NR 667 CEA FNP Comprehensive Exam Test Bank
2026/2027 | Complete Verified Practice Questions
with Correct Answers and Detailed Clinical
Rationales | Latest Updated Edition - Graded A+
Question 1
A patient currently undergoing concurrent chemotherapy/radiation treatment for glottic
squamous cell carcinoma is admitted to the rehab unit you oversee for management of
intractable nausea, vomiting, and dehydration. Admission CBC showed WBC 1.3, Hgb 7.5,
PLT 4.5, ANC 0.8. Which of the following conditions is this patient at risk for?
A. Macrocytic anemia due to B12 deficiency
B. Iron deficiency anemia due to chronic blood loss
C. Microcytic anemia due to chronic kidney disease
D. Aplastic anemia due to bone marrow suppression
Answer: D
Rationale: The patient's pancytopenia (low WBC, Hgb, and platelets) with ANC <1.0
indicates severe bone marrow suppression from chemotherapy/radiation. This is consistent
with aplastic anemia due to bone marrow suppression. The treatment for glottic squamous
cell carcinoma with concurrent chemoradiation causes myelosuppression, putting the
patient at risk for aplastic anemia.
Question 2
Your patient presents to the urgent care clinic with a swollen exudative pharynx, profound
fatigue, and a very tender left upper quadrant abdomen. What is the most likely diagnosis?
A. Strep pharyngitis
B. Tonsillitis
C. Epstein Barr virus (EBV)
D. Pancreatitis
Answer: C
Rationale: The triad of exudative pharyngitis, profound fatigue, and left upper quadrant
tenderness (splenomegaly) is classic for Epstein Barr virus (infectious mononucleosis).
Strep pharyngitis typically does not cause splenomegaly, and pancreatitis would present
with epigastric pain rather than left upper quadrant tenderness.
1
,Question 3
Which of the following best characterizes presbycusis in the older adult?
A. Bilateral low-frequency sensorineural hearing loss
B. Bilateral high-frequency sensorineural hearing loss
C. Unilateral high-frequency sensorineural hearing loss
D. Unilateral low-frequency sensorineural hearing loss
Answer: B
Rationale: Presbycusis is age-related hearing loss characterized by bilateral, symmetric,
high-frequency sensorineural hearing loss. It typically affects higher frequencies first,
making it difficult to hear consonants and understand speech in noisy environments.
Question 4
A 35-year-old woman presents with allergic rhinitis, experiencing significant nasal
congestion, sneezing, and itchy eyes. She has tried over-the-counter antihistamines with
limited relief. What is the most appropriate next step in management?
A. Oral decongestants
B. Nasal saline irrigation
C. Intranasal corticosteroids
D. Referral to an allergist for immunotherapy
Answer: C
Rationale: Intranasal corticosteroids are the most effective treatment for moderate to
severe allergic rhinitis and are recommended when antihistamines alone provide inadequate
relief. They reduce inflammation and are more effective than oral decongestants or saline
irrigation alone.
Question 5
A 78-year-old male patient reports chronic infections, bruising, fatigue, SOB, and fevers.
He has a history of rectal adenocarcinoma and completed concurrent
chemotherapy/radiation earlier this year. His CBC shows Hgb 7.5, PLT 8.8, WBC 1.2,
ANC 0.8, and peripheral smear shows dysplasia. What additional work-up would you
anticipate for this patient?
A. Colonoscopy and fecal occult blood test
B. Bone marrow biopsy and flow cytometry
C. No additional work-up is required, these are expected sequela of his oncologic treatment
D. Repeat CBC/CMP/peripheral smear in eight weeks
Answer: B
Rationale: The presence of pancytopenia with peripheral smear showing dysplasia in a
patient with history of chemotherapy/radiation raises concern for therapy-related
myelodysplastic syndrome. A bone marrow biopsy with flow cytometry is necessary to
2
,evaluate for MDS or AML. Waiting eight weeks (D) is inappropriate given the severity of
cytopenias.
Question 6
Progression to Acute Myelogenous Leukemia (AML) is a risk for untreated or poorly
responsive:
A. Pancytopenia
B. Aplastic anemia
C. Macrocytic anemia
D. Myelodysplastic syndrome
Answer: D
Rationale: Myelodysplastic syndrome (MDS) is a bone marrow disorder characterized by
ineffective hematopoiesis and dysplastic changes. It has a significant risk of progression to
acute myelogenous leukemia (AML), particularly in higher-risk subtypes. Untreated or
poorly responsive MDS carries a substantial risk of leukemic transformation.
Question 7
Treatment for symptomatic aplastic anemia includes all the following except:
A. Bone marrow transplant
B. PRBC/Platelet/WBC transfusions
C. Prophylactic antibiotics
D. Removal of bone marrow stimulants
Answer: D
Rationale: Treatment for aplastic anemia includes bone marrow transplant (for eligible
patients), supportive care with blood product transfusions, and prophylactic antibiotics to
prevent infections. There are no "bone marrow stimulants" to remove; the bone marrow is
failing to produce cells. Immunosuppressive therapy is used to stop immune-mediated
destruction of stem cells.
