CEA Prep Practice Exam Study Guide (full)
2025 Questions & Accurate Answers
An 18-month-old child presents with a bulging, immobile tympanic membrane; T = 103°F (39.4°C). Assessment
also reveals a grade II/VI systolic murmur at the left sternal border. After initiation of treatment for otitis
media, the most appropriate intervention is to:
reevaluate the patient in 10 days
Rationale: Heart murmurs in toddlers are relatively common and can be either innocent (benign) or
pathological (indicative of underlying heart conditions). Proper evaluation and monitoring are essential to
determine the nature of the murmur and to ensure the child's health and development are not adversely
affected. Re-evaluating in 10 days is an appropriate next course of action.
A 7-year-old child presents with group A streptococcal infection confirmed by throat culture. Past history
includes treatment for positive streptococcal infection with erythromycin (EryPed oral suspension) 3 weeks
ago. What is the most appropriate next intervention?
Treat with amoxicillin for 10 days.
Rationale: If erythromycin treatment for streptococcal infection did not work, the next course of action
typically involves switching to Amoxicillin. This is often the first-line antibiotic for streptococcal infections.
Which of the following fine motor skills is typically expected of a 3-year-old child?
Drawing a straight line
Rationale: By the age of 3, children typically develop a range of fine motor skills that allow them to engage in
more detailed and precise activities. They start to draw basic shapes such as circles, lines, and simple pictures.
An 18-month-old child presents with a bulging, immobile tympanic membrane; T = 103°F (39.4°C). Assessment
also reveals a grade II/VI systolic murmur at the left sternal border. After initiation of treatment for otitis
media, the most appropriate intervention is to:
reevaluate the patient in 10 days.
Rationale: Heart murmurs in toddlers are relatively common and can be either innocent (benign) or
pathological (indicative of underlying heart conditions). Proper evaluation and monitoring are essential to
determine the nature of the murmur and to ensure the child's health and development are not adversely
affected. Re-evaluating in 10 days is an appropriate next course of action.
The 16-year-old mother of a 2-month-old presents the infant, reporting that the child is very irritable and does
not feed well. During physical examination, the child's head drops back and the child exhibits sudden flexing of
the extremities. As the flexing stops, the child cries uncontrollably. Funduscopic examination reveals retinal
hemorrhages. Which of the following diagnostic tests should be ordered?
CT scan
,Rationale: Retinal hemorrhages are a characteristic finding in abusive head trauma, particularly shaking
injuries. They result from the forceful shaking causing shearing and tearing of blood vessels in the retina. A CT
scan is indicated in this case.
At what age should a child typically be able to sit without support?
6 months
Rationale: Typically, a child should be able to sit without support around the age of 6 to 8 months.
What is the most common trigger for asthma exacerbations in children?
Seasonal allergies
Rationale: The most common cause of asthma in children is allergic asthma. Allergic asthma is triggered by
exposure to allergens that cause inflammation and narrowing of the airways in the lungs. Common allergens
that can trigger allergic asthma include:
Dust mites: Microscopic organisms that thrive in bedding, carpets, and upholstered furniture.
Pollen: Small particles released by trees, grasses, and weeds, particularly during certain seasons.
Pet dander: Tiny flecks of skin shed by cats, dogs, and other furry animals.
Mold: Fungi that can grow indoors in damp areas such as bathrooms, basements, and kitchens.
Cockroach allergens: Substances produced by cockroaches that can trigger asthma symptoms in sensitive
individuals.
Other allergens: Certain foods, especially in young children, and environmental factors like cigarette smoke,
air pollution, and strong odors can also exacerbate asthma symptoms.
A 13-year-old patient returns to the office complaining of intermittent headache for the past couple of years.
Which would be the most concerning symptom?
Stiff neck
Rationale: Inflammation of the membranes (meninges) surrounding the brain and spinal cord, often caused by a
viral or bacterial infection. This can cause severe headache, stiff neck, fever, and sensitivity to light.
