NR 603 CEA Exam | Latest Update 2026/2027 | 200 Questions
& Verified Answers with Detailed Rationales | Chamberlain
FNP Complete Test Bank | A+ Graded
Section 1: Cardiovascular System (Questions 1–30)
Question 1
A 58yearold male with hypertension presents to the ED with substernal chest pressure radiating to his
left arm, accompanied by diaphoresis and nausea. What is the most appropriate initial diagnostic test?
A) Chest Xray
B) 12lead ECG
C) Cardiac troponin
D) Stress echocardiogram
Correct Answer: B) 12lead ECG
Rationale: A 12lead ECG should be obtained within 10 minutes of arrival for any patient with chest pain
suspicious for myocardial infarction. It immediately identifies STelevation MI (STEMI), which requires
urgent reperfusion. While troponin is critical, the ECG provides immediate, timesensitive information.
Question 2
Which cardiac biomarker is the most specific for myocardial infarction?
A) CKMB
B) BNP
C) Troponin I
,D) Ddimer
Correct Answer: C) Troponin I
Rationale: Troponin I is highly specific for myocardial injury and is the preferred biomarker for
diagnosing MI. CKMB is less specific and can be elevated in skeletal muscle injury. BNP indicates heart
failure, and Ddimer is used for thromboembolic evaluation.
Question 3
A 65yearold African American patient with hypertension has not achieved target blood pressure on an
ACE inhibitor. According to JNC8 guidelines, which medication class should be considered as firstline
therapy?
A) Betablockers
B) Calcium channel blockers
C) Thiazide diuretics
D) ARBs
Correct Answer: B) Calcium channel blockers
Rationale: JNC8 guidelines recommend calcium channel blockers (particularly dihydropyridines like
amlodipine) over ACE inhibitors in African American patients due to better outcomes. Lifestyle changes
such as the DASH diet and salt restriction should also be implemented.
Question 4
A patient with chronic hypertension presents with proteinuria on urinalysis. Which complication of
hypertension is most likely responsible?
,A) Hemorrhagic stroke
B) Arteriovenous nicking
C) Renal damage
D) Peripheral neuropathy
Correct Answer: C) Renal damage
Rationale: Chronic hypertension can cause proteinuria as a result of renal damage. Other direct
complications include arteriovenous (AV) nicking and hemorrhagic stroke. Peripheral neuropathy is
more commonly associated with diabetes but may cooccur in hypertensive patients with diabetes.
Question 5
A 72yearold patient with a history of hypertension presents with dyspnea on exertion, orthopnea, and
bilateral crackles on lung auscultation. Jugular venous distention is also noted. What is the most likely
diagnosis?
A) Myocardial infarction
B) Congestive heart failure
C) Pulmonary embolism
D) Pneumonia
Correct Answer: B) Congestive heart failure
Rationale: Dyspnea on exertion, orthopnea, jugular venous distention (JVD), and bilateral crackles are
classic signs of congestive heart failure (CHF). JVD and pulmonary crackles indicate CHF over other
conditions like myocardial infarction.
, Question 6
A patient with heart failure has an ejection fraction of 35% following a myocardial infarction. What
intervention is recommended for sudden cardiac death prevention?
A) Betablocker therapy alone
B) ACE inhibitor therapy
C) LifeVest or implantable cardioverterdefibrillator (AICD)
D) Digoxin
Correct Answer: C) LifeVest or implantable cardioverterdefibrillator (AICD)
Rationale: Patients with EF ≤35% should use a LifeVest or AICD for sudden cardiac death prevention.
Low EF increases arrhythmia risk. Reassessment with an echocardiogram 23 months postMI monitors
recovery.
Question 7
Which of the following best describes diastolic dysfunction?
