Chamberlain NR 667 CEA Final Exam Study Guide |
100% Complete 150 Q&A Bundle | Verified Level 3
Pass NR 667 CEA Final Exam 2026: Actual Questions
with Verified Answers & Rationales – Chamberlain
University FNP Capstone
Cardiovascular and Respiratory Management
1. A 62-year-old male presents to the clinic for a routine follow-up. His blood pressure
readings today average 144/92 mm Hg, and his last visit readings were 142/90 mm
Hg. He has no prior medical history. According to the ACC/AHA guidelines, which of
the following is the most appropriate initial management?
A) Initiate lifestyle modifications and recheck blood pressure in 6 months.
B) Initiate lifestyle modifications and start a low-dose thiazide diuretic or ACE
inhibitor.
C) Initiate dual-therapy with an ACE inhibitor and a calcium channel blocker
immediately.
D) Prescribe a beta-blocker as first-line therapy.
Stage 2 hypertension is defined as a systolic BP of 140 mm Hg or higher, or a
diastolic BP of 90 mm Hg or higher. Because the patient has had documented Stage
2 readings across two separate visits, pharmacologic treatment should be initiated
alongside lifestyle changes. Thiazides, ACE inhibitors, ARBs, or CCBs are preferred
first-line classes; beta-blockers are not first-line unless a compelling cardiac
indication exists.
,2. A 45-year-old female with a history of heart failure with reduced ejection fraction
(HFrEF) presents with persistent dry cough. She was started on lisinopril 4 weeks
ago. Which of the following is the most appropriate alternative medication class to
manage her hypertension and HFrEF?
A) Calcium channel blocker
B) Angiotensin receptor blocker (ARB)
C) Beta-blocker monotherapy
D) Loop diuretic
ACE inhibitor-induced cough is caused by the accumulation of bradykinin in the
respiratory tract. Switching the patient to an ARB (such as losartan or valsartan)
provides similar neurohormonal benefits for HFrEF without accumulating bradykinin,
effectively eliminating the cough.
3. An 18-year-old college student presents with an acute exacerbation of asthma. She
has been using her albuterol inhaler 4 times daily for the past 3 days. Her peak
expiratory flow (PEF) is 65% of her personal best. In addition to scheduling regular
short-acting beta-agonists, which of the following should be prescribed immediately?
A) A 10-day course of oral antibiotics
B) A short course of oral corticosteroids (e.g., prednisone 40–50 mg daily for 5
days)
C) A long-acting beta-agonist (LABA) inhaler alone
D) Daily leukotriene receptor antagonists
A PEF between 50% and 79% indicates a moderate asthma exacerbation. The
immediate treatment goal is to reduce airway inflammation using a short course of
oral systemic corticosteroids. Antibiotics are not indicated unless there is clear
evidence of a secondary bacterial infection.
, 4. A 68-year-old smoker presents with progressive dyspnea on exertion and a chronic
productive cough. A spirometry test reveals a post-bronchodilator FEV1/FVC ratio of
0.62. Which of the following confirms the diagnosis?
A) COPD, based on a post-bronchodilator FEV1/FVC ratio less than 0.70
C) Acute bronchitis, requiring immediate antibiotic therapy
C) Asthma, due to the presence of a productive cough
D) Pulmonary fibrosis, indicated by obstructive airway patterns
The definitive diagnostic criterion for COPD according to the GOLD guidelines is a
post-bronchodilator FEV1/FVC ratio of less than 0.70, which confirms persistent,
irreversible airflow limitation.
5. A 55-year-old male with a history of hypertension presents with sudden onset of
palpitations and mild dizziness. An ECG reveals an irregularly irregular rhythm with
absent P waves and a narrow QRS complex. The ventricular rate is 122 bpm. The
patient is hemodynamically stable. What is the priority management strategy in the
primary care setting?
A) Immediate synchronized cardioversion
B) Initiate rate control with a beta-blocker or non-dihydropyridine calcium
channel blocker and assess stroke risk.
C) Administer a high-dose IV fluid bolus and discharge home.
D) Prescribe amiodarone and recheck in 2 weeks.
For stable, acute atrial fibrillation, the initial primary care priorities are rate control
(typically using a beta-blocker like metoprolol or a CCB like diltiazem) and calculating
the stroke risk using the CHA2DS2-VASc score to guide anticoagulation therapy.
Cardioversion is reserved for unstable patients.
Endocrine and Metabolic Disorders
, 6. A 52-year-old female presents for a evaluation of her type 2 diabetes. Her
hemoglobin A1C is 8.4% despite taking metformin 1,000 mg twice daily for the past 6
months. She has a history of atherosclerotic cardiovascular disease (ASCVD).
Which of the following medications should be added next?
A) Glipizide (Sulfonylurea)
B) Pioglitazone (Thiazolidinedione)
C) Empagliflozin (SGLT2 inhibitor) or Liraglutide (GLP-1 receptor agonist)
D) NPH Insulin at bedtime
For patients with type 2 diabetes and established ASCVD, chronic kidney disease
(CKD), or heart failure, ADA guidelines strongly recommend adding an SGLT2
inhibitor or a GLP-1 receptor agonist with proven cardiovascular benefit, independent
of the baseline A1C level.
7. A 34-year-old female presents with heat intolerance, weight loss, palpitations, and
diffuse enlargement of the thyroid gland. Laboratory results reveal a TSH of <0.01
mIU/L and a free T4 of 2.8 ng/dL. Which of the following is the most likely diagnosis?
