NR511 Week 2 CEA Exam Actual Exam 2026/2027 with Detailed Rationales |
Complete Exam-Style Questions | 100% Verified | Pass Guaranteed – A+ Graded
EXAM INFORMATION
Total Questions: 50
Recommended Time: 75 minutes
Passing Threshold: 80%
Exam Format: Multiple Choice Questions (MCQs)
Question Style: Scenario-Based, Applied, and Professional Decision-Making Questions
==============================
SECTION 1: Advanced Health Assessment and Clinical Reasoning
Question 1: A 58-year-old male presents with a chief complaint of chest pain that began
30 minutes ago while mowing his lawn. He describes the pain as a pressure sensation
radiating to his left jaw and arm. His blood pressure is 168/96 mmHg, heart rate 102
bpm, respiratory rate 18, and oxygen saturation 94% on room air. Which assessment
finding would most strongly support a diagnosis of acute coronary syndrome over
stable angina?
A. Pain that is reproducible with palpation of the chest wall
B. Pain that began at rest and has persisted for 30 minutes
C. Pain that is relieved by sublingual nitroglycerin within 5 minutes
D. Pain that is localized to a specific point on the chest
,Correct Answer: B
Rationale: Acute coronary syndrome (ACS) is characterized by unstable angina or
myocardial infarction, where chest pain occurs at rest or with minimal exertion and
persists for more than 20 minutes. Stable angina typically occurs with predictable
exertion and is relieved by rest or nitroglycerin within 5 minutes. Pain reproducible with
palpation suggests musculoskeletal etiology. Localized point tenderness is also
atypical for cardiac pain, which is usually diffuse and pressure-like.
Question 2: During a routine physical examination of a 45-year-old female, the nurse
practitioner auscultates a mid-systolic click followed by a late systolic murmur at the
apex. The murmur intensifies when the patient moves from supine to standing. Which
valvular disorder is most consistent with these findings?
A. Aortic stenosis
B. Mitral valve prolapse
C. Mitral regurgitation
D. Tricuspid regurgitation
Correct Answer: B
Rationale: The classic auscultatory findings of mitral valve prolapse include a
mid-systolic click and a late systolic murmur best heard at the apex. The murmur of
mitral valve prolapse lengthens and intensifies with maneuvers that decrease left
ventricular volume, such as moving from supine to standing or during the Valsalva
maneuver. Aortic stenosis produces a crescendo-decrescendo systolic murmur at the
right upper sternal border. Mitral regurgitation typically presents with a holosystolic
,murmur. Tricuspid regurgitation produces a holosystolic murmur that increases with
inspiration.
Question 3: A 62-year-old patient with a history of chronic obstructive pulmonary
disease presents with increased dyspnea, productive cough with purulent sputum, and
low-grade fever. On physical examination, the nurse practitioner notes diminished
breath sounds and hyperresonance to percussion over the right lower lobe. Which
additional finding would best differentiate a pneumothorax from a COPD exacerbation
with lobar consolidation?
A. Decreased tactile fremitus on the affected side
B. Increased tactile fremitus on the affected side
C. Dullness to percussion over the affected area
D. Crackles auscultated over the affected area
Correct Answer: A
Rationale: Pneumothorax is characterized by decreased or absent tactile fremitus,
hyperresonance to percussion, and diminished breath sounds on the affected side due
to air in the pleural space. In contrast, lobar consolidation from pneumonia or COPD
exacerbation would present with increased tactile fremitus, dullness to percussion, and
possibly crackles or bronchial breath sounds. Decreased fremitus is the key
distinguishing finding for pneumothorax.
, Question 4: A 38-year-old female presents with fatigue, weight gain, cold intolerance,
and dry skin. Laboratory studies reveal a TSH of 12.4 mIU/L and free T4 of 0.6 ng/dL.
During the physical examination, which finding would be most specific for confirming
the suspected diagnosis?
A. Exophthalmos and lid lag
B. Fine tremor and warm moist skin
C. Delayed deep tendon reflexes and periorbital edema
D. Tachycardia and widened pulse pressure
Correct Answer: C
Rationale: The laboratory values indicate primary hypothyroidism with elevated TSH and
low free T4. Physical examination findings specific to hypothyroidism include delayed
relaxation phase of deep tendon reflexes, periorbital edema, dry coarse skin, and
bradycardia. Exophthalmos, lid lag, fine tremor, warm moist skin, tachycardia, and
widened pulse pressure are all characteristic of hyperthyroidism, not hypothyroidism.
Question 5: A 28-year-old male presents after a motor vehicle accident complaining of
severe left shoulder pain. He is holding his left arm close to his body with the forearm
rotated externally. There is a palpable depression below the acromion process, and the
patient is unable to actively abduct the arm. Which special test would provide the most
definitive confirmation of the suspected injury?
