CEA PREP: FULL PRACTICE EXAM
WITH VERIFIED ANSWERS
The spatient sis sexhibiting sa sproductive scough sand sa slow-grade sfever. sChest sX-ray
son sPA sview sshows sa sleft slower schest sarea sof sconsolidation sadjacent sto sthe sleft
sborder sof sthe sheart sapproximately s2 srib sspaces sabove sthe scostophrenic sangle.
sThe slateral sx-ray sview sshows sthis slesion sabsent sof sthe swindow sposterior sto sthe
scardiac ssilhouette. sWhich sis sthe smost slikely slocation sof sthis sarea sof sfocal
sconsolidation?
*Left supper slobe sapex
*Right smiddle slobe
*Left supper slobe slingula
*Left slower slobe s- scorrect sanswers s-Left supper slobe slingula
Ratonale: sLingular sconsolidation sis sdescribed sin sthis squestion sprecisely. sIf sthe
scardiac smargin/silhouette sis sobliterated sby sthe smass, sthe slesion sis seither sright
smiddle slobe sor sleft supper slobe slingula.
,The sinability sto sfully srelax sthe smyocardium sduring srelaxation sis sa strademark sof
swhich sof sthe sfollowing sdiagnoses? s- scorrect sanswers s-Diastolic sdysfunction
Rationale: sThe sinability sfor sthe sheart sto srelax sis sa strademark sof sthe sdiagnosis sof
sdiastolic sdysfunction sand sis scommon sin spatients swith sthickened shypertrophic
smyocardium.
An sotherwise shealthy sAfrican sAmerican sadult smale shas sbeen sdiagnosed swith
shypertension. sHe shas sbeen srestricting shis ssalt sintake, seating sa sDASH s(Dietary
sApproaches sto sStop sHypertension) sdiet, sand sexercising smore, sbut shis sblood
spressure sis sstill selevated. sWhich sis sthe sBEST smedication sto sprescribe shim? s-
scorrect sanswers s-Calcium schannel sblocker
Rationale: sAfrican sAmerican spatients sper sJNC8 sHypertension sGuidelines sshould
sbe smanaged swith sa sdihydropyridine scalcium schannel sblocker ssuch sas samlodipine
s(Norvasc) sas sfirst sline smanagement stherapy sfor shypertension snot sat sgoal swith
sDASH sand slifestyle smodifications.
Your spatient shas sbeen sdiagnosed swith sa s4.5cm sascending saortic saneurysm.
sWhich smedical simaging sis sconsidered sstandard sof scare sfor sserial ssurveillance? s-
scorrect sanswers s-CT sangiography sof sthe schest
Rationale: sCT sangiography sis sconsidered sthe sstandard sof scare sfor smeasuring
svascular sluminal sdimensions swith scontrast. sCT sPE sprotocol sis snot stimed sproperly
sfor sthe saorta s(it's stimed sfor sthe spulmonary sartery). sAlthough sa splain sfilm sis sable
sto scatch slarge saneurysms sat stimes, sthey sare snot sable sto sprovide smulti-axis
sreconstruction sneeded sto saccurately smeasure sthe ssize. sTransesophageal secho sis
snot sneeded sto saccurately smeasure sthe saorta sand srequires sthe spatient sto
sundergo ssedation swhich sis sunnecessary.
Which sof sthe sfollowing smedications sdoes snot scause sbeta s1 sstimulation? s- scorrect
sanswers s-phenylephrine
Rationale: sPhenylephrine sonly sstimulates salpha s1 sreceptors. sThe sremaining sthree
sall shave sbeta sreceptor sactivity.
A s50-year-old swoman swith sa shistory sof shypertension spresents swith sdyspnea son
sexertion sand sorthopnea. sOn sexamination, sshe shas sjugular svenous sdistention sand
sbilateral scrackles son slung sauscultation. sWhat sis sthe smost slikely sdiagnosis? s-
scorrect sanswers s-Congestive sheart sfailure
Rationale: sOf sthe savailable soptions, sthe smost saccurate sresponse sis scongestive
sheart sfailure sas sit sis ssignifying sboth sa sright sventricular sback sup swith sjugular
svenous sextension sand scrackles son slung sassault, swhich sare ssuggestive sof sleft
sventricular sback sup. sit sis spossible sthe spatient smay shave san sacute smyocardial
sinfarction sthat sprecipitated sthis, showever, sa spatient shas snot sdescribed sthat,
srather sis sonly sdescribing sdyspnea son sexertion sand sorthopnea, swhich sboth sspeak
sto sa sstate sof sfluid soverload. sThe sonly sappropriate sresponse sof sthese savailable sis
scongestive sheart sfailure.
