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NR 667 CEA Exit Newest Exam Preparation With
Complete Questions And Correct Answers With
Rationales Already Graded A+Brand New Version!!
QUESTION 1
A 72-year-old male patient with a history of hypertension and type 2
diabetes mellitus presents to the emergency department with sudden
onset of severe, tearing chest pain that radiates to his back. His blood
pressure is 180/110 mmHg in the right arm and 140/90 mmHg in the
left arm. Which of the following is the most likely diagnosis?
A) Acute myocardial infarction
B) Pulmonary embolism
C) Aortic dissection
D) Pericarditis
Answer: C) Aortic dissection
Explanation: The classic presentation of aortic dissection includes
sudden, severe, tearing chest pain that radiates to the back, often
associated with a difference in blood pressure between the arms. This
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patient's history of hypertension and diabetes further increases his risk
for aortic dissection. Acute myocardial infarction typically presents with
pressure-like chest pain and does not cause a blood pressure
differential. Pulmonary embolism usually presents with pleuritic chest
pain, dyspnea, and tachycardia. Pericarditis pain is typically sharp and
positional, relieved by sitting forward.
QUESTION 2
A 45-year-old female presents with progressive dyspnea on exertion,
dry cough, and fatigue. Chest auscultation reveals bilateral basilar
crackles. Echocardiography demonstrates a reduced ejection fraction of
35%. Which of the following medications has been shown to reduce
mortality in this patient population by inhibiting the renin-angiotensin-
aldosterone system?
A) Metoprolol
B) Lisinopril
C) Furosemide
D) Digoxin
Answer: B) Lisinopril
Explanation: Lisinopril is an angiotensin-converting enzyme (ACE)
inhibitor that has been demonstrated to reduce mortality in patients
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with heart failure with reduced ejection fraction (HFrEF) by decreasing
afterload and preload, inhibiting the renin-angiotensin-aldosterone
system, and preventing ventricular remodeling. Metoprolol is a beta-
blocker that also reduces mortality but works through a different
mechanism. Furosemide is a loop diuretic used for symptom
management but does not improve mortality. Digoxin may reduce
hospitalizations but has not been shown to reduce mortality.
QUESTION 3
A 56-year-old male with a history of chronic obstructive pulmonary
disease (COPD) presents with worsening shortness of breath, increased
sputum production, and purulent sputum. Which of the following
findings on arterial blood gas analysis is most consistent with acute
respiratory acidosis in this patient?
A) pH 7.35, PaCO2 48 mmHg, HCO3- 26 mEq/L
B) pH 7.28, PaCO2 55 mmHg, HCO3- 24 mEq/L
C) pH 7.40, PaCO2 40 mmHg, HCO3- 24 mEq/L
D) pH 7.50, PaCO2 30 mmHg, HCO3- 22 mEq/L
Answer: B) pH 7.28, PaCO2 55 mmHg, HCO3- 24 mEq/L
Explanation: Acute respiratory acidosis is characterized by a decreased
pH (less than 7.35) and an elevated PaCO2 (greater than 45 mmHg).
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Option B shows pH 7.28 (acidemia) with PaCO2 55 mmHg
(hypercapnia), and HCO3- 24 mEq/L, which is within normal range
indicating that renal compensation has not yet occurred. Option A
shows mild respiratory acidosis with some metabolic compensation.
Option C represents normal values. Option D represents respiratory
alkalosis.
QUESTION 4
A 34-year-old pregnant woman at 38 weeks gestation presents with
sudden onset of severe, sharp abdominal pain, vaginal bleeding, and a
rigid, tender uterus. She has a history of preeclampsia. Which of the
following is the most likely diagnosis?
A) Placenta previa
B) Uterine rupture
C) Abruptio placentae
D) Preterm labor
Answer: C) Abruptio placentae
Explanation: Abruptio placentae is the premature separation of a
normally implanted placenta from the uterine wall. Classic signs include
sudden onset of severe abdominal pain, vaginal bleeding (which may be
concealed), and a rigid, tender uterus (board-like abdomen). Risk
NR 667 CEA Exit Newest Exam Preparation With
Complete Questions And Correct Answers With
Rationales Already Graded A+Brand New Version!!