A) The heart's inability to contract effectively
B) The heart's inability to relax fully, leading to reduced filling during diastole
C) Decreased cardiac output due to valve stenosis
D) Impaired electrical conduction through the AV node
Correct Answer: B) The heart's inability to relax fully, leading to reduced filling during diastole
& Verified Answers with Detailed Rationales | Chamberlain
FNP Complete Test Bank | A+ Graded
Section 1: Cardiovascular System (Questions 1–30)
Question 1
A 58yearold male with hypertension presents to the ED with substernal chest pressure radiating to his
left arm, accompanied by diaphoresis and nausea. What is the most appropriate initial diagnostic test?
A) Chest Xray
B) 12lead ECG
C) Cardiac troponin
D) Stress echocardiogram
Correct Answer: B) 12lead ECG
Rationale: A 12lead ECG should be obtained within 10 minutes of arrival for any patient with chest pain
suspicious for myocardial infarction. It immediately identifies STelevation MI (STEMI), which requires
urgent reperfusion. While troponin is critical, the ECG provides immediate, timesensitive information.
Question 2
Which cardiac biomarker is the most specific for myocardial infarction?
A) CKMB
B) BNP
C) Troponin I
,D) Ddimer
Correct Answer: C) Troponin I
Rationale: Troponin I is highly specific for myocardial injury and is the preferred biomarker for
diagnosing MI. CKMB is less specific and can be elevated in skeletal muscle injury. BNP indicates heart
failure, and Ddimer is used for thromboembolic evaluation.
Question 3
A 65yearold African American patient with hypertension has not achieved target blood pressure on an
ACE inhibitor. According to JNC8 guidelines, which medication class should be considered as firstline
therapy?
A) Betablockers
B) Calcium channel blockers
C) Thiazide diuretics
D) ARBs
Correct Answer: B) Calcium channel blockers
Rationale: JNC8 guidelines recommend calcium channel blockers (particularly dihydropyridines like
amlodipine) over ACE inhibitors in African American patients due to better outcomes. Lifestyle changes
such as the DASH diet and salt restriction should also be implemented.
Question 4
A patient with chronic hypertension presents with proteinuria on urinalysis. Which complication of
hypertension is most likely responsible?
,A) Hemorrhagic stroke
B) Arteriovenous nicking
C) Renal damage
D) Peripheral neuropathy
Correct Answer: C) Renal damage
Rationale: Chronic hypertension can cause proteinuria as a result of renal damage. Other direct
complications include arteriovenous (AV) nicking and hemorrhagic stroke. Peripheral neuropathy is
more commonly associated with diabetes but may cooccur in hypertensive patients with diabetes.
Question 5
A 72yearold patient with a history of hypertension presents with dyspnea on exertion, orthopnea, and
bilateral crackles on lung auscultation. Jugular venous distention is also noted. What is the most likely
diagnosis?
A) Myocardial infarction
B) Congestive heart failure
C) Pulmonary embolism
D) Pneumonia
Correct Answer: B) Congestive heart failure
Rationale: Dyspnea on exertion, orthopnea, jugular venous distention (JVD), and bilateral crackles are
classic signs of congestive heart failure (CHF). JVD and pulmonary crackles indicate CHF over other
conditions like myocardial infarction.
, Question 6
A patient with heart failure has an ejection fraction of 35% following a myocardial infarction. What
intervention is recommended for sudden cardiac death prevention?
A) Betablocker therapy alone
B) ACE inhibitor therapy
C) LifeVest or implantable cardioverterdefibrillator (AICD)
D) Digoxin
Correct Answer: C) LifeVest or implantable cardioverterdefibrillator (AICD)
Rationale: Patients with EF ≤35% should use a LifeVest or AICD for sudden cardiac death prevention.
Low EF increases arrhythmia risk. Reassessment with an echocardiogram 23 months postMI monitors
recovery.
Question 7
Which of the following best describes diastolic dysfunction?
A) The heart's inability to contract effectively
B) The heart's inability to relax fully, leading to reduced filling during diastole
C) Decreased cardiac output due to valve stenosis
D) Impaired electrical conduction through the AV node
Correct Answer: B) The heart's inability to relax fully, leading to reduced filling during diastole