,Your spatient swith sa shistory sof sHFrEF s(heart sfailure swith sreduced sejection sfraction)
swith san sejection sfraction sof s40% swho sis salso snot son soptimal smedical stherapy
shas sbeen sdiagnosed swith sa smyocardial sinfarction sthis sadmission sand sreceived
semergent splacement sof sa sdrug-eluting sstent sto sthe sleft santerior sdescending
sartery. sAs sthe smedical shome swho swill smanage sthis spatient safter sdischarge,
swhich smedication sstrategy swould syou sexpect sto sbe sa spriority sin sthe spatient's
scare? s- scorrect sanswers s-Ordering sa stransthoracic sechocardiogram sand sorder sa
sLifevest sif sEF sis sless sthan s35%
Rationale: sThe spatient sshould shave sa sprotective smechanism ssuch sas san
simplantable sautomated scardioverter sdefibrillator s(AICD) sor sa sLifevest sif sthe sEF sis
sless sthan s35% sdue sto sthe sincreased srisk sof ssudden scardiac sdeath swith slow sEF
sstates. sSince smost spatients sare snot seligible sfor s90 sdays sfor san sAICD sin sthis
sstate, soptimizing stheir smedication sregimen sand srepeating san secho sin s2-3 smonths
sto sre-evaluate sfor simprovement sin stheir sEF sis srequired sby smost sinsurance
scompanies. sA sbaseline secho sis sneeded sat sdischarge sto sprovide sa sbaseline sfor
simprovement svs stheir srepeat secho sin s2-3 smonths.
Dual santi-platelet stherapy sis srequired sfor s12 smonths sminimum spost-MI. s
A sHolter smonitor sdoes snot sprovide sany sconceivable sbenefit sfor sthis spatient sas
spresented.
Which sof sthe sfollowing speople sgroups srepresent sthe sleast srisk sof scardiac
sdisease? s- scorrect sanswers s-Caucasians
Rationale: sStatistically sAfrican sAmericans, sNative sHawaiians, sand sAmerican
sIndians sare sat sat sincreased srisk sof scardiac sdisease sdue sto shigher srates sof
shypertension, sdiabetes, sand sobesity sthan sCaucasians.
A s65-year-old swoman spresents sfor sa sfollow-up sexamination. sShe sis sa ssmoker,
sand sher shypertension sis snow sadequately scontrolled swith smedication. sHer smother
sdied sat sage s40 sfrom sa sheart sattack. sThe sfasting slipid sprofile sshows scholesterol
s= s240 smg/dL, sHDL s= s30, sand sLDL s= s200. sIn saddition sto sstarting stherapeutic
slifestyle schanges, sthe snurse spractitioner sshould sstart sthe spatient son: s- scorrect
sanswers s-a sstatin sdrug.
Rationale: sBile sacid ssequestrants sand scholesterol sabsorption sinhibitors smay sbe
suseful sin sreducing sASVD srisk, sbut sfor sa spatient swho sis san sactive ssmoker swith
spremature scoronary sdisease shistory s(less sthan sage s65 sfor swomen), shas
shypertension sand sis sfar sfrom san sLDL sgoal, sthis spatient sis smost scertainly sa
scandidate sfor sstatin stherapy, swhich srepresents sthe smost saggressive stherapy
soption sof sthese sfour slisted.
Which sof sthe sfollowing send-organ ssequelae sis snot sdirectly scaused sby suncontrolled
shypertension? s- scorrect sanswers s-Peripheral sneuropathy
Ratioanle: sAlthough spatients swith shypertension sfrequently shave speripheral
sneuropathy, sit sis sonly sdirectly sattributed sto spatients swho sare salso sdiabetic sand sis
scommonly sfound sin snon-hypertensive sdiabetic spatients. sProteinuria, sAV snicking,
sand shemorrhagic sstroke sare sall scaused sby suncontrolled shypertension.