Question 8
A patient diagnosed with iron deficiency anemia requires iron supplementation. Which of
the following treatments would likely be ineffective?
A. Ferrous sulfate 325 mg PO BID for a 43 y.o. F s/p gastric bypass 2 years ago
B. Iron sucrose 200 mg IV infusion weekly x 8 weeks in a 26 y.o. F at 34 weeks of
pregnancy
C. Ferrous sulfate 325 mg PO TID for a 25 y.o. F with menorrhagia
D. Ferrous sulfate 325 mg PO BID for a 63 y.o. M with ulcerative colitis
3
, Answer: A
Rationale: Oral iron is ineffective in patients with gastric bypass because the duodenum
and proximal jejunum (where iron is primarily absorbed) are bypassed. IV iron is required
for these patients. The pregnant patient (B) can receive IV iron, the patient with
menorrhagia (C) can take oral iron, and the patient with ulcerative colitis (D) can take oral
iron (enteric-coated or liquid preparations may be better tolerated).
Question 9
Which of the following is not a common mechanism of neutrophil expenditure and resultant
neutropenia?
A. Decreased neutrophil production in the bone marrow
B. Redistribution of neutrophils to the spleen or vascular endothelium
C. Loss of circulating neutrophils in acute blood loss
D. Immune destruction
Answer: C
Rationale: Neutropenia is caused by decreased production, increased destruction, or
redistribution. Loss of circulating neutrophils in acute blood loss does not cause
neutropenia because acute blood loss primarily reduces red blood cells and volume. While
severe hemorrhage can cause leukopenia, it is not a primary mechanism of neutrophil
expenditure.
Question 10
Which of the following blood lead levels (BLL) would likely require chelation therapy?
A. < 80 mg/dL
B. 35 mcg/dL
C. >100 mg/dL
D. 75 mcg/dL
Answer: D
Rationale: Chelation therapy is recommended for blood lead levels (BLL) ≥ 45 mcg/dL in
children and ≥ 70 mcg/dL in adults. A level of 75 mcg/dL would require chelation therapy.
Levels of 35 mcg/dL may require environmental intervention but not necessarily chelation.
Values >100 mg/dL (using incorrect units) would certainly require chelation, but the correct
units for lead are mcg/dL.
Question 11
A geriatric patient with anemia, back pain, osteoporosis, and elevated erythrocyte
sedimentation rate should be evaluated for:
4
2026/2027 | Complete Verified Practice Questions
with Correct Answers and Detailed Clinical
Rationales | Latest Updated Edition - Graded A+
Question 1
A patient currently undergoing concurrent chemotherapy/radiation treatment for glottic
squamous cell carcinoma is admitted to the rehab unit you oversee for management of
intractable nausea, vomiting, and dehydration. Admission CBC showed WBC 1.3, Hgb 7.5,
PLT 4.5, ANC 0.8. Which of the following conditions is this patient at risk for?
A. Macrocytic anemia due to B12 deficiency
B. Iron deficiency anemia due to chronic blood loss
C. Microcytic anemia due to chronic kidney disease
D. Aplastic anemia due to bone marrow suppression
Answer: D
Rationale: The patient's pancytopenia (low WBC, Hgb, and platelets) with ANC <1.0
indicates severe bone marrow suppression from chemotherapy/radiation. This is consistent
with aplastic anemia due to bone marrow suppression. The treatment for glottic squamous
cell carcinoma with concurrent chemoradiation causes myelosuppression, putting the
patient at risk for aplastic anemia.
Question 2
Your patient presents to the urgent care clinic with a swollen exudative pharynx, profound
fatigue, and a very tender left upper quadrant abdomen. What is the most likely diagnosis?
A. Strep pharyngitis
B. Tonsillitis
C. Epstein Barr virus (EBV)
D. Pancreatitis
Answer: C
Rationale: The triad of exudative pharyngitis, profound fatigue, and left upper quadrant
tenderness (splenomegaly) is classic for Epstein Barr virus (infectious mononucleosis).
Strep pharyngitis typically does not cause splenomegaly, and pancreatitis would present
with epigastric pain rather than left upper quadrant tenderness.
1
,Question 3
Which of the following best characterizes presbycusis in the older adult?
A. Bilateral low-frequency sensorineural hearing loss
B. Bilateral high-frequency sensorineural hearing loss
C. Unilateral high-frequency sensorineural hearing loss
D. Unilateral low-frequency sensorineural hearing loss
Answer: B
Rationale: Presbycusis is age-related hearing loss characterized by bilateral, symmetric,
high-frequency sensorineural hearing loss. It typically affects higher frequencies first,
making it difficult to hear consonants and understand speech in noisy environments.
Question 4
A 35-year-old woman presents with allergic rhinitis, experiencing significant nasal
congestion, sneezing, and itchy eyes. She has tried over-the-counter antihistamines with
limited relief. What is the most appropriate next step in management?
