CHAMBERLAIN NR 575 CLINICAL EVALUATION
ASSESSMENT (CEA) EXAM 200 ACTUAL
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALE LATEST 2026/2027 ALREADY
GRADED A+
1. A 55-year-old male presents with a 3-day history of severe, tearing chest
pain radiating to the back. Blood pressure is 200/110 mmHg in the right arm
and 110/70 mmHg in the left arm. Which diagnosis is most likely?
A) Acute myocardial infarction
B) Aortic dissection
C) Pulmonary embolism
D) Pericarditis
Answer B: Aortic dissection
Rationale: Tearing chest pain with unequal arm blood pressures is classic for
aortic dissection. Hypertensive emergency is a key risk factor.
2. A 68-year-old female with a history of hypertension presents with acute
onset of right-sided weakness and aphasia. Last known normal was 1 hour
ago. Head CT shows no hemorrhage. Which therapy is indicated if no
contraindications?
A) Aspirin 325 mg
,B) IV tissue plasminogen activator (tPA)
C) Heparin infusion
D) Carotid endarterectomy
Answer B: IV tissue plasminogen activator (tPA)
Rationale: tPA within 3-4.5 hours improves outcomes in acute ischemic stroke.
Strict criteria: BP <185/110, no recent surgery or bleeding.
3. A 34-year-old female presents with a several-week history of fatigue,
arthralgias, malar rash, and oral ulcers. ANA is positive at 1:320. Which
antibody is most specific for systemic lupus erythematosus?
A) Anti-Ro (SSA)
B) Anti-Smith (anti-Sm)
C) Anti-dsDNA
D) Anti-RNP
Answer B: Anti-Smith (anti-Sm)
Rationale: Anti-Sm is highly specific (>99%) for SLE, though not sensitive. Anti-
dsDNA also correlates with disease activity.
4. A 45-year-old male with a history of alcohol use disorder presents with
confusion, ataxia, and ophthalmoplegia. Which vitamin deficiency is
responsible?
A) Vitamin B12
B) Thiamine (B1)
,C) Niacin
D) Vitamin E
Answer B: Thiamine (B1)
Rationale: Wernicke’s encephalopathy (confusion, ataxia, ophthalmoplegia) is due
to thiamine deficiency. Give IV thiamine before glucose.
5. A 62-year-old male with COPD presents with worsening dyspnea, cough,
and purulent sputum. He has a fever of 38.5°C. Which antibiotic is
appropriate for acute exacerbation without risk factors for Pseudomonas?
A) Doxycycline
B) Doxycycline or macrolide
C) Levofloxacin
D) Amoxicillin-clavulanate
Answer B: Doxycycline or macrolide
Rationale: For mild-moderate exacerbation, doxycycline or macrolides are first-
line. Fluoroquinolones reserved for severe exacerbations.
6. A 55-year-old female presents with a 2-week history of progressive
dysphagia to solids, then liquids, and weight loss. She has a 40-pack-year
smoking history. Which initial imaging study is most appropriate?
A) Barium swallow
B) Upper endoscopy
C) CT chest with contrast
, D) Chest X-ray
Answer B: Upper endoscopy
Rationale: Endoscopy allows direct visualization and biopsy of esophageal masses
(squamous cell or adenocarcinoma).
7. A 28-year-old female presents with acute, severe, right lower quadrant
pain, nausea, and vomiting. She has a positive pregnancy test. Transvaginal
ultrasound shows no intrauterine pregnancy and a left adnexal mass. β-hCG
is 2,500 mIU/mL. Which diagnosis is most likely?
A) Corpus luteal cyst
B) Ectopic pregnancy
C) Ovarian torsion
D) Appendicitis
Answer B: Ectopic pregnancy
Rationale: Absence of intrauterine pregnancy with β-hCG above discriminatory
zone (1,500-2,000) suggests ectopic. Methotrexate or surgery depending on
stability.
8. A 72-year-old male presents with a 2-week history of progressive
confusion, unsteady gait, and urinary incontinence. Head CT shows enlarged
ventricles with no significant cortical atrophy. Which diagnosis is most likely?