Which of the following medical exam requires the patient to be sedated?
*Transesophageal echocardiogram (TEE)
*Nuclear tress test
*Tilt table test
*Transthoracic echocardiogram (TTE)
Transesophageal echocardiogram (TEE)
Rationale: Due to the invasive nature of the TEE, patients will require procedural sedation. The patient
undergoing a transthoracic echo, tilt table, and nuclear stress test are all fully alert during these procedures.
,A "code blue" is called on your patient in the waiting room of your urgent care. When you arrive, cardiac
monitoring is applied and their rhythm appears to be normal sinus rhythm with a rate of 80. On palpation over
the carotid artery, you do not feel a pulse. What is the name of this cardiac rhythm?
*Idioventricular rhythm
*Junctional Tachycardia
*Wandering Atrial Pacemaker (WAP)
*Pulseless Electrical Activity (PEA)
Pulseless Electrical Activity (PEA)
Rationale: PEA appears as a normal rhythm without a pulse. Idioventricular rhythm is very slow (20-40),
Junctional tachycardia and WAP both without pulses are considered PEA also.
A grade III/VI, low-pitched, diastolic, rumbling murmur heard at the apex, and best heard in the left lateral
decubitus position, is most indicative of which of the following types of valve problem?
*Aortic stenosis
*Mitral regurgitation
*Mitral stenosis
*Aortic regurgitation
Mitral stenosis
rationale: As a general study rule, left chest wall murmurs are mitral in etiology, right chest and neck murmurs
are aortic in nature.
A diastolic low-pitch mitral murmur represents the sound of blood filling the left ventricle through a restriction
(stenosis), which is by definition mitral stenosis. The only other diastolic murmur listed in this question is
aortic regurgitation, and that would be heard in a different spot (RSB 2 ICS) and potentially radiate to the neck
and be high pitched.
A 45-year-old man presents with chest pain radiating to the left arm, diaphoresis, and shortness of breath. His
ECG shows ST-segment elevation. What is the initial management response?
*Administer nitroglycerin sublingually
*Administer aspirin and call for emergency medical services
*Perform immediate coronary angiography
*Start intravenous heparin
Administer aspirin and call for emergency medical services
Recommendation for lipid check in adolescent with type 1 DM?
, 2 years
10 years
5 years
1 year
1 year
Rationale: Remember than with pediatric patients with diabetes, the easiest way to remember the evaluation
schedule is to perform lipid checks is with annual physicals.
An older adult with diabetes mellitus presents with leg cramps. She states that the cramps as worst when
walking to the supermarket. If she stops to rest, the pain subsides. The nurse practitioner knows that this
patient needs a workup for:
*Benign nocturnal leg cramps
*Popliteal aneurism
*Intermittent claudication
*Deep vein thrombosis
Intermittent claudication
An adult female who recently returned from a business trip to Japan presents for a recheck appointment. The
only remarkable laboratory result is for thyroid-stimulating hormone (TSH), at 0.3 microunits/mL (normal =
0.4-6 microunits/mL). The patient reports that her neck hurts; examination reveals thyroid tenderness. Which
of the following laboratory tests should the nurse practitioner order now?
*Triiodothyronine (T3) and free thyroxine (FT4)
*Triiodothyronine (T3) and free triiodothyronine (FT3)
*Triiodothyronine (T3) only
*Triiodothyronine (T3) resin uptake assay
Triiodothyronine (T3) and free thyroxine (FT4)
Rationale: The patient has a low TSH which when paired with elevated T3 and T4, suggest hyperthyroidism.
The next steps for this patient are to check the T3 and T4 levels which would presumably be high and clinically
correlate the findings for a diagnosis of hyperthyroidism.
A patient has a 2 cm pituitary adenoma on MRI. Deficiency of one of the pituitary hormones can cause
immediate hemodynamic instability and has a risk of death. Which is the most critical hormone deficiency to
rule out?
