1
NR667 Chamberlain CEA Final Exam Questions with
Answers: Comprehensive Advanced Practice
Nursing Study Guide
Questions 1–200 with detailed rationales| 100%
Pass Guaranteed | Graded A+
1. A 45-year-old female presents with fatigue, weight gain, cold intolerance, constipation,
and dry skin. Physical examination reveals bradycardia, delayed deep tendon reflexes,
and a palpable goiter. What is the most appropriate initial diagnostic test?
A. Free T4 and TSH
B. Thyroid ultrasound
C. Thyroid antibody panel
D. Thyroid scan
Correct Answer: A
Explanation: TSH and free T4 are the initial tests for suspected thyroid dysfunction. TSH is the
most sensitive marker for hypothyroidism (elevated). Free T4 confirms the diagnosis. Ultrasound
(B) is indicated for nodule evaluation. Antibodies (C) confirm autoimmune etiology (Hashimoto's)
but are not initial. Thyroid scan (D) is for hyperthyroidism or nodule evaluation .
2. A 28-year-old male patient with HIV would be considered well managed when they have
which of the following in addition to having undetectable or very low viral copies?
A. CD4 count of 200
B. CD4 count of 500
C. CD4 count of 100
D. CD4 count of 350
Correct Answer: B
Explanation: A CD4 count of 500 indicates a well-functioning immune system in a patient with
HIV who also has undetectable or very low viral copies. This represents successful antiretroviral
therapy .
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3. Your patient has expressed concern about a skin lesion which you identify as a darkened,
round, and raised lesion. This benign lesion that appears like "stuck on" to the skin.
Which of the following lesions best fits this description?
A. Actinic keratosis
B. Seborrheic keratosis
C. Basal cell carcinoma
D. Melanoma
Correct Answer: B
Explanation: Seborrheic keratosis is a benign skin lesion that appears "stuck on" to the skin, with
a darkened, round, and raised appearance. Actinic keratosis (A) is precancerous. Basal cell
carcinoma (C) and melanoma (D) are malignant .
4. You are treating a patient who has stopped taking their diuretic regimen against medical
advice while they were on vacation since it made them urinate too frequently for their
plans. Now they are 21 pounds heavier than their baseline weight, have respiratory
crackles in bilateral bases, and have severe generalized lower extremity and truncal
edema extending to the sacrum and abdomen. On your documentation, this is referred
to as which of the following conditions?
A. Peripheral edema
B. Anasarca
C. Ascites
D. Pitting edema
Correct Answer: B
Explanation: Anasarca refers to severe, generalized edema affecting the entire body, including
the lower extremities, trunk, sacrum, and abdomen. This is consistent with severe fluid overload
from diuretic discontinuation .
5. While evaluating a patient in your clinic for a routine health visit, you auscultate crackles
in the posterior left lower lobe, have the patient cough, with follow-up auscultation
revealing clear breath sounds. Which one of the following would you suspect?
A. Pneumonia
B. Atelectasis
C. Pulmonary fibrosis
D. Pleural effusion
, 3
Correct Answer: B
Explanation: Crackles that clear after coughing are characteristic of atelectasis. In pneumonia
(A), crackles typically do not clear with coughing. Pulmonary fibrosis (C) produces persistent fine
crackles. Pleural effusion (D) produces dullness and decreased breath sounds .
6. Gladys is a 72-year-old patient with a history of anemia of chronic disease from kidney
failure, diabetes mellitus, and hypothyroidism, presents today with concerns her thyroid
medication is not working well enough. Her most recent labs reflect her TSH is 5.9
(normal range 0.5-5 uU/mL) and Free T4 is 0.3 ng/dL (normal range 0.8-2.8 ng/dL).
Which one of the following clinical signs and/or symptoms would you expect a patient
with these findings to present with?
A. Heat intolerance
B. Cold intolerance
C. Weight loss
D. Tachycardia
Correct Answer: B
Explanation: The patient has elevated TSH and low Free T4, consistent with hypothyroidism. Cold
intolerance is a classic symptom of hypothyroidism. Heat intolerance (A), weight loss (C), and
tachycardia (D) are symptoms of hyperthyroidism .
7. You are examining the mouth of a patient and ask the patient to stick out their tongue
and notice that the tongue deviates by pointing to the left. Which one of the following is
the correct diagnosis of this finding?