A. Neer impingement test
B. Hawkins-Kennedy test
C. Anterior drawer test of the shoulder
Complete Exam-Style Questions | 100% Verified | Pass Guaranteed – A+ Graded
EXAM INFORMATION
Total Questions: 50
Recommended Time: 75 minutes
Passing Threshold: 80%
Exam Format: Multiple Choice Questions (MCQs)
Question Style: Scenario-Based, Applied, and Professional Decision-Making Questions
==============================
SECTION 1: Advanced Health Assessment and Clinical Reasoning
Question 1: A 58-year-old male presents with a chief complaint of chest pain that began
30 minutes ago while mowing his lawn. He describes the pain as a pressure sensation
radiating to his left jaw and arm. His blood pressure is 168/96 mmHg, heart rate 102
bpm, respiratory rate 18, and oxygen saturation 94% on room air. Which assessment
finding would most strongly support a diagnosis of acute coronary syndrome over
stable angina?
A. Pain that is reproducible with palpation of the chest wall
B. Pain that began at rest and has persisted for 30 minutes
C. Pain that is relieved by sublingual nitroglycerin within 5 minutes
D. Pain that is localized to a specific point on the chest
,Correct Answer: B
Rationale: Acute coronary syndrome (ACS) is characterized by unstable angina or
myocardial infarction, where chest pain occurs at rest or with minimal exertion and
persists for more than 20 minutes. Stable angina typically occurs with predictable
exertion and is relieved by rest or nitroglycerin within 5 minutes. Pain reproducible with
palpation suggests musculoskeletal etiology. Localized point tenderness is also
atypical for cardiac pain, which is usually diffuse and pressure-like.
Question 2: During a routine physical examination of a 45-year-old female, the nurse
practitioner auscultates a mid-systolic click followed by a late systolic murmur at the
apex. The murmur intensifies when the patient moves from supine to standing. Which
valvular disorder is most consistent with these findings?
A. Aortic stenosis
B. Mitral valve prolapse
C. Mitral regurgitation
D. Tricuspid regurgitation
Correct Answer: B
Rationale: The classic auscultatory findings of mitral valve prolapse include a
mid-systolic click and a late systolic murmur best heard at the apex. The murmur of
mitral valve prolapse lengthens and intensifies with maneuvers that decrease left
ventricular volume, such as moving from supine to standing or during the Valsalva
maneuver. Aortic stenosis produces a crescendo-decrescendo systolic murmur at the
right upper sternal border. Mitral regurgitation typically presents with a holosystolic
,murmur. Tricuspid regurgitation produces a holosystolic murmur that increases with
inspiration.
Question 3: A 62-year-old patient with a history of chronic obstructive pulmonary
disease presents with increased dyspnea, productive cough with purulent sputum, and
low-grade fever. On physical examination, the nurse practitioner notes diminished
breath sounds and hyperresonance to percussion over the right lower lobe. Which
additional finding would best differentiate a pneumothorax from a COPD exacerbation
with lobar consolidation?
A. Decreased tactile fremitus on the affected side
B. Increased tactile fremitus on the affected side
C. Dullness to percussion over the affected area
D. Crackles auscultated over the affected area
Correct Answer: A
Rationale: Pneumothorax is characterized by decreased or absent tactile fremitus,
hyperresonance to percussion, and diminished breath sounds on the affected side due
to air in the pleural space. In contrast, lobar consolidation from pneumonia or COPD
exacerbation would present with increased tactile fremitus, dullness to percussion, and
possibly crackles or bronchial breath sounds. Decreased fremitus is the key
distinguishing finding for pneumothorax.
, Question 4: A 38-year-old female presents with fatigue, weight gain, cold intolerance,
and dry skin. Laboratory studies reveal a TSH of 12.4 mIU/L and free T4 of 0.6 ng/dL.
During the physical examination, which finding would be most specific for confirming
the suspected diagnosis?
A. Exophthalmos and lid lag
B. Fine tremor and warm moist skin
C. Delayed deep tendon reflexes and periorbital edema
D. Tachycardia and widened pulse pressure
Correct Answer: C
Rationale: The laboratory values indicate primary hypothyroidism with elevated TSH and
low free T4. Physical examination findings specific to hypothyroidism include delayed
relaxation phase of deep tendon reflexes, periorbital edema, dry coarse skin, and
bradycardia. Exophthalmos, lid lag, fine tremor, warm moist skin, tachycardia, and
widened pulse pressure are all characteristic of hyperthyroidism, not hypothyroidism.
Question 5: A 28-year-old male presents after a motor vehicle accident complaining of
severe left shoulder pain. He is holding his left arm close to his body with the forearm
rotated externally. There is a palpable depression below the acromion process, and the
patient is unable to actively abduct the arm. Which special test would provide the most
definitive confirmation of the suspected injury?
A. Neer impingement test
B. Hawkins-Kennedy test
C. Anterior drawer test of the shoulder