, Preventive scardiac scare sshould sfocus sprimarily son saddressing sall sthe sfollowing
sexcept? s- scorrect sanswers s-Genetic spredisposition
Rationale: sSmoking scessation, sexercise, sand smedication scompliance sall srepresent
smodifiable srisk sfactors sand sshould sbe sthe sfocus sof spreventive scare. sNon-
modifiable srisk sfactors ssuch sas sage, sgender, sgenetic/family shistory sshould snot sbe
sthe sprimary sfocus sof sprevention.
A s33-year-old swoman spresents swith sirregular smenstrual scycles, shirsutism, sand
sobesity. sLaboratory stests sreveal selevated sserum stestosterone sand sLH sratio s>
s2:1. sWhat sis sthe smost sappropriate sinitial streatment? s- scorrect sanswers s-Oral
scontraceptives
Rationale: sThese sare sclassic ssymptoms sof spolycystic sovarian ssyndrome sand sthe
spatient sshould sbe streated swith soral scontraceptives sto shelp sstabilize stheir
sestrogen sand sprogesterone. sAdditionally, sthey smay sbe smanaged son smetformin
sand/or sspironolactone sfor stheir sPCOS.
Oral scontraceptive spills s(OCPs) sare soften sthe sfirst spharmacological streatment sfor
spolycystic sovary ssyndrome s(PCOS) sbecause sthey shelp smanage sin sseveral sways:
Menstrual sirregularities: sOCPs scan shelp sregulate smenstrual scycles, smaking
speriods slighter sand smore sregular. sThis sis simportant sbecause sirregular sovulation
scan slead sto sendometrial shyperplasia, swhich sis sa sbuildup sof suterine stissue sthat
scan sincrease sthe srisk sof suterine scancer.
Androgen sexcess: sOCPs scan sreduce sandrogen sproduction sand sincrease ssex
shormone-binding sglobulin s(SHBG), swhich sbinds sandrogens. sThis scan shelp sreduce
ssymptoms slike sacne, shirsutism s(unwanted sbody sand sfacial shair), sand sandrogenic
salopecia s(male spattern sbaldness).
Endometrium sprotection: sOCPs scan sprotect sthe sendometrium sby sensuring sregular
sovulation
A s50-year-old swoman swith shypertension sand sdiabetes scomes sin sfor sa sroutine
scheck-up. sWhat sscreening stest sshould sbe sregularly sperformed sto smonitor sfor
searly ssigns sof sdiabetic snephropathy? s- scorrect sanswers s-Urine sdipstick sfor
sprotein
Rationale: sThe smost ssensitive sindicator sof sdiabetic snephropathy swould sbe sthe
sevidence sof ssmall sproteins sin sthe surine s(proteinuria) sas sfound son surinalysis. sThe
sother soptions smight sdescribe smacro-organ sfunction s(such sas sBUN/Creat sfrom sa
sBMP, sa srenal sbiopsy swhich sis snot sindicated sfor sroutine sdiabetic snephropathy
stesting, sand sa sAbd sCT, swhich sis smore sakin sto sevaluation sof sless ssubtle
sfindings), sbut sat sthe sfunctional slevel sof sthe snephron, snamely sthe sglomerulus,
sevidence sof sglucose-related sdamage sis seasily sidentified swith sproteinuria sfrom sa
sUA.