A. Cranial nerve XII (hypoglossal nerve) lesion on the left
B. Cranial nerve XII (hypoglossal nerve) lesion on the right
C. Cranial nerve X (vagus nerve) lesion on the left
D. Cranial nerve V (trigeminal nerve) lesion on the left
Correct Answer: A
Explanation: The tongue deviates toward the side of the lesion when the hypoglossal nerve (CN
XII) is damaged. Therefore, deviation to the left indicates a left CN XII lesion. The vagus nerve (C)
affects the gag reflex. The trigeminal nerve (D) affects facial sensation and mastication .
, 4
8. Your 31-year-old female patient states they are experiencing lateral lower back pain and
urinalysis reveals bacteria in the urine, culture reveals gram negative rods after 24 hours
of growth. Which of the following is least likely agent to cause her urinary tract
infection?
A. Escherichia coli
B. Klebsiella
C. Proteus
D. Enterococcus
Correct Answer: D
Explanation: Enterococcus is a gram-positive organism, not gram-negative. E. coli (A), Klebsiella
(B), and Proteus (C) are all gram-negative rods that commonly cause UTIs .
9. Marvin, your 47-year-old African American patient with a diagnosis of severe COPD and
coronary artery disease has been complaining of shortness of breath and wheezing after
initiation of a new medicine for his coronary artery disease management. Given his
health history which of the following agents is considered the safest beta blocker for his
CAD management?
A. Metoprolol (Lopressor)
B. Propranolol
C. Carvedilol
D. Nadolol
Correct Answer: A
Explanation: Metoprolol is a cardioselective beta-1 blocker, making it safer in patients with
COPD compared to non-selective beta blockers like propranolol (B), carvedilol (C), and nadolol
(D), which can cause bronchospasm .
10. Melissa, your 56-year-old Caucasian female patient presents with a health history of
hypertension, migraines, hyperlipidemia, seasonal depression and obesity for a visit to
establish care. She was without any medical care for a long time and being newly
established to your clinic is prescribed aspirin 81 mg daily, atorvastatin 40 mg daily,
betide 10 mg daily, lisinopril 20 mg daily, amlodipine 10 mg daily, and Wellbutrin 300 mg
daily as well as diet and exercise. After the visit she calls your office nurse and states she
has been experiencing considerably lower blood pressure and dizziness. Which
medication is most likely causing these symptoms?
NR667 Chamberlain CEA Final Exam Questions with
Answers: Comprehensive Advanced Practice
Nursing Study Guide
Questions 1–200 with detailed rationales| 100%
Pass Guaranteed | Graded A+
1. A 45-year-old female presents with fatigue, weight gain, cold intolerance, constipation,
and dry skin. Physical examination reveals bradycardia, delayed deep tendon reflexes,
and a palpable goiter. What is the most appropriate initial diagnostic test?
A. Free T4 and TSH
B. Thyroid ultrasound
C. Thyroid antibody panel
D. Thyroid scan
Correct Answer: A
Explanation: TSH and free T4 are the initial tests for suspected thyroid dysfunction. TSH is the
most sensitive marker for hypothyroidism (elevated). Free T4 confirms the diagnosis. Ultrasound
(B) is indicated for nodule evaluation. Antibodies (C) confirm autoimmune etiology (Hashimoto's)
but are not initial. Thyroid scan (D) is for hyperthyroidism or nodule evaluation .
2. A 28-year-old male patient with HIV would be considered well managed when they have
which of the following in addition to having undetectable or very low viral copies?
A. CD4 count of 200
B. CD4 count of 500
C. CD4 count of 100
D. CD4 count of 350
Correct Answer: B
Explanation: A CD4 count of 500 indicates a well-functioning immune system in a patient with
HIV who also has undetectable or very low viral copies. This represents successful antiretroviral
therapy .
, 2
3. Your patient has expressed concern about a skin lesion which you identify as a darkened,
round, and raised lesion. This benign lesion that appears like "stuck on" to the skin.
Which of the following lesions best fits this description?
A. Actinic keratosis
B. Seborrheic keratosis
C. Basal cell carcinoma
D. Melanoma
Correct Answer: B
Explanation: Seborrheic keratosis is a benign skin lesion that appears "stuck on" to the skin, with
a darkened, round, and raised appearance. Actinic keratosis (A) is precancerous. Basal cell
carcinoma (C) and melanoma (D) are malignant .
4. You are treating a patient who has stopped taking their diuretic regimen against medical
advice while they were on vacation since it made them urinate too frequently for their
plans. Now they are 21 pounds heavier than their baseline weight, have respiratory
crackles in bilateral bases, and have severe generalized lower extremity and truncal
edema extending to the sacrum and abdomen. On your documentation, this is referred
to as which of the following conditions?
