NR 667 CEA Quiz Bank | Full Questions and
Answers | 2026/2027 Updated | 100% Correct
- Chamberlain.
Practice Question Bank & Answer Rationale
THIS PACK CONTAINS
147 exam-style multiple-choice questions. Each question includes the correct answer and a complete
rationale for focused revision.
COVERAGE
This comprehensive quiz bank assesses advanced clinical reasoning, diagnostic interpretation,
pharmacologic management, and evidence-based practice competencies required of the Certified Nurse
Practitioner (CNP). Items span the full scope of NP practice, including health promotion, complex chronic
disease management, and interprofessional collaboration, aligned with current national certification board
standards.
STUDY GUIDE
Recommended duration: 2 hours. Passing target: 80%.
HIGHP - Page 1 of 49
,1. A patient on warfarin for atrial fibrillation is prescribed a course of
trimethoprim-sulfamethoxazole for a urinary tract infection. Which monitoring parameter
is most critical to assess within 3-5 days of initiating the antibiotic?
[ ] A. Serum potassium level
[ ] B. INR
[ ] C. Serum creatinine
[ ] D. Hemoglobin A1c
CORRECT: B. INR
Trimethoprim-sulfamethoxazole inhibits CYP2C9, which metabolizes warfarin, potentially causing a significant
increase in INR and bleeding risk. While potassium and creatinine can also be affected, the most critical
immediate safety parameter is INR. Hemoglobin A1c is unrelated to acute anticoagulation management.
2. Which finding on a 12-lead ECG is most consistent with hyperkalemia in a patient with
stage 4 chronic kidney disease?
[ ] A. Prominent U waves
[ ] B. Prolonged QT interval
[ ] C. Peaked T waves
[ ] D. ST-segment elevation in contiguous leads
CORRECT: C. Peaked T waves
Hyperkalemia classically produces tall, peaked T waves, followed by widening of the QRS complex and loss
of P waves. U waves are associated with hypokalemia, prolonged QT with hypocalcemia or drug effects, and
ST elevation with ischemia or pericarditis.
3. A patient with type 2 diabetes has an A1c of 8.5% on metformin monotherapy. Which
add-on therapy is most appropriate given a strong family history of cardiovascular
disease and a BMI of 32?
[ ] A. Glipizide
[ ] B. Pioglitazone
[ ] C. Empagliflozin
[ ] D. Insulin glargine
CORRECT: C. Empagliflozin
SGLT2 inhibitors like empagliflozin have proven cardiovascular and renal benefits in patients with type 2
diabetes and high cardiovascular risk, and they promote weight loss. Sulfonylureas and insulin cause weight
gain and lack cardiovascular outcome benefits; pioglitazone may cause fluid retention and heart failure
exacerbation.
HIGHP - Page 2 of 49
,4. According to the latest USPSTF recommendations, which colorectal cancer screening
strategy is considered a primary option for average-risk adults starting at age 45?
[ ] A. Colonoscopy every 5 years
[ ] B. FIT annually
[ ] C. CT colonography every 10 years
[ ] D. Flexible sigmoidoscopy every 10 years
CORRECT: B. FIT annually
The USPSTF recommends screening for colorectal cancer starting at age 45, with annual FIT as a primary
non-invasive option. Colonoscopy is recommended every 10 years, not 5; CT colonography and
sigmoidoscopy are alternatives but not the most commonly endorsed primary strategies.
5. A patient presents with acute onset of unilateral facial droop, arm drift, and slurred
speech that began 90 minutes ago. Which action should the NP take first?
[ ] A. Administer aspirin 325 mg orally
[ ] B. Obtain a non-contrast head CT immediately
[ ] C. Start a nitroglycerin infusion
[ ] D. Order a carotid duplex ultrasound
CORRECT: B. Obtain a non-contrast head CT immediately
In suspected acute ischemic stroke, immediate non-contrast head CT is essential to rule out hemorrhage
before thrombolytic therapy. Aspirin is not given acutely before imaging, nitroglycerin is for cardiac ischemia,
and carotid ultrasound is not the initial emergency diagnostic step.
6. Which statement best reflects the principle of motivational interviewing when
counseling a patient resistant to smoking cessation?
[ ] A. Directly advise the patient to quit immediately
[ ] B. Explore the patient's ambivalence and elicit change talk
[ ] C. Provide a list of all available nicotine replacement products
[ ] D. Inform the patient that continued smoking will disqualify them from care
CORRECT: B. Explore the patient's ambivalence and elicit change talk
Motivational interviewing is a patient-centered, directive method for enhancing intrinsic motivation by
exploring and resolving ambivalence. Direct advice, product lists, or ultimatums are not consistent with this
approach and may increase resistance.
7. A patient with a history of heart failure with reduced ejection fraction (HFrEF) is
prescribed a new medication. Which class has the strongest evidence for reducing
mortality in HFrEF?