*FSH/LH
*ACTH
*Prolactin
*TSH
2025 Questions & Accurate Answers
An 18-month-old child presents with a bulging, immobile tympanic membrane; T = 103°F (39.4°C). Assessment
also reveals a grade II/VI systolic murmur at the left sternal border. After initiation of treatment for otitis
media, the most appropriate intervention is to:
reevaluate the patient in 10 days
Rationale: Heart murmurs in toddlers are relatively common and can be either innocent (benign) or
pathological (indicative of underlying heart conditions). Proper evaluation and monitoring are essential to
determine the nature of the murmur and to ensure the child's health and development are not adversely
affected. Re-evaluating in 10 days is an appropriate next course of action.
A 7-year-old child presents with group A streptococcal infection confirmed by throat culture. Past history
includes treatment for positive streptococcal infection with erythromycin (EryPed oral suspension) 3 weeks
ago. What is the most appropriate next intervention?
Treat with amoxicillin for 10 days.
Rationale: If erythromycin treatment for streptococcal infection did not work, the next course of action
typically involves switching to Amoxicillin. This is often the first-line antibiotic for streptococcal infections.
Which of the following fine motor skills is typically expected of a 3-year-old child?
Drawing a straight line
Rationale: By the age of 3, children typically develop a range of fine motor skills that allow them to engage in
more detailed and precise activities. They start to draw basic shapes such as circles, lines, and simple pictures.
An 18-month-old child presents with a bulging, immobile tympanic membrane; T = 103°F (39.4°C). Assessment
also reveals a grade II/VI systolic murmur at the left sternal border. After initiation of treatment for otitis
media, the most appropriate intervention is to:
reevaluate the patient in 10 days.
Rationale: Heart murmurs in toddlers are relatively common and can be either innocent (benign) or
pathological (indicative of underlying heart conditions). Proper evaluation and monitoring are essential to
determine the nature of the murmur and to ensure the child's health and development are not adversely
affected. Re-evaluating in 10 days is an appropriate next course of action.
The 16-year-old mother of a 2-month-old presents the infant, reporting that the child is very irritable and does
not feed well. During physical examination, the child's head drops back and the child exhibits sudden flexing of
the extremities. As the flexing stops, the child cries uncontrollably. Funduscopic examination reveals retinal
hemorrhages. Which of the following diagnostic tests should be ordered?
CT scan
,Rationale: Retinal hemorrhages are a characteristic finding in abusive head trauma, particularly shaking
injuries. They result from the forceful shaking causing shearing and tearing of blood vessels in the retina. A CT
scan is indicated in this case.
At what age should a child typically be able to sit without support?
6 months
Rationale: Typically, a child should be able to sit without support around the age of 6 to 8 months.
What is the most common trigger for asthma exacerbations in children?
Seasonal allergies
Rationale: The most common cause of asthma in children is allergic asthma. Allergic asthma is triggered by
exposure to allergens that cause inflammation and narrowing of the airways in the lungs. Common allergens
that can trigger allergic asthma include:
Dust mites: Microscopic organisms that thrive in bedding, carpets, and upholstered furniture.
Pollen: Small particles released by trees, grasses, and weeds, particularly during certain seasons.
Pet dander: Tiny flecks of skin shed by cats, dogs, and other furry animals.
Mold: Fungi that can grow indoors in damp areas such as bathrooms, basements, and kitchens.
Cockroach allergens: Substances produced by cockroaches that can trigger asthma symptoms in sensitive
individuals.
Other allergens: Certain foods, especially in young children, and environmental factors like cigarette smoke,
air pollution, and strong odors can also exacerbate asthma symptoms.
A 13-year-old patient returns to the office complaining of intermittent headache for the past couple of years.
Which would be the most concerning symptom?
Stiff neck
Rationale: Inflammation of the membranes (meninges) surrounding the brain and spinal cord, often caused by a
viral or bacterial infection. This can cause severe headache, stiff neck, fever, and sensitivity to light.