QUESTION 1
A 72-year-old male patient with a history of hypertension and type 2
diabetes mellitus presents to the emergency department with sudden
onset of severe, tearing chest pain that radiates to his back. His blood
pressure is 180/110 mmHg in the right arm and 140/90 mmHg in the
left arm. Which of the following is the most likely diagnosis?
A) Acute myocardial infarction
B) Pulmonary embolism
C) Aortic dissection
D) Pericarditis
Answer: C) Aortic dissection
Explanation: The classic presentation of aortic dissection includes
sudden, severe, tearing chest pain that radiates to the back, often
associated with a difference in blood pressure between the arms. This
,2|Page
patient's history of hypertension and diabetes further increases his risk
for aortic dissection. Acute myocardial infarction typically presents with
pressure-like chest pain and does not cause a blood pressure
differential. Pulmonary embolism usually presents with pleuritic chest
pain, dyspnea, and tachycardia. Pericarditis pain is typically sharp and
positional, relieved by sitting forward.
QUESTION 2
A 45-year-old female presents with progressive dyspnea on exertion,
dry cough, and fatigue. Chest auscultation reveals bilateral basilar
crackles. Echocardiography demonstrates a reduced ejection fraction of
35%. Which of the following medications has been shown to reduce
mortality in this patient population by inhibiting the renin-angiotensin-
aldosterone system?
A) Metoprolol
B) Lisinopril
C) Furosemide
D) Digoxin
Answer: B) Lisinopril
Explanation: Lisinopril is an angiotensin-converting enzyme (ACE)
inhibitor that has been demonstrated to reduce mortality in patients
,3|Page
with heart failure with reduced ejection fraction (HFrEF) by decreasing
afterload and preload, inhibiting the renin-angiotensin-aldosterone
system, and preventing ventricular remodeling. Metoprolol is a beta-
blocker that also reduces mortality but works through a different
mechanism. Furosemide is a loop diuretic used for symptom
management but does not improve mortality. Digoxin may reduce
hospitalizations but has not been shown to reduce mortality.
QUESTION 3
A 56-year-old male with a history of chronic obstructive pulmonary
disease (COPD) presents with worsening shortness of breath, increased
sputum production, and purulent sputum. Which of the following
findings on arterial blood gas analysis is most consistent with acute
respiratory acidosis in this patient?
A) pH 7.35, PaCO2 48 mmHg, HCO3- 26 mEq/L
B) pH 7.28, PaCO2 55 mmHg, HCO3- 24 mEq/L
C) pH 7.40, PaCO2 40 mmHg, HCO3- 24 mEq/L
D) pH 7.50, PaCO2 30 mmHg, HCO3- 22 mEq/L
Answer: B) pH 7.28, PaCO2 55 mmHg, HCO3- 24 mEq/L
Explanation: Acute respiratory acidosis is characterized by a decreased
pH (less than 7.35) and an elevated PaCO2 (greater than 45 mmHg).
, 4|Page
Option B shows pH 7.28 (acidemia) with PaCO2 55 mmHg
(hypercapnia), and HCO3- 24 mEq/L, which is within normal range
indicating that renal compensation has not yet occurred. Option A
shows mild respiratory acidosis with some metabolic compensation.
Option C represents normal values. Option D represents respiratory
alkalosis.
QUESTION 4
A 34-year-old pregnant woman at 38 weeks gestation presents with
sudden onset of severe, sharp abdominal pain, vaginal bleeding, and a
rigid, tender uterus. She has a history of preeclampsia. Which of the
following is the most likely diagnosis?
A) Placenta previa
B) Uterine rupture
C) Abruptio placentae
D) Preterm labor
Answer: C) Abruptio placentae
Explanation: Abruptio placentae is the premature separation of a
normally implanted placenta from the uterine wall. Classic signs include
sudden onset of severe abdominal pain, vaginal bleeding (which may be
concealed), and a rigid, tender uterus (board-like abdomen). Risk