[ ] A. Calcium channel blockers
HIGHP - Page 3 of 49
, [ ] B. Beta-blockers (e.g., carvedilol, metoprolol succinate)
[ ] C. Alpha-1 antagonists
[ ] D. Thiazolidinediones
CORRECT: B. Beta-blockers (e.g., carvedilol, metoprolol succinate)
Beta-blockers such as carvedilol, metoprolol succinate, and bisoprolol are guideline-directed medical therapy
for HFrEF and reduce mortality. Calcium channel blockers (except amlodipine/felodipine) are generally
avoided, alpha-blockers are for BPH, and thiazolidinediones can worsen heart failure.
8. A 68-year-old male presents with nocturia, decreased force of urinary stream, and a
feeling of incomplete emptying. Which diagnostic test is most appropriate to assess for
benign prostatic hyperplasia (BPH)?
[ ] A. Serum prostate-specific antigen (PSA)
[ ] B. Urinalysis and International Prostate Symptom Score (IPSS)
[ ] C. Transrectal ultrasound
[ ] D. Cystoscopy
CORRECT: B. Urinalysis and International Prostate Symptom Score (IPSS)
Initial evaluation of BPH symptoms includes a urinalysis to rule out infection and the IPSS to quantify
symptom severity. PSA is used for cancer screening and may be considered but is not the primary diagnostic
for BPH; ultrasound and cystoscopy are reserved for complications or surgical planning.
9. Which vaccine is contraindicated in a patient receiving high-dose corticosteroids for an
autoimmune flare?
[ ] A. Inactivated influenza vaccine
[ ] B. Recombinant zoster vaccine
[ ] C. Live attenuated measles-mumps-rubella (MMR) vaccine
[ ] D. Tetanus-diphtheria-acellular pertussis (Tdap) vaccine
CORRECT: C. Live attenuated measles-mumps-rubella (MMR) vaccine
Live attenuated vaccines such as MMR are contraindicated in immunocompromised patients due to the risk
of vaccine-derived infection. Inactivated, recombinant, and toxoid vaccines are generally safe, though
immune response may be diminished.
10. A patient with major depressive disorder has not responded to an adequate trial of an
SSRI. Which action is most appropriate according to current evidence?
[ ] A. Add a second SSRI
[ ] B. Switch to a different SSRI or an SNRI
[ ] C. Add a stimulant
[ ] D. Add an antipsychotic as first-line augmentation
HIGHP - Page 4 of 49
Answers | 2026/2027 Updated | 100% Correct
- Chamberlain.
Practice Question Bank & Answer Rationale
THIS PACK CONTAINS
147 exam-style multiple-choice questions. Each question includes the correct answer and a complete
rationale for focused revision.
COVERAGE
This comprehensive quiz bank assesses advanced clinical reasoning, diagnostic interpretation,
pharmacologic management, and evidence-based practice competencies required of the Certified Nurse
Practitioner (CNP). Items span the full scope of NP practice, including health promotion, complex chronic
disease management, and interprofessional collaboration, aligned with current national certification board
standards.
STUDY GUIDE
Recommended duration: 2 hours. Passing target: 80%.
HIGHP - Page 1 of 49
,1. A patient on warfarin for atrial fibrillation is prescribed a course of
trimethoprim-sulfamethoxazole for a urinary tract infection. Which monitoring parameter
is most critical to assess within 3-5 days of initiating the antibiotic?
[ ] A. Serum potassium level
[ ] B. INR
[ ] C. Serum creatinine
[ ] D. Hemoglobin A1c
CORRECT: B. INR
Trimethoprim-sulfamethoxazole inhibits CYP2C9, which metabolizes warfarin, potentially causing a significant
increase in INR and bleeding risk. While potassium and creatinine can also be affected, the most critical
immediate safety parameter is INR. Hemoglobin A1c is unrelated to acute anticoagulation management.
2. Which finding on a 12-lead ECG is most consistent with hyperkalemia in a patient with
stage 4 chronic kidney disease?
[ ] A. Prominent U waves
[ ] B. Prolonged QT interval
[ ] C. Peaked T waves
[ ] D. ST-segment elevation in contiguous leads
CORRECT: C. Peaked T waves
Hyperkalemia classically produces tall, peaked T waves, followed by widening of the QRS complex and loss
of P waves. U waves are associated with hypokalemia, prolonged QT with hypocalcemia or drug effects, and
ST elevation with ischemia or pericarditis.
3. A patient with type 2 diabetes has an A1c of 8.5% on metformin monotherapy. Which
add-on therapy is most appropriate given a strong family history of cardiovascular
disease and a BMI of 32?