A. Oral decongestants
B. Nasal saline irrigation
C. Intranasal corticosteroids
D. Referral to an allergist for immunotherapy
Answer: C
Rationale: Intranasal corticosteroids are the most effective treatment for moderate to
severe allergic rhinitis and are recommended when antihistamines alone provide inadequate
relief. They reduce inflammation and are more effective than oral decongestants or saline
irrigation alone.
Question 5
A 78-year-old male patient reports chronic infections, bruising, fatigue, SOB, and fevers.
He has a history of rectal adenocarcinoma and completed concurrent
chemotherapy/radiation earlier this year. His CBC shows Hgb 7.5, PLT 8.8, WBC 1.2,
ANC 0.8, and peripheral smear shows dysplasia. What additional work-up would you
anticipate for this patient?
A. Colonoscopy and fecal occult blood test
B. Bone marrow biopsy and flow cytometry
C. No additional work-up is required, these are expected sequela of his oncologic treatment
D. Repeat CBC/CMP/peripheral smear in eight weeks
Answer: B
Rationale: The presence of pancytopenia with peripheral smear showing dysplasia in a
patient with history of chemotherapy/radiation raises concern for therapy-related
myelodysplastic syndrome. A bone marrow biopsy with flow cytometry is necessary to
2
,evaluate for MDS or AML. Waiting eight weeks (D) is inappropriate given the severity of
cytopenias.
Question 6
Progression to Acute Myelogenous Leukemia (AML) is a risk for untreated or poorly
responsive:
A. Pancytopenia
B. Aplastic anemia
C. Macrocytic anemia
D. Myelodysplastic syndrome
Answer: D
Rationale: Myelodysplastic syndrome (MDS) is a bone marrow disorder characterized by
ineffective hematopoiesis and dysplastic changes. It has a significant risk of progression to
acute myelogenous leukemia (AML), particularly in higher-risk subtypes. Untreated or
poorly responsive MDS carries a substantial risk of leukemic transformation.
Question 7
Treatment for symptomatic aplastic anemia includes all the following except:
A. Bone marrow transplant
B. PRBC/Platelet/WBC transfusions
C. Prophylactic antibiotics
D. Removal of bone marrow stimulants
Answer: D
Rationale: Treatment for aplastic anemia includes bone marrow transplant (for eligible
patients), supportive care with blood product transfusions, and prophylactic antibiotics to
prevent infections. There are no "bone marrow stimulants" to remove; the bone marrow is
failing to produce cells. Immunosuppressive therapy is used to stop immune-mediated
destruction of stem cells.
Question 8
A patient diagnosed with iron deficiency anemia requires iron supplementation. Which of
the following treatments would likely be ineffective?
A. Ferrous sulfate 325 mg PO BID for a 43 y.o. F s/p gastric bypass 2 years ago
B. Iron sucrose 200 mg IV infusion weekly x 8 weeks in a 26 y.o. F at 34 weeks of
pregnancy
C. Ferrous sulfate 325 mg PO TID for a 25 y.o. F with menorrhagia
D. Ferrous sulfate 325 mg PO BID for a 63 y.o. M with ulcerative colitis
3
, Answer: A
Rationale: Oral iron is ineffective in patients with gastric bypass because the duodenum
and proximal jejunum (where iron is primarily absorbed) are bypassed. IV iron is required
for these patients. The pregnant patient (B) can receive IV iron, the patient with
menorrhagia (C) can take oral iron, and the patient with ulcerative colitis (D) can take oral
iron (enteric-coated or liquid preparations may be better tolerated).
Question 9
Which of the following is not a common mechanism of neutrophil expenditure and resultant
neutropenia?
A. Decreased neutrophil production in the bone marrow
B. Redistribution of neutrophils to the spleen or vascular endothelium
C. Loss of circulating neutrophils in acute blood loss
D. Immune destruction
Answer: C
Rationale: Neutropenia is caused by decreased production, increased destruction, or
redistribution. Loss of circulating neutrophils in acute blood loss does not cause
neutropenia because acute blood loss primarily reduces red blood cells and volume. While
severe hemorrhage can cause leukopenia, it is not a primary mechanism of neutrophil
expenditure.
Question 10
Which of the following blood lead levels (BLL) would likely require chelation therapy?
A. < 80 mg/dL
B. 35 mcg/dL
C. >100 mg/dL
D. 75 mcg/dL
Answer: D
Rationale: Chelation therapy is recommended for blood lead levels (BLL) ≥ 45 mcg/dL in
children and ≥ 70 mcg/dL in adults. A level of 75 mcg/dL would require chelation therapy.
Levels of 35 mcg/dL may require environmental intervention but not necessarily chelation.
Values >100 mg/dL (using incorrect units) would certainly require chelation, but the correct
units for lead are mcg/dL.
Question 11
A geriatric patient with anemia, back pain, osteoporosis, and elevated erythrocyte
sedimentation rate should be evaluated for:
4