A) Alzheimer’s disease
B) Normal pressure hydrocephalus
ASSESSMENT (CEA) EXAM 200 ACTUAL
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALE LATEST 2026/2027 ALREADY
GRADED A+
1. A 55-year-old male presents with a 3-day history of severe, tearing chest
pain radiating to the back. Blood pressure is 200/110 mmHg in the right arm
and 110/70 mmHg in the left arm. Which diagnosis is most likely?
A) Acute myocardial infarction
B) Aortic dissection
C) Pulmonary embolism
D) Pericarditis
Answer B: Aortic dissection
Rationale: Tearing chest pain with unequal arm blood pressures is classic for
aortic dissection. Hypertensive emergency is a key risk factor.
2. A 68-year-old female with a history of hypertension presents with acute
onset of right-sided weakness and aphasia. Last known normal was 1 hour
ago. Head CT shows no hemorrhage. Which therapy is indicated if no
contraindications?
A) Aspirin 325 mg
,B) IV tissue plasminogen activator (tPA)
C) Heparin infusion
D) Carotid endarterectomy
Answer B: IV tissue plasminogen activator (tPA)
Rationale: tPA within 3-4.5 hours improves outcomes in acute ischemic stroke.
Strict criteria: BP <185/110, no recent surgery or bleeding.
3. A 34-year-old female presents with a several-week history of fatigue,
arthralgias, malar rash, and oral ulcers. ANA is positive at 1:320. Which
antibody is most specific for systemic lupus erythematosus?
A) Anti-Ro (SSA)
B) Anti-Smith (anti-Sm)
C) Anti-dsDNA
D) Anti-RNP
Answer B: Anti-Smith (anti-Sm)
Rationale: Anti-Sm is highly specific (>99%) for SLE, though not sensitive. Anti-
dsDNA also correlates with disease activity.
4. A 45-year-old male with a history of alcohol use disorder presents with
confusion, ataxia, and ophthalmoplegia. Which vitamin deficiency is
responsible?
A) Vitamin B12
B) Thiamine (B1)
,C) Niacin
D) Vitamin E
Answer B: Thiamine (B1)
Rationale: Wernicke’s encephalopathy (confusion, ataxia, ophthalmoplegia) is due
to thiamine deficiency. Give IV thiamine before glucose.
5. A 62-year-old male with COPD presents with worsening dyspnea, cough,
and purulent sputum. He has a fever of 38.5°C. Which antibiotic is
appropriate for acute exacerbation without risk factors for Pseudomonas?
A) Doxycycline
B) Doxycycline or macrolide
C) Levofloxacin
D) Amoxicillin-clavulanate
Answer B: Doxycycline or macrolide
Rationale: For mild-moderate exacerbation, doxycycline or macrolides are first-
line. Fluoroquinolones reserved for severe exacerbations.
6. A 55-year-old female presents with a 2-week history of progressive
dysphagia to solids, then liquids, and weight loss. She has a 40-pack-year
smoking history. Which initial imaging study is most appropriate?
A) Barium swallow
B) Upper endoscopy
C) CT chest with contrast
, D) Chest X-ray
Answer B: Upper endoscopy
Rationale: Endoscopy allows direct visualization and biopsy of esophageal masses
(squamous cell or adenocarcinoma).
7. A 28-year-old female presents with acute, severe, right lower quadrant
pain, nausea, and vomiting. She has a positive pregnancy test. Transvaginal
ultrasound shows no intrauterine pregnancy and a left adnexal mass. β-hCG
is 2,500 mIU/mL. Which diagnosis is most likely?
A) Corpus luteal cyst
B) Ectopic pregnancy
C) Ovarian torsion
D) Appendicitis
Answer B: Ectopic pregnancy
Rationale: Absence of intrauterine pregnancy with β-hCG above discriminatory
zone (1,500-2,000) suggests ectopic. Methotrexate or surgery depending on
stability.
8. A 72-year-old male presents with a 2-week history of progressive
confusion, unsteady gait, and urinary incontinence. Head CT shows enlarged
ventricles with no significant cortical atrophy. Which diagnosis is most likely?
A) Alzheimer’s disease
B) Normal pressure hydrocephalus
