators is diagnostic for COPD. Asthma typically reverses
significantly with bronchodilators.
A 25-year-old female presents with episodic wheezing, coughing,
and chest tightness that worsens at night and early in the morning.
Symptoms are exacerbated by exercise and cold air. What is the
most likely diagnosis?
A) Acute bronchitis
B) Asthma
C) GERD
D) Anxiety
Answer: B
Rationale: Episodic wheezing, cough, and chest tightness triggered
by exercise, cold air, and nocturnal patterns are classic for asthma.
GERD can cause cough but typically not wheezing without
aspiration.
A 70-year-old male presents with a fever, productive cough with
rust-colored sputum, and pleuritic chest pain. Auscultation reveals
bronchial breath sounds in the right lower lobe. Chest X-ray shows a
lobar consolidation. What is the most likely diagnosis?
A) Viral pneumonia
B) Bacterial pneumonia
C) Pulmonary embolism
D) Lung abscess
Answer: B
Rationale: Acute onset fever, productive cough with rust-colored
sputum, pleuritic pain, and lobar consolidation on X-ray are classic
for typical bacterial pneumonia (e.g., Streptococcus pneumoniae).
Viral pneumonia usually presents with diffuse infiltrates.
