NR 603 CEA FINAL EXAM PREP 2026/2027 Complete 200-Question Practice Test Bank with Answers & Rationales

NR 603 CEA FINAL EXAM PREP 2026/2027
Complete 200-Question Practice Test Bank
with Answers & Rationales

SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1-35)
Question 1
A 68-year-old male with a history of hypertension presents with acute onset of
substernal chest pressure radiating to the jaw, accompanied by diaphoresis and
nausea. ECG shows ST-segment elevation in leads V1-V4. Which intervention
should be prioritized?
A) Administer sublingual nitroglycerin
B) Obtain cardiac enzymes
C) Activate emergency response for primary PCI
D) Perform bedside echocardiogram
Answer: C
Rationale: ST-elevation myocardial infarction (STEMI) requires immediate
reperfusion. Primary percutaneous coronary intervention (PCI) is the gold standard
if available within 90 minutes of first medical contact. Nitroglycerin and enzymes
are secondary to reperfusion strategy. Delaying PCI for other interventions
increases myocardial damage and mortality .


Question 2
A 72-year-old female with heart failure with reduced ejection fraction (HFrEF)
presents with worsening dyspnea, jugular venous distension, and bilateral lower
extremity edema. Her medications include lisinopril, carvedilol, and furosemide.
What is the most appropriate next step?
A) Increase carvedilol dose
B) Add spironolactone

,C) Start digoxin
D) Replace lisinopril with losartan
Answer: B
Rationale: ACCF/AHA guidelines recommend adding a mineralocorticoid
receptor antagonist (spironolactone or eplerenone) for patients with persistent
symptoms and NYHA class II-IV HFrEF despite optimal therapy with ACE
inhibitor and beta-blocker .


Question 3
A 55-year-old man with untreated hypertension presents with severe "tearing"
chest pain radiating to the back. Blood pressure is 180/110 mmHg in right arm and
130/80 mmHg in left arm. Which diagnostic study is most definitive?
A) Chest X-ray
B) CT angiography of chest
C) Transthoracic echocardiogram
D) D-dimer assay
Answer: B
Rationale: Acute aortic dissection is suspected based on unequal blood pressures
and tearing pain. CT angiography has >95% sensitivity and specificity for
identifying dissection flap and extent of involvement. This is the diagnostic study
of choice .


Question 4
A patient with atrial fibrillation (AF) has a CHA₂DS₂-VASc score of 4 and HAS-
BLED score of 2. Which anticoagulation strategy is recommended?
A) Aspirin 81 mg daily
B) Direct oral anticoagulant (apixaban)
C) Warfarin with INR 2.0-3.0
D) No anticoagulation needed

,Answer: B
Rationale: CHA₂DS₂-VASc score ≥2 in men or ≥3 in women warrants
anticoagulation. DOACs are preferred over warfarin for non-valvular AF due to
lower bleeding risk and no need for INR monitoring. HAS-BLED score of 2 does
not contraindicate anticoagulation .


Question 5
A 45-year-old presents with episodic palpitations, anxiety, and diaphoresis. Blood
pressure is 160/100 mmHg during episodes. Which condition is most likely?
A) Panic disorder
B) Pheochromocytoma
C) Hyperthyroidism
D) Cardiac arrhythmia
Answer: B
Rationale: Pheochromocytoma classically presents with episodic hypertension,
palpitations, diaphoresis, and anxiety. Diagnosis is confirmed by elevated plasma
or urine metanephrines. Imaging with CT or MRI localizes the adrenal tumor.


Question 6
Which finding on cardiac auscultation is most consistent with hypertrophic
cardiomyopathy?
A) Fixed splitting of S2
B) Harsh systolic murmur that increases with Valsalva
C) Diastolic rumble at apex
D) Continuous murmur at left sternal border
Answer: B
Rationale: Hypertrophic cardiomyopathy murmur (from LVOT obstruction)
increases with decreased preload (Valsalva, standing) and decreases with increased
preload (squatting, hand grip). Murmur is systolic, harsh, best heard at left sternal
border .

, Question 7 k




A 75-year-old with aortic stenosis presents with syncope during exertion. Which
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intervention is most appropriate?
k k k k




A) Start carvedilol k




B) Refer for surgical or transcatheter valve replacement
k k k k k k




C) Prescribe nitrates for chest pain k k k k




D) Recommend activity restriction only k k k




Answer: B k




Rationale: Symptomatic severe aortic stenosis (dyspnea, angina, syncope) carries
k k k k k k k k




poor prognosis without valve replacement. Indications for AVR include symptoms or
k k k k k k k k k k k




LV dysfunction (EF <50%). Medical management is not curative .
k k k k k k k k k k




Question 8 k




A patient with known peripheral arterial disease (PAD) complains of calf pain with
k k k k k k k k k k k k




walking that resolves with rest. This symptom is called:
k k k k k k k k k




A) Rest pain k




B) Intermittent claudication k




C) Neurogenic claudication k




D) Venous insufficiency k




Answer: B k




Rationale: Intermittent claudication is defined as reproducible muscle pain (usually
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in the calf) with exercise that resolves with rest within 2-5 minutes. It indicates
k k k k k k k k k k k k k k




significant arterial stenosis limiting blood flow during exercise .
k k k k k k k k k




Question 9 k




A patient with peripheral arterial disease (PAD) should be treated with:
k k k k k k k k k k




A) Antiplatelet therapy (aspirin or clopidogrel) k k k k




B) Anticoagulation