CEA PREP: FULL PRACTICE EXAM QUESTIONS
WITH COMPLETE SOLUTIONS
Workup to rule out cardiac source of an embolic stroke should
include which of the following exams?
*12 Lead EKG
*CT chest without contrast
*CT facial bones
*Transthoracic or Transesophageal echocardiogram
Transthoracic or Transesophageal echocardiogram
Rationale: Patients with acute embolic strokes should have a
transthoracic echocardiogram to evaluate for any presence of
valvular dysfunction. With presence of pharyngitis, the risk of
bacterial endocarditis must be ruled out, and valvular vegetation
as a cause must be evaluated with an echocardiogram. If any
findings are noted, a transesophageal echocardiogram may be
performed to better identify the vegetation.
A patient presents to the urgent care with SOB, fatigue,
headache, and chest pain. Cardiac work-up is negative but CBC
reveals a hemoglobin of 6.5. Which of the following indices
would indicate a potential iron deficiency anemia?
*MCV 72, MCHC 38
*MCV 112, MCHC 40
*MCV 95, MCHC 34
*MCV 67, MCHC 29
MCV 67, MCHC 29
Rationale: Iron deficiency anemia (IDA) is identified as a
,microcytic, hypochromic anemia. Normal MCV is 80-100 and
normal MCHC is 33-37 therefore MCV less than 80 and MCHC
less than 33 is considered microcytic hypochromic and
indicative
A 49 y.o. M patient, who works in an automotive battery
factory, presents to urgent care with three-day onset of
abdominal pain, constipation, anorexia, muscle aches, headache,
and excessive fatigue. Considering the patient's occupation, the
provider should include which of the following labs in his work-
up?
*C. difficile stool culture
*Hemoglobin A1C
*Vitamin B12/Folate
*Blood lead level
Blood lead level
Rationale: Factories which produce batteries have a higher risk
of workplace exposure to lead. This patient's symptoms are
consistent with an elevated blood lead level and, potentially,
lead poisoning.
A patient is taking warfarin, 4 mg daily for atrial fibrillation.
The patient's current International Normalized Ratio (INR) is 5.5
mg/dL. The nurse practitioner would:
*Answer hold the warfarin for 1 day and then recheck in two
days.
*decrease the warfarin to 3 mg daily.
*increase the warfarin to 5 mg daily.
*hold the warfarin for 4 days and then recheck the INR.
,Answer hold the warfarin for 1 day and then recheck in two
days.
Rationale: As warfarin has a long half life, it typically takes
several days to see meaningful change in levels of dose change.
The INR of 5.5 is supratherapeutic and must be reduced for the
risk of bleeding. Of these options, the only one that offers a
reduction/cessation and and a recheck of the level is to hold the
warfarin for one day and recheck the INR in 2 days.
Your patient presents with painless lymph node swelling, weight
loss, night sweats, and asks what is wrong with him. Which of
the following represents a most appropriate intervention to
confirm a diagnosis of lymphoma?
*Order a CBC and TSH
*Consult pulmonology
*Order a core needle biopsy
*Examine the patient
Order a core needle biopsy
Rationale: This question is asking for an intervention. Although
examining the patient is useful, it is an evaluation tool, as is
ordering routine lab work. Pulmonology is not an appropriate
consultation for this patient; rather, hematology or oncology
would be best suited to evaluate and work up this patient. A
diagnostic needle biopsy is the most definitive intervention to
gain a diagnosis for a suspected lymphoma.
Your patient arrives the urgent care complaining of a swollen
throat and vocal changes. Which of the following statements
made by the patient brings an index of suspicion of angioedema?
, *This seems to be getting better already getting out of the cold
*I have been taking my lisinopril for the past week as prescribed
*I have never had this happen before
*I do not take any ibuprofen since it gives me an upset stomach
I have been taking my lisinopril for the past week as prescribed
Rationale: Use of ACE Inhibitors and NSAIDS is a common
precipitating factor in angioedema. The rest do not suggest any
relationship to angioedema.
A 35-year-old woman presents with a new, darkly pigmented
lesion on her back that she noticed a few months ago. The lesion
is asymmetrical, has irregular borders, and varies in color. What
is the most appropriate next step in management?
*Perform a shave biopsy
*Reassure the patient and advise regular monitoring
*Perform an excisional biopsy
*Perform a punch biopsy
Perform an excisional biopsy
Rationale: When a healthcare provider needs to definitively
diagnose or rule out a suspected condition, such as a skin lesion
or tumor, an excisional biopsy allows for the entire lesion or a
significant portion of it to be removed and examined under a
microscope by a pathologist.
An adult daycare worker presents with severe itching on the
arms and around the arms and wrists. The patient's skin is mildly
excoriated from scratching. Microscopic examination of a skin
reveals scabies. The treatment of choice for the patient would
be?