A. Peripheral edema
B. Anasarca
C. Ascites
D. Pitting edema
Correct Answer: B
Explanation: Anasarca refers to severe, generalized edema affecting the entire body, including
the lower extremities, trunk, sacrum, and abdomen. This is consistent with severe fluid overload
from diuretic discontinuation .
5. While evaluating a patient in your clinic for a routine health visit, you auscultate crackles
in the posterior left lower lobe, have the patient cough, with follow-up auscultation
revealing clear breath sounds. Which one of the following would you suspect?
A. Pneumonia
B. Atelectasis
C. Pulmonary fibrosis
D. Pleural effusion
, 3
Correct Answer: B
Explanation: Crackles that clear after coughing are characteristic of atelectasis. In pneumonia
(A), crackles typically do not clear with coughing. Pulmonary fibrosis (C) produces persistent fine
crackles. Pleural effusion (D) produces dullness and decreased breath sounds .
6. Gladys is a 72-year-old patient with a history of anemia of chronic disease from kidney
failure, diabetes mellitus, and hypothyroidism, presents today with concerns her thyroid
medication is not working well enough. Her most recent labs reflect her TSH is 5.9
(normal range 0.5-5 uU/mL) and Free T4 is 0.3 ng/dL (normal range 0.8-2.8 ng/dL).
Which one of the following clinical signs and/or symptoms would you expect a patient
with these findings to present with?
A. Heat intolerance
B. Cold intolerance
C. Weight loss
D. Tachycardia
Correct Answer: B
Explanation: The patient has elevated TSH and low Free T4, consistent with hypothyroidism. Cold
intolerance is a classic symptom of hypothyroidism. Heat intolerance (A), weight loss (C), and
tachycardia (D) are symptoms of hyperthyroidism .
7. You are examining the mouth of a patient and ask the patient to stick out their tongue
and notice that the tongue deviates by pointing to the left. Which one of the following is
the correct diagnosis of this finding?
A. Cranial nerve XII (hypoglossal nerve) lesion on the left
B. Cranial nerve XII (hypoglossal nerve) lesion on the right
C. Cranial nerve X (vagus nerve) lesion on the left
D. Cranial nerve V (trigeminal nerve) lesion on the left
Correct Answer: A
Explanation: The tongue deviates toward the side of the lesion when the hypoglossal nerve (CN
XII) is damaged. Therefore, deviation to the left indicates a left CN XII lesion. The vagus nerve (C)
affects the gag reflex. The trigeminal nerve (D) affects facial sensation and mastication .
, 4
8. Your 31-year-old female patient states they are experiencing lateral lower back pain and
urinalysis reveals bacteria in the urine, culture reveals gram negative rods after 24 hours
of growth. Which of the following is least likely agent to cause her urinary tract
infection?
A. Escherichia coli
B. Klebsiella
C. Proteus
D. Enterococcus
Correct Answer: D
Explanation: Enterococcus is a gram-positive organism, not gram-negative. E. coli (A), Klebsiella
(B), and Proteus (C) are all gram-negative rods that commonly cause UTIs .
9. Marvin, your 47-year-old African American patient with a diagnosis of severe COPD and
coronary artery disease has been complaining of shortness of breath and wheezing after
initiation of a new medicine for his coronary artery disease management. Given his
health history which of the following agents is considered the safest beta blocker for his
CAD management?
A. Metoprolol (Lopressor)
B. Propranolol
C. Carvedilol
D. Nadolol
Correct Answer: A
Explanation: Metoprolol is a cardioselective beta-1 blocker, making it safer in patients with
COPD compared to non-selective beta blockers like propranolol (B), carvedilol (C), and nadolol
(D), which can cause bronchospasm .
10. Melissa, your 56-year-old Caucasian female patient presents with a health history of
hypertension, migraines, hyperlipidemia, seasonal depression and obesity for a visit to
establish care. She was without any medical care for a long time and being newly
established to your clinic is prescribed aspirin 81 mg daily, atorvastatin 40 mg daily,
betide 10 mg daily, lisinopril 20 mg daily, amlodipine 10 mg daily, and Wellbutrin 300 mg
daily as well as diet and exercise. After the visit she calls your office nurse and states she
has been experiencing considerably lower blood pressure and dizziness. Which
medication is most likely causing these symptoms?
