NR603 CEA Exam 2026/2027 | Practice
Questions, Case Studies, Verified Answers &
Rationales | Chamberlain University | Just
Released This Year PDF | Updated This Year
NR603 CEA EXAM 2026/2027 PRACTICE QUESTIONS
Complete Study Guide with Verified Answers & Rationales
DOCUMENT OVERVIEW:
• This comprehensive practice exam contains carefully selected questions aligned
with the NR603 Comprehensive Exam for Advanced Practice Nurses, covering all
major clinical domains and evidence-based management strategies to prepare you
for successful certification.
• Use this material by reviewing questions systematically, carefully studying the
detailed rationales for both correct and incorrect answers, and focusing on areas
where you demonstrate knowledge gaps to optimize your exam preparation.
QUESTION 1
A 52-year-old male presents with chest pain radiating to the left arm,
shortness of breath, and diaphoresis. His ECG shows ST elevation in leads II,
III, and aVF. What is the most appropriate immediate intervention?
A) Administer aspirin 325 mg and schedule cardiac catheterization for the next day
B) Start the patient on sublingual nitroglycerin and arrange immediate cardiac
catheterization
C) Obtain a chest X-ray and start the patient on beta-blockers
D) Administer morphine and refer to cardiology clinic within 48 hours
E) Start continuous oxygen and observe in the emergency department for 6 hours
,CORRECT ANSWER: B) Start the patient on sublingual nitroglycerin and
arrange immediate cardiac catheterization
Rationale: This patient presents with an acute ST-elevation myocardial infarction
(STEMI) in the inferior wall. Immediate interventions include aspirin, antiplatelet
therapy, and urgent cardiac catheterization with percutaneous coronary
intervention (PCI). Sublingual nitroglycerin should be administered to relieve chest
pain and reduce cardiac preload. Immediate cardiac catheterization (not delayed) is
the gold standard for STEMI management, as time is myocardium. The door-to-
balloon time should be less than 90 minutes. Options A, C, D, and E delay necessary
intervention or fail to address the acute nature of STEMI.
QUESTION 2
A 68-year-old woman with a 10-year history of hypertension and diabetes
presents with exertional dyspnea and peripheral edema. Echocardiography
reveals a left ventricular ejection fraction of 35%. What is the most
appropriate first-line pharmacotherapy?
A) Diuretics alone to manage fluid overload
B) ACE inhibitors or angiotensin receptor blockers (ARBs)
C) Beta-blockers without additional agents
D) Calcium channel blockers as monotherapy
E) Vasodilators only
CORRECT ANSWER: B) ACE inhibitors or angiotensin receptor blockers (ARBs)
Rationale: In heart failure with reduced ejection fraction (HFrEF), ACE inhibitors
and ARBs are foundational therapies that reduce mortality, improve symptoms,
and slow disease progression by inhibiting the renin-angiotensin-aldosterone
system (RAAS). These agents should be initiated early in all patients with HFrEF
unless contraindicated. While diuretics address fluid overload symptoms, they do
not modify disease progression. Beta-blockers are also essential but are typically
used in combination with ACE inhibitors/ARBs. Calcium channel blockers do not
,have the same mortality benefit and may worsen HF. Vasodilators alone lack the
evidence-based benefit of RAAS inhibitors.
QUESTION 3
A 45-year-old male with COPD presents with acute exacerbation characterized
by increased dyspnea, cough, and purulent sputum. His FEV1 is 45% predicted.
Which antibiotic class is most appropriate as empiric therapy?
A) Fluoroquinolones or beta-lactam with beta-lactamase inhibitor
B) Macrolides alone
C) Aminoglycosides
D) First-generation cephalosporins
E) Penicillin monotherapy
CORRECT ANSWER: A) Fluoroquinolones or beta-lactam with beta-lactamase
inhibitor
Rationale: In moderate to severe COPD exacerbations, empiric antibiotic coverage
should target common pathogens including Haemophilus influenzae, Moraxella
catarrhalis, and Streptococcus pneumoniae. Fluoroquinolones (levofloxacin,
moxifloxacin) and beta-lactams with beta-lactamase inhibitors (amoxicillin-
clavulanate) provide appropriate coverage. Macrolides alone have limited spectrum
and emerging resistance. Aminoglycosides are not first-line and carry toxicity risks.
