NR667 APEA Post-Predictor University Exam (CEA Exit Exam)
— Week 8 Complete Questions (Verified Update)
Format: Question → Answer → Detailed Rationale | Complete
Verified Questions | Graded A+
Exam Weight: 300 points (of total course grade) | Week 8
Comprehensive Exit Assessment
SECTION 1: CARDIOVASCULAR (Questions)
1. A 65-year-old male presents with an acute onset of severe,
tearing chest pain that radiates to his back. What is the most
likely diagnosis?
A) Acute myocardial infarction
B) Aortic dissection
C) Acute pericarditis
D) Pulmonary embolism
Correct Answer: B
Rationale: An acute aortic dissection classically presents as a
sudden, catastrophic onset of "tearing" or "ripping" chest pain
that radiates through to the back (interscapular region). A key
,physical exam finding can also include blood pressure
differentials between the right and left arms.
2. Which anti-hypertensive medication class is considered
first-line for a diabetic patient due to its renal-protective
properties?
A) Calcium channel blockers
B) Beta-blockers
C) ACE inhibitors
D) Thiazide diuretics
Correct Answer: C
Rationale: Angiotensin-converting enzyme (ACE) inhibitors, or
angiotensin receptor blockers (ARBs), are preferred first-line
agents for patients with hypertension and concurrent diabetes
mellitus or chronic kidney disease. These medications dilate the
efferent arteriole in the kidneys, decreasing intraglomerular
pressure and slowing the progression of diabetic nephropathy.
3. During which phase of the cardiac cycle is the first heart
sound (S1) best heard on auscultation?
A) Diastole
B) Atrial filling phase
C) Ventricular systole
D) Isovolumetric relaxation
Correct Answer: C
Rationale: S1 ("lub") occurs when the mitral and tricuspid
,valves close at the beginning of ventricular systole. It signals the
start of ejection. Diastole and isovolumetric relaxation are
associated with S2 and S3/S4.
4. A 62-year-old African American male, BP 156/96 x2 visits,
no CKD/DM, BMI 31, 10-year ASCVD 12%. What is the FNP's
first-line antihypertensive choice?
A) Lisinopril alone
B) Thiazide-type diuretic or dihydropyridine CCB
C) Beta-blocker atenolol
D) Clonidine
Correct Answer: B
Rationale: For Black adults with hypertension without CKD or
HF, thiazide diuretics or CCBs are first-line per JNC-8/AHA, with
superior stroke reduction.
5. A 60-year-old man with hypertension and diabetes presents
with sudden severe headache, blurred vision, and BP 200/110
mmHg. The FNP should:
A) Start an oral ACE inhibitor and schedule follow-up in one
week
B) Refer the patient immediately to the emergency department
C) Order a stat CT scan and manage as outpatient
D) Recommend lifestyle modifications and recheck in 48 hours
Correct Answer: B
Rationale: This is a hypertensive emergency (BP ≥180/120
, mmHg with acute target organ damage). Immediate IV
antihypertensive therapy in a controlled setting is required to
prevent stroke or renal failure.
6. A 58-year-old patient presents with new onset atrial
fibrillation. Which medication is considered first-line for rate
control?
A) Amiodarone
B) Metoprolol succinate
C) Flecainide
D) Digoxin
Correct Answer: B
Rationale: Beta-blockers such as metoprolol succinate are first-
line for rate control in atrial fibrillation.
7. A patient with a new onset rapid heart rate that is
irregularly irregular, HR 100, BP 120/74. This has been going
on for the past four days straight. First priority intervention:
A) Immediate synchronized cardioversion
B) Maintain rate control and anticoagulation prior to rhythm
conversion
C) Administer adenosine 6 mg IV push
D) Start amiodarone infusion
Correct Answer: B
Rationale: For atrial fibrillation lasting >48 hours, rate control
— Week 8 Complete Questions (Verified Update)
Format: Question → Answer → Detailed Rationale | Complete
Verified Questions | Graded A+
Exam Weight: 300 points (of total course grade) | Week 8
Comprehensive Exit Assessment
SECTION 1: CARDIOVASCULAR (Questions)
1. A 65-year-old male presents with an acute onset of severe,
tearing chest pain that radiates to his back. What is the most
likely diagnosis?
A) Acute myocardial infarction
B) Aortic dissection
C) Acute pericarditis
D) Pulmonary embolism
Correct Answer: B
Rationale: An acute aortic dissection classically presents as a
sudden, catastrophic onset of "tearing" or "ripping" chest pain
that radiates through to the back (interscapular region). A key
,physical exam finding can also include blood pressure
differentials between the right and left arms.
2. Which anti-hypertensive medication class is considered
first-line for a diabetic patient due to its renal-protective
properties?
A) Calcium channel blockers
B) Beta-blockers
C) ACE inhibitors
D) Thiazide diuretics
Correct Answer: C
Rationale: Angiotensin-converting enzyme (ACE) inhibitors, or
angiotensin receptor blockers (ARBs), are preferred first-line
agents for patients with hypertension and concurrent diabetes
mellitus or chronic kidney disease. These medications dilate the
efferent arteriole in the kidneys, decreasing intraglomerular
pressure and slowing the progression of diabetic nephropathy.
3. During which phase of the cardiac cycle is the first heart
sound (S1) best heard on auscultation?
A) Diastole
B) Atrial filling phase
C) Ventricular systole
D) Isovolumetric relaxation
Correct Answer: C
Rationale: S1 ("lub") occurs when the mitral and tricuspid
,valves close at the beginning of ventricular systole. It signals the
start of ejection. Diastole and isovolumetric relaxation are
associated with S2 and S3/S4.
4. A 62-year-old African American male, BP 156/96 x2 visits,
no CKD/DM, BMI 31, 10-year ASCVD 12%. What is the FNP's
first-line antihypertensive choice?
A) Lisinopril alone
B) Thiazide-type diuretic or dihydropyridine CCB
C) Beta-blocker atenolol
D) Clonidine
Correct Answer: B
Rationale: For Black adults with hypertension without CKD or
HF, thiazide diuretics or CCBs are first-line per JNC-8/AHA, with
superior stroke reduction.
5. A 60-year-old man with hypertension and diabetes presents
with sudden severe headache, blurred vision, and BP 200/110
mmHg. The FNP should:
A) Start an oral ACE inhibitor and schedule follow-up in one
week
B) Refer the patient immediately to the emergency department
C) Order a stat CT scan and manage as outpatient
D) Recommend lifestyle modifications and recheck in 48 hours
Correct Answer: B
Rationale: This is a hypertensive emergency (BP ≥180/120
, mmHg with acute target organ damage). Immediate IV
antihypertensive therapy in a controlled setting is required to
prevent stroke or renal failure.
6. A 58-year-old patient presents with new onset atrial
fibrillation. Which medication is considered first-line for rate
control?
A) Amiodarone
B) Metoprolol succinate
C) Flecainide
D) Digoxin
Correct Answer: B
Rationale: Beta-blockers such as metoprolol succinate are first-
line for rate control in atrial fibrillation.
7. A patient with a new onset rapid heart rate that is
irregularly irregular, HR 100, BP 120/74. This has been going
on for the past four days straight. First priority intervention:
A) Immediate synchronized cardioversion
B) Maintain rate control and anticoagulation prior to rhythm
conversion
C) Administer adenosine 6 mg IV push
D) Start amiodarone infusion
Correct Answer: B
Rationale: For atrial fibrillation lasting >48 hours, rate control