Which of the following medical exam requires the patient to be sedated?
*Transesophageal echocardiogram (TEE)
*Nuclear tress test
*Tilt table test
*Transthoracic echocardiogram (TTE)
Transesophageal echocardiogram (TEE)
Rationale: Due to the invasive nature of the TEE, patients will require procedural sedation. The patient
undergoing a transthoracic echo, tilt table, and nuclear stress test are all fully alert during these procedures.
,A "code blue" is called on your patient in the waiting room of your urgent care. When you arrive, cardiac
monitoring is applied and their rhythm appears to be normal sinus rhythm with a rate of 80. On palpation over
the carotid artery, you do not feel a pulse. What is the name of this cardiac rhythm?
*Idioventricular rhythm
*Junctional Tachycardia
*Wandering Atrial Pacemaker (WAP)
*Pulseless Electrical Activity (PEA)
Pulseless Electrical Activity (PEA)
Rationale: PEA appears as a normal rhythm without a pulse. Idioventricular rhythm is very slow (20-40),
Junctional tachycardia and WAP both without pulses are considered PEA also.
A grade III/VI, low-pitched, diastolic, rumbling murmur heard at the apex, and best heard in the left lateral
decubitus position, is most indicative of which of the following types of valve problem?
*Aortic stenosis
*Mitral regurgitation
*Mitral stenosis
*Aortic regurgitation
Mitral stenosis
rationale: As a general study rule, left chest wall murmurs are mitral in etiology, right chest and neck murmurs
are aortic in nature.
A diastolic low-pitch mitral murmur represents the sound of blood filling the left ventricle through a restriction
(stenosis), which is by definition mitral stenosis. The only other diastolic murmur listed in this question is
aortic regurgitation, and that would be heard in a different spot (RSB 2 ICS) and potentially radiate to the neck
and be high pitched.
A 45-year-old man presents with chest pain radiating to the left arm, diaphoresis, and shortness of breath. His
ECG shows ST-segment elevation. What is the initial management response?
*Administer nitroglycerin sublingually
*Administer aspirin and call for emergency medical services
*Perform immediate coronary angiography
*Start intravenous heparin
Administer aspirin and call for emergency medical services
Recommendation for lipid check in adolescent with type 1 DM?
, 2 years
10 years
5 years
1 year
1 year
Rationale: Remember than with pediatric patients with diabetes, the easiest way to remember the evaluation
schedule is to perform lipid checks is with annual physicals.
An older adult with diabetes mellitus presents with leg cramps. She states that the cramps as worst when
walking to the supermarket. If she stops to rest, the pain subsides. The nurse practitioner knows that this
patient needs a workup for:
*Benign nocturnal leg cramps
*Popliteal aneurism
*Intermittent claudication
*Deep vein thrombosis
Intermittent claudication
An adult female who recently returned from a business trip to Japan presents for a recheck appointment. The
only remarkable laboratory result is for thyroid-stimulating hormone (TSH), at 0.3 microunits/mL (normal =
0.4-6 microunits/mL). The patient reports that her neck hurts; examination reveals thyroid tenderness. Which
of the following laboratory tests should the nurse practitioner order now?
*Triiodothyronine (T3) and free thyroxine (FT4)
*Triiodothyronine (T3) and free triiodothyronine (FT3)
*Triiodothyronine (T3) only
*Triiodothyronine (T3) resin uptake assay
Triiodothyronine (T3) and free thyroxine (FT4)
Rationale: The patient has a low TSH which when paired with elevated T3 and T4, suggest hyperthyroidism.
The next steps for this patient are to check the T3 and T4 levels which would presumably be high and clinically
correlate the findings for a diagnosis of hyperthyroidism.
A patient has a 2 cm pituitary adenoma on MRI. Deficiency of one of the pituitary hormones can cause
immediate hemodynamic instability and has a risk of death. Which is the most critical hormone deficiency to
rule out?
*FSH/LH
*ACTH
*Prolactin
*TSH