First-generation cephalosporins have inadequate coverage. Penicillin monotherapy
is inadequate for resistant organisms.
QUESTION 4
A 38-year-old female with Crohn's disease presents with severe abdominal
pain, fever, and leukocytosis (WBC 14,000). Imaging reveals a localized
abscess. What is the most appropriate management?
A) Immediate surgical resection of the affected bowel segment
, B) IV antibiotics and percutaneous drainage if >3 cm
C) Mesalamine suppositories only
D) Total parenteral nutrition without antibiotic therapy
E) Azathioprine monotherapy
CORRECT ANSWER: B) IV antibiotics and percutaneous drainage if >3 cm
Rationale: Localized abscesses in inflammatory bowel disease should be managed
medically first with IV broad-spectrum antibiotics targeting aerobic and anaerobic
organisms. Percutaneous drainage or CT-guided drainage is performed if the
abscess is >3 cm or fails to respond to antibiotics within 7-10 days. Surgery is
reserved for perforation, uncontrolled sepsis, or failed medical management.
Mesalamine suppositories are not adequate for acute abscess management. TPN
may be supportive but does not address the infection. Azathioprine alone would be
inappropriate for an acute infection.
QUESTION 5
A 72-year-old male with a history of atrial fibrillation on warfarin presents
with acute ischemic stroke. CT shows no hemorrhage. His INR is 2.8. What is
the most appropriate initial management?
A) Administer fresh frozen plasma (FFP) immediately and hold warfarin
B) Administer alteplase (tPA) without modification of warfarin therapy
C) Hold warfarin and administer vitamin K 10 mg IV for reversal
D) Continue warfarin at current dose and start aspirin
E) Administer low-molecular-weight heparin as bridge therapy
CORRECT ANSWER: A) Administer fresh frozen plasma (FFP) immediately and
hold warfarin
Rationale: In acute ischemic stroke with elevated INR (>1.4), management depends
on candidacy for thrombolytic therapy and bleeding risk. An INR of 2.8
contraindicates alteplase administration. FFP (10-15 mL/kg) rapidly provides vitamin
Questions, Case Studies, Verified Answers &
Rationales | Chamberlain University | Just
Released This Year PDF | Updated This Year
NR603 CEA EXAM 2026/2027 PRACTICE QUESTIONS
Complete Study Guide with Verified Answers & Rationales
DOCUMENT OVERVIEW:
• This comprehensive practice exam contains carefully selected questions aligned
with the NR603 Comprehensive Exam for Advanced Practice Nurses, covering all
major clinical domains and evidence-based management strategies to prepare you
for successful certification.
• Use this material by reviewing questions systematically, carefully studying the
detailed rationales for both correct and incorrect answers, and focusing on areas
where you demonstrate knowledge gaps to optimize your exam preparation.
QUESTION 1
A 52-year-old male presents with chest pain radiating to the left arm,
shortness of breath, and diaphoresis. His ECG shows ST elevation in leads II,
III, and aVF. What is the most appropriate immediate intervention?
A) Administer aspirin 325 mg and schedule cardiac catheterization for the next day
B) Start the patient on sublingual nitroglycerin and arrange immediate cardiac
catheterization
C) Obtain a chest X-ray and start the patient on beta-blockers
D) Administer morphine and refer to cardiology clinic within 48 hours
E) Start continuous oxygen and observe in the emergency department for 6 hours
,CORRECT ANSWER: B) Start the patient on sublingual nitroglycerin and
arrange immediate cardiac catheterization
Rationale: This patient presents with an acute ST-elevation myocardial infarction
(STEMI) in the inferior wall. Immediate interventions include aspirin, antiplatelet
therapy, and urgent cardiac catheterization with percutaneous coronary
intervention (PCI). Sublingual nitroglycerin should be administered to relieve chest
pain and reduce cardiac preload. Immediate cardiac catheterization (not delayed) is
the gold standard for STEMI management, as time is myocardium. The door-to-
balloon time should be less than 90 minutes. Options A, C, D, and E delay necessary
intervention or fail to address the acute nature of STEMI.