WITH COMPLETE SOLUTIONS
Workup to rule out cardiac source of an embolic stroke should
include which of the following exams?
*12 Lead EKG
*CT chest without contrast
*CT facial bones
*Transthoracic or Transesophageal echocardiogram
Transthoracic or Transesophageal echocardiogram
Rationale: Patients with acute embolic strokes should have a
transthoracic echocardiogram to evaluate for any presence of
valvular dysfunction. With presence of pharyngitis, the risk of
bacterial endocarditis must be ruled out, and valvular vegetation
as a cause must be evaluated with an echocardiogram. If any
findings are noted, a transesophageal echocardiogram may be
performed to better identify the vegetation.
A patient presents to the urgent care with SOB, fatigue,
headache, and chest pain. Cardiac work-up is negative but CBC
reveals a hemoglobin of 6.5. Which of the following indices
would indicate a potential iron deficiency anemia?
*MCV 72, MCHC 38
*MCV 112, MCHC 40
*MCV 95, MCHC 34
*MCV 67, MCHC 29
MCV 67, MCHC 29
Rationale: Iron deficiency anemia (IDA) is identified as a
,microcytic, hypochromic anemia. Normal MCV is 80-100 and
normal MCHC is 33-37 therefore MCV less than 80 and MCHC
less than 33 is considered microcytic hypochromic and
indicative
A 49 y.o. M patient, who works in an automotive battery
factory, presents to urgent care with three-day onset of
abdominal pain, constipation, anorexia, muscle aches, headache,
and excessive fatigue. Considering the patient's occupation, the
provider should include which of the following labs in his work-
up?
*C. difficile stool culture
*Hemoglobin A1C
*Vitamin B12/Folate
*Blood lead level
Blood lead level
Rationale: Factories which produce batteries have a higher risk
of workplace exposure to lead. This patient's symptoms are
consistent with an elevated blood lead level and, potentially,
lead poisoning.
A patient is taking warfarin, 4 mg daily for atrial fibrillation.
The patient's current International Normalized Ratio (INR) is 5.5
mg/dL. The nurse practitioner would:
*Answer hold the warfarin for 1 day and then recheck in two
days.
*decrease the warfarin to 3 mg daily.
*increase the warfarin to 5 mg daily.
*hold the warfarin for 4 days and then recheck the INR.
,Answer hold the warfarin for 1 day and then recheck in two
days.
Rationale: As warfarin has a long half life, it typically takes
several days to see meaningful change in levels of dose change.
The INR of 5.5 is supratherapeutic and must be reduced for the
risk of bleeding. Of these options, the only one that offers a
reduction/cessation and and a recheck of the level is to hold the
warfarin for one day and recheck the INR in 2 days.
Your patient presents with painless lymph node swelling, weight
loss, night sweats, and asks what is wrong with him. Which of
the following represents a most appropriate intervention to
confirm a diagnosis of lymphoma?
*Order a CBC and TSH
*Consult pulmonology
*Order a core needle biopsy
*Examine the patient
Order a core needle biopsy
Rationale: This question is asking for an intervention. Although
examining the patient is useful, it is an evaluation tool, as is
ordering routine lab work. Pulmonology is not an appropriate
consultation for this patient; rather, hematology or oncology
would be best suited to evaluate and work up this patient. A
diagnostic needle biopsy is the most definitive intervention to
gain a diagnosis for a suspected lymphoma.
Your patient arrives the urgent care complaining of a swollen
throat and vocal changes. Which of the following statements
made by the patient brings an index of suspicion of angioedema?
, *This seems to be getting better already getting out of the cold
*I have been taking my lisinopril for the past week as prescribed
*I have never had this happen before
*I do not take any ibuprofen since it gives me an upset stomach
I have been taking my lisinopril for the past week as prescribed
Rationale: Use of ACE Inhibitors and NSAIDS is a common
precipitating factor in angioedema. The rest do not suggest any
relationship to angioedema.
A 35-year-old woman presents with a new, darkly pigmented
lesion on her back that she noticed a few months ago. The lesion
is asymmetrical, has irregular borders, and varies in color. What
is the most appropriate next step in management?
*Perform a shave biopsy
*Reassure the patient and advise regular monitoring
*Perform an excisional biopsy
*Perform a punch biopsy
Perform an excisional biopsy
Rationale: When a healthcare provider needs to definitively
diagnose or rule out a suspected condition, such as a skin lesion
or tumor, an excisional biopsy allows for the entire lesion or a
significant portion of it to be removed and examined under a
microscope by a pathologist.
An adult daycare worker presents with severe itching on the
arms and around the arms and wrists. The patient's skin is mildly
excoriated from scratching. Microscopic examination of a skin
reveals scabies. The treatment of choice for the patient would
be?