Which sof sthe sfollowing sis sat shighest srisk sfor sDMII? s- scorrect sanswers s-An sadult
swoman swith sa sBMI sof s27 swho sjust sdelivered sa sbaby sweighing s9 s1/2 slbs
Rationale: sOf sthese soptions, san sadult swoman swith sa sBMI sof s27 swho sjust
sdelivered sa sbaby sweighing s9 s1/2 slbs sis sthe smost slikely sdue sto stheir sincreased
sBMI sand sthe slarge ssize sof sthe sbaby. sgiving sbirth sto sa slarge sbaby, salso sknown
WITH VERIFIED ANSWERS
The spatient sis sexhibiting sa sproductive scough sand sa slow-grade sfever. sChest sX-ray
son sPA sview sshows sa sleft slower schest sarea sof sconsolidation sadjacent sto sthe sleft
sborder sof sthe sheart sapproximately s2 srib sspaces sabove sthe scostophrenic sangle.
sThe slateral sx-ray sview sshows sthis slesion sabsent sof sthe swindow sposterior sto sthe
scardiac ssilhouette. sWhich sis sthe smost slikely slocation sof sthis sarea sof sfocal
sconsolidation?
*Left supper slobe sapex
*Right smiddle slobe
*Left supper slobe slingula
*Left slower slobe s- scorrect sanswers s-Left supper slobe slingula
Ratonale: sLingular sconsolidation sis sdescribed sin sthis squestion sprecisely. sIf sthe
scardiac smargin/silhouette sis sobliterated sby sthe smass, sthe slesion sis seither sright
smiddle slobe sor sleft supper slobe slingula.
,The sinability sto sfully srelax sthe smyocardium sduring srelaxation sis sa strademark sof
swhich sof sthe sfollowing sdiagnoses? s- scorrect sanswers s-Diastolic sdysfunction
Rationale: sThe sinability sfor sthe sheart sto srelax sis sa strademark sof sthe sdiagnosis sof
sdiastolic sdysfunction sand sis scommon sin spatients swith sthickened shypertrophic
smyocardium.
An sotherwise shealthy sAfrican sAmerican sadult smale shas sbeen sdiagnosed swith
shypertension. sHe shas sbeen srestricting shis ssalt sintake, seating sa sDASH s(Dietary
sApproaches sto sStop sHypertension) sdiet, sand sexercising smore, sbut shis sblood
spressure sis sstill selevated. sWhich sis sthe sBEST smedication sto sprescribe shim? s-
scorrect sanswers s-Calcium schannel sblocker
Rationale: sAfrican sAmerican spatients sper sJNC8 sHypertension sGuidelines sshould
sbe smanaged swith sa sdihydropyridine scalcium schannel sblocker ssuch sas samlodipine
s(Norvasc) sas sfirst sline smanagement stherapy sfor shypertension snot sat sgoal swith
sDASH sand slifestyle smodifications.
Your spatient shas sbeen sdiagnosed swith sa s4.5cm sascending saortic saneurysm.
sWhich smedical simaging sis sconsidered sstandard sof scare sfor sserial ssurveillance? s-
scorrect sanswers s-CT sangiography sof sthe schest
Rationale: sCT sangiography sis sconsidered sthe sstandard sof scare sfor smeasuring
svascular sluminal sdimensions swith scontrast. sCT sPE sprotocol sis snot stimed sproperly
sfor sthe saorta s(it's stimed sfor sthe spulmonary sartery). sAlthough sa splain sfilm sis sable
sto scatch slarge saneurysms sat stimes, sthey sare snot sable sto sprovide smulti-axis
sreconstruction sneeded sto saccurately smeasure sthe ssize. sTransesophageal secho sis
snot sneeded sto saccurately smeasure sthe saorta sand srequires sthe spatient sto
sundergo ssedation swhich sis sunnecessary.
Which sof sthe sfollowing smedications sdoes snot scause sbeta s1 sstimulation? s- scorrect
sanswers s-phenylephrine
Rationale: sPhenylephrine sonly sstimulates salpha s1 sreceptors. sThe sremaining sthree
sall shave sbeta sreceptor sactivity.
A s50-year-old swoman swith sa shistory sof shypertension spresents swith sdyspnea son
sexertion sand sorthopnea. sOn sexamination, sshe shas sjugular svenous sdistention sand
sbilateral scrackles son slung sauscultation. sWhat sis sthe smost slikely sdiagnosis? s-
scorrect sanswers s-Congestive sheart sfailure
Rationale: sOf sthe savailable soptions, sthe smost saccurate sresponse sis scongestive
sheart sfailure sas sit sis ssignifying sboth sa sright sventricular sback sup swith sjugular
svenous sextension sand scrackles son slung sassault, swhich sare ssuggestive sof sleft
sventricular sback sup. sit sis spossible sthe spatient smay shave san sacute smyocardial
sinfarction sthat sprecipitated sthis, showever, sa spatient shas snot sdescribed sthat,
srather sis sonly sdescribing sdyspnea son sexertion sand sorthopnea, swhich sboth sspeak
sto sa sstate sof sfluid soverload. sThe sonly sappropriate sresponse sof sthese savailable sis
scongestive sheart sfailure.