QUESTION 2
A 68-year-old woman with a 10-year history of hypertension and diabetes
presents with exertional dyspnea and peripheral edema. Echocardiography
reveals a left ventricular ejection fraction of 35%. What is the most
appropriate first-line pharmacotherapy?
A) Diuretics alone to manage fluid overload
B) ACE inhibitors or angiotensin receptor blockers (ARBs)
C) Beta-blockers without additional agents
D) Calcium channel blockers as monotherapy
E) Vasodilators only
CORRECT ANSWER: B) ACE inhibitors or angiotensin receptor blockers (ARBs)
Rationale: In heart failure with reduced ejection fraction (HFrEF), ACE inhibitors
and ARBs are foundational therapies that reduce mortality, improve symptoms,
and slow disease progression by inhibiting the renin-angiotensin-aldosterone
system (RAAS). These agents should be initiated early in all patients with HFrEF
unless contraindicated. While diuretics address fluid overload symptoms, they do
not modify disease progression. Beta-blockers are also essential but are typically
used in combination with ACE inhibitors/ARBs. Calcium channel blockers do not
,have the same mortality benefit and may worsen HF. Vasodilators alone lack the
evidence-based benefit of RAAS inhibitors.
QUESTION 3
A 45-year-old male with COPD presents with acute exacerbation characterized
by increased dyspnea, cough, and purulent sputum. His FEV1 is 45% predicted.
Which antibiotic class is most appropriate as empiric therapy?
A) Fluoroquinolones or beta-lactam with beta-lactamase inhibitor
B) Macrolides alone
C) Aminoglycosides
D) First-generation cephalosporins
E) Penicillin monotherapy
CORRECT ANSWER: A) Fluoroquinolones or beta-lactam with beta-lactamase
inhibitor
Rationale: In moderate to severe COPD exacerbations, empiric antibiotic coverage
should target common pathogens including Haemophilus influenzae, Moraxella
catarrhalis, and Streptococcus pneumoniae. Fluoroquinolones (levofloxacin,
moxifloxacin) and beta-lactams with beta-lactamase inhibitors (amoxicillin-
clavulanate) provide appropriate coverage. Macrolides alone have limited spectrum
and emerging resistance. Aminoglycosides are not first-line and carry toxicity risks.
First-generation cephalosporins have inadequate coverage. Penicillin monotherapy
is inadequate for resistant organisms.
QUESTION 4
A 38-year-old female with Crohn's disease presents with severe abdominal
pain, fever, and leukocytosis (WBC 14,000). Imaging reveals a localized
abscess. What is the most appropriate management?
A) Immediate surgical resection of the affected bowel segment
, B) IV antibiotics and percutaneous drainage if >3 cm
C) Mesalamine suppositories only
D) Total parenteral nutrition without antibiotic therapy
E) Azathioprine monotherapy
CORRECT ANSWER: B) IV antibiotics and percutaneous drainage if >3 cm
Rationale: Localized abscesses in inflammatory bowel disease should be managed
medically first with IV broad-spectrum antibiotics targeting aerobic and anaerobic
organisms. Percutaneous drainage or CT-guided drainage is performed if the
abscess is >3 cm or fails to respond to antibiotics within 7-10 days. Surgery is
reserved for perforation, uncontrolled sepsis, or failed medical management.
Mesalamine suppositories are not adequate for acute abscess management. TPN
may be supportive but does not address the infection. Azathioprine alone would be
inappropriate for an acute infection.
QUESTION 5
A 72-year-old male with a history of atrial fibrillation on warfarin presents
with acute ischemic stroke. CT shows no hemorrhage. His INR is 2.8. What is
the most appropriate initial management?
A) Administer fresh frozen plasma (FFP) immediately and hold warfarin
B) Administer alteplase (tPA) without modification of warfarin therapy
C) Hold warfarin and administer vitamin K 10 mg IV for reversal
D) Continue warfarin at current dose and start aspirin
E) Administer low-molecular-weight heparin as bridge therapy
CORRECT ANSWER: A) Administer fresh frozen plasma (FFP) immediately and
hold warfarin
Rationale: In acute ischemic stroke with elevated INR (>1.4), management depends
on candidacy for thrombolytic therapy and bleeding risk. An INR of 2.8
contraindicates alteplase administration. FFP (10-15 mL/kg) rapidly provides vitamin