[ ] A. Glipizide
[ ] B. Pioglitazone
[ ] C. Empagliflozin
[ ] D. Insulin glargine
CORRECT: C. Empagliflozin
SGLT2 inhibitors like empagliflozin have proven cardiovascular and renal benefits in patients with type 2
diabetes and high cardiovascular risk, and they promote weight loss. Sulfonylureas and insulin cause weight
gain and lack cardiovascular outcome benefits; pioglitazone may cause fluid retention and heart failure
exacerbation.
HIGHP - Page 2 of 49
,4. According to the latest USPSTF recommendations, which colorectal cancer screening
strategy is considered a primary option for average-risk adults starting at age 45?
[ ] A. Colonoscopy every 5 years
[ ] B. FIT annually
[ ] C. CT colonography every 10 years
[ ] D. Flexible sigmoidoscopy every 10 years
CORRECT: B. FIT annually
The USPSTF recommends screening for colorectal cancer starting at age 45, with annual FIT as a primary
non-invasive option. Colonoscopy is recommended every 10 years, not 5; CT colonography and
sigmoidoscopy are alternatives but not the most commonly endorsed primary strategies.
5. A patient presents with acute onset of unilateral facial droop, arm drift, and slurred
speech that began 90 minutes ago. Which action should the NP take first?
[ ] A. Administer aspirin 325 mg orally
[ ] B. Obtain a non-contrast head CT immediately
[ ] C. Start a nitroglycerin infusion
[ ] D. Order a carotid duplex ultrasound
CORRECT: B. Obtain a non-contrast head CT immediately
In suspected acute ischemic stroke, immediate non-contrast head CT is essential to rule out hemorrhage
before thrombolytic therapy. Aspirin is not given acutely before imaging, nitroglycerin is for cardiac ischemia,
and carotid ultrasound is not the initial emergency diagnostic step.
6. Which statement best reflects the principle of motivational interviewing when
counseling a patient resistant to smoking cessation?
[ ] A. Directly advise the patient to quit immediately
[ ] B. Explore the patient's ambivalence and elicit change talk
[ ] C. Provide a list of all available nicotine replacement products
[ ] D. Inform the patient that continued smoking will disqualify them from care
CORRECT: B. Explore the patient's ambivalence and elicit change talk
Motivational interviewing is a patient-centered, directive method for enhancing intrinsic motivation by
exploring and resolving ambivalence. Direct advice, product lists, or ultimatums are not consistent with this
approach and may increase resistance.
7. A patient with a history of heart failure with reduced ejection fraction (HFrEF) is
prescribed a new medication. Which class has the strongest evidence for reducing
mortality in HFrEF?
[ ] A. Calcium channel blockers
HIGHP - Page 3 of 49
, [ ] B. Beta-blockers (e.g., carvedilol, metoprolol succinate)
[ ] C. Alpha-1 antagonists
[ ] D. Thiazolidinediones
CORRECT: B. Beta-blockers (e.g., carvedilol, metoprolol succinate)
Beta-blockers such as carvedilol, metoprolol succinate, and bisoprolol are guideline-directed medical therapy
for HFrEF and reduce mortality. Calcium channel blockers (except amlodipine/felodipine) are generally
avoided, alpha-blockers are for BPH, and thiazolidinediones can worsen heart failure.
8. A 68-year-old male presents with nocturia, decreased force of urinary stream, and a
feeling of incomplete emptying. Which diagnostic test is most appropriate to assess for
benign prostatic hyperplasia (BPH)?
[ ] A. Serum prostate-specific antigen (PSA)
[ ] B. Urinalysis and International Prostate Symptom Score (IPSS)
[ ] C. Transrectal ultrasound
[ ] D. Cystoscopy
CORRECT: B. Urinalysis and International Prostate Symptom Score (IPSS)
Initial evaluation of BPH symptoms includes a urinalysis to rule out infection and the IPSS to quantify
symptom severity. PSA is used for cancer screening and may be considered but is not the primary diagnostic
for BPH; ultrasound and cystoscopy are reserved for complications or surgical planning.
9. Which vaccine is contraindicated in a patient receiving high-dose corticosteroids for an
autoimmune flare?
[ ] A. Inactivated influenza vaccine
[ ] B. Recombinant zoster vaccine
[ ] C. Live attenuated measles-mumps-rubella (MMR) vaccine
[ ] D. Tetanus-diphtheria-acellular pertussis (Tdap) vaccine
CORRECT: C. Live attenuated measles-mumps-rubella (MMR) vaccine
Live attenuated vaccines such as MMR are contraindicated in immunocompromised patients due to the risk
of vaccine-derived infection. Inactivated, recombinant, and toxoid vaccines are generally safe, though
immune response may be diminished.
10. A patient with major depressive disorder has not responded to an adequate trial of an
SSRI. Which action is most appropriate according to current evidence?
[ ] A. Add a second SSRI
[ ] B. Switch to a different SSRI or an SNRI
[ ] C. Add a stimulant
[ ] D. Add an antipsychotic as first-line augmentation
HIGHP - Page 4 of 49