,Your spatient swith sa shistory sof sHFrEF s(heart sfailure swith sreduced sejection sfraction)
swith san sejection sfraction sof s40% swho sis salso snot son soptimal smedical stherapy
shas sbeen sdiagnosed swith sa smyocardial sinfarction sthis sadmission sand sreceived
semergent splacement sof sa sdrug-eluting sstent sto sthe sleft santerior sdescending
sartery. sAs sthe smedical shome swho swill smanage sthis spatient safter sdischarge,
swhich smedication sstrategy swould syou sexpect sto sbe sa spriority sin sthe spatient's
scare? s- scorrect sanswers s-Ordering sa stransthoracic sechocardiogram sand sorder sa
sLifevest sif sEF sis sless sthan s35%
Rationale: sThe spatient sshould shave sa sprotective smechanism ssuch sas san
simplantable sautomated scardioverter sdefibrillator s(AICD) sor sa sLifevest sif sthe sEF sis
sless sthan s35% sdue sto sthe sincreased srisk sof ssudden scardiac sdeath swith slow sEF
sstates. sSince smost spatients sare snot seligible sfor s90 sdays sfor san sAICD sin sthis
sstate, soptimizing stheir smedication sregimen sand srepeating san secho sin s2-3 smonths
sto sre-evaluate sfor simprovement sin stheir sEF sis srequired sby smost sinsurance
scompanies. sA sbaseline secho sis sneeded sat sdischarge sto sprovide sa sbaseline sfor
simprovement svs stheir srepeat secho sin s2-3 smonths.
Dual santi-platelet stherapy sis srequired sfor s12 smonths sminimum spost-MI. s
A sHolter smonitor sdoes snot sprovide sany sconceivable sbenefit sfor sthis spatient sas
spresented.
Which sof sthe sfollowing speople sgroups srepresent sthe sleast srisk sof scardiac
sdisease? s- scorrect sanswers s-Caucasians
Rationale: sStatistically sAfrican sAmericans, sNative sHawaiians, sand sAmerican
sIndians sare sat sat sincreased srisk sof scardiac sdisease sdue sto shigher srates sof
shypertension, sdiabetes, sand sobesity sthan sCaucasians.
A s65-year-old swoman spresents sfor sa sfollow-up sexamination. sShe sis sa ssmoker,
sand sher shypertension sis snow sadequately scontrolled swith smedication. sHer smother
sdied sat sage s40 sfrom sa sheart sattack. sThe sfasting slipid sprofile sshows scholesterol
s= s240 smg/dL, sHDL s= s30, sand sLDL s= s200. sIn saddition sto sstarting stherapeutic
slifestyle schanges, sthe snurse spractitioner sshould sstart sthe spatient son: s- scorrect
sanswers s-a sstatin sdrug.
Rationale: sBile sacid ssequestrants sand scholesterol sabsorption sinhibitors smay sbe
suseful sin sreducing sASVD srisk, sbut sfor sa spatient swho sis san sactive ssmoker swith
spremature scoronary sdisease shistory s(less sthan sage s65 sfor swomen), shas
shypertension sand sis sfar sfrom san sLDL sgoal, sthis spatient sis smost scertainly sa
scandidate sfor sstatin stherapy, swhich srepresents sthe smost saggressive stherapy
soption sof sthese sfour slisted.
Which sof sthe sfollowing send-organ ssequelae sis snot sdirectly scaused sby suncontrolled
shypertension? s- scorrect sanswers s-Peripheral sneuropathy
Ratioanle: sAlthough spatients swith shypertension sfrequently shave speripheral
sneuropathy, sit sis sonly sdirectly sattributed sto spatients swho sare salso sdiabetic sand sis
scommonly sfound sin snon-hypertensive sdiabetic spatients. sProteinuria, sAV snicking,
sand shemorrhagic sstroke sare sall scaused sby suncontrolled shypertension.
, Preventive scardiac scare sshould sfocus sprimarily son saddressing sall sthe sfollowing
sexcept? s- scorrect sanswers s-Genetic spredisposition
Rationale: sSmoking scessation, sexercise, sand smedication scompliance sall srepresent
smodifiable srisk sfactors sand sshould sbe sthe sfocus sof spreventive scare. sNon-
modifiable srisk sfactors ssuch sas sage, sgender, sgenetic/family shistory sshould snot sbe
sthe sprimary sfocus sof sprevention.
A s33-year-old swoman spresents swith sirregular smenstrual scycles, shirsutism, sand
sobesity. sLaboratory stests sreveal selevated sserum stestosterone sand sLH sratio s>
s2:1. sWhat sis sthe smost sappropriate sinitial streatment? s- scorrect sanswers s-Oral
scontraceptives
Rationale: sThese sare sclassic ssymptoms sof spolycystic sovarian ssyndrome sand sthe
spatient sshould sbe streated swith soral scontraceptives sto shelp sstabilize stheir
sestrogen sand sprogesterone. sAdditionally, sthey smay sbe smanaged son smetformin
sand/or sspironolactone sfor stheir sPCOS.
Oral scontraceptive spills s(OCPs) sare soften sthe sfirst spharmacological streatment sfor
spolycystic sovary ssyndrome s(PCOS) sbecause sthey shelp smanage sin sseveral sways:
Menstrual sirregularities: sOCPs scan shelp sregulate smenstrual scycles, smaking
speriods slighter sand smore sregular. sThis sis simportant sbecause sirregular sovulation
scan slead sto sendometrial shyperplasia, swhich sis sa sbuildup sof suterine stissue sthat
scan sincrease sthe srisk sof suterine scancer.
Androgen sexcess: sOCPs scan sreduce sandrogen sproduction sand sincrease ssex
shormone-binding sglobulin s(SHBG), swhich sbinds sandrogens. sThis scan shelp sreduce
ssymptoms slike sacne, shirsutism s(unwanted sbody sand sfacial shair), sand sandrogenic
salopecia s(male spattern sbaldness).
Endometrium sprotection: sOCPs scan sprotect sthe sendometrium sby sensuring sregular
sovulation
A s50-year-old swoman swith shypertension sand sdiabetes scomes sin sfor sa sroutine
scheck-up. sWhat sscreening stest sshould sbe sregularly sperformed sto smonitor sfor
searly ssigns sof sdiabetic snephropathy? s- scorrect sanswers s-Urine sdipstick sfor
sprotein
Rationale: sThe smost ssensitive sindicator sof sdiabetic snephropathy swould sbe sthe
sevidence sof ssmall sproteins sin sthe surine s(proteinuria) sas sfound son surinalysis. sThe
sother soptions smight sdescribe smacro-organ sfunction s(such sas sBUN/Creat sfrom sa
sBMP, sa srenal sbiopsy swhich sis snot sindicated sfor sroutine sdiabetic snephropathy
stesting, sand sa sAbd sCT, swhich sis smore sakin sto sevaluation sof sless ssubtle
sfindings), sbut sat sthe sfunctional slevel sof sthe snephron, snamely sthe sglomerulus,
sevidence sof sglucose-related sdamage sis seasily sidentified swith sproteinuria sfrom sa
sUA.
Which sof sthe sfollowing sis sat shighest srisk sfor sDMII? s- scorrect sanswers s-An sadult
swoman swith sa sBMI sof s27 swho sjust sdelivered sa sbaby sweighing s9 s1/2 slbs
Rationale: sOf sthese soptions, san sadult swoman swith sa sBMI sof s27 swho sjust
sdelivered sa sbaby sweighing s9 s1/2 slbs sis sthe smost slikely sdue sto stheir sincreased
sBMI sand sthe slarge ssize sof sthe sbaby. sgiving sbirth sto sa slarge sbaby, salso sknown