A) Hashimoto's thyroiditis
B) Graves' disease
C) Subacute thyroiditis
D) Primary hyperparathyroidism
Graves' disease is the most common cause of primary hyperthyroidism,
characterized by suppressed TSH and elevated free T4 levels, along with
hypermetabolic symptoms such as heat intolerance, weight loss, and goiter.
8. A 45-year-old male is diagnosed with primary hypothyroidism. His weight is 80 kg.
Which of the following is the most appropriate initial daily dose of levothyroxine for a
healthy middle-aged adult?
A) 25 mcg/day
100% Complete 150 Q&A Bundle | Verified Level 3
Pass NR 667 CEA Final Exam 2026: Actual Questions
with Verified Answers & Rationales – Chamberlain
University FNP Capstone
Cardiovascular and Respiratory Management
1. A 62-year-old male presents to the clinic for a routine follow-up. His blood pressure
readings today average 144/92 mm Hg, and his last visit readings were 142/90 mm
Hg. He has no prior medical history. According to the ACC/AHA guidelines, which of
the following is the most appropriate initial management?
A) Initiate lifestyle modifications and recheck blood pressure in 6 months.
B) Initiate lifestyle modifications and start a low-dose thiazide diuretic or ACE
inhibitor.
C) Initiate dual-therapy with an ACE inhibitor and a calcium channel blocker
immediately.
D) Prescribe a beta-blocker as first-line therapy.
Stage 2 hypertension is defined as a systolic BP of 140 mm Hg or higher, or a
diastolic BP of 90 mm Hg or higher. Because the patient has had documented Stage
2 readings across two separate visits, pharmacologic treatment should be initiated
alongside lifestyle changes. Thiazides, ACE inhibitors, ARBs, or CCBs are preferred
first-line classes; beta-blockers are not first-line unless a compelling cardiac
indication exists.
,2. A 45-year-old female with a history of heart failure with reduced ejection fraction
(HFrEF) presents with persistent dry cough. She was started on lisinopril 4 weeks
ago. Which of the following is the most appropriate alternative medication class to
manage her hypertension and HFrEF?
A) Calcium channel blocker
B) Angiotensin receptor blocker (ARB)
C) Beta-blocker monotherapy
D) Loop diuretic
ACE inhibitor-induced cough is caused by the accumulation of bradykinin in the
respiratory tract. Switching the patient to an ARB (such as losartan or valsartan)
provides similar neurohormonal benefits for HFrEF without accumulating bradykinin,
effectively eliminating the cough.
3. An 18-year-old college student presents with an acute exacerbation of asthma. She
has been using her albuterol inhaler 4 times daily for the past 3 days. Her peak
expiratory flow (PEF) is 65% of her personal best. In addition to scheduling regular
short-acting beta-agonists, which of the following should be prescribed immediately?
A) A 10-day course of oral antibiotics
B) A short course of oral corticosteroids (e.g., prednisone 40–50 mg daily for 5
days)
C) A long-acting beta-agonist (LABA) inhaler alone
D) Daily leukotriene receptor antagonists
A PEF between 50% and 79% indicates a moderate asthma exacerbation. The
immediate treatment goal is to reduce airway inflammation using a short course of
oral systemic corticosteroids. Antibiotics are not indicated unless there is clear
evidence of a secondary bacterial infection.
, 4. A 68-year-old smoker presents with progressive dyspnea on exertion and a chronic
productive cough. A spirometry test reveals a post-bronchodilator FEV1/FVC ratio of
0.62. Which of the following confirms the diagnosis?
A) COPD, based on a post-bronchodilator FEV1/FVC ratio less than 0.70
C) Acute bronchitis, requiring immediate antibiotic therapy
C) Asthma, due to the presence of a productive cough
D) Pulmonary fibrosis, indicated by obstructive airway patterns
The definitive diagnostic criterion for COPD according to the GOLD guidelines is a
post-bronchodilator FEV1/FVC ratio of less than 0.70, which confirms persistent,
irreversible airflow limitation.
5. A 55-year-old male with a history of hypertension presents with sudden onset of
palpitations and mild dizziness. An ECG reveals an irregularly irregular rhythm with
absent P waves and a narrow QRS complex. The ventricular rate is 122 bpm. The
patient is hemodynamically stable. What is the priority management strategy in the
primary care setting?
A) Immediate synchronized cardioversion
B) Initiate rate control with a beta-blocker or non-dihydropyridine calcium
channel blocker and assess stroke risk.
C) Administer a high-dose IV fluid bolus and discharge home.
D) Prescribe amiodarone and recheck in 2 weeks.
For stable, acute atrial fibrillation, the initial primary care priorities are rate control
(typically using a beta-blocker like metoprolol or a CCB like diltiazem) and calculating
the stroke risk using the CHA2DS2-VASc score to guide anticoagulation therapy.
Cardioversion is reserved for unstable patients.
Endocrine and Metabolic Disorders
, 6. A 52-year-old female presents for a evaluation of her type 2 diabetes. Her
hemoglobin A1C is 8.4% despite taking metformin 1,000 mg twice daily for the past 6
months. She has a history of atherosclerotic cardiovascular disease (ASCVD).
Which of the following medications should be added next?
A) Glipizide (Sulfonylurea)
B) Pioglitazone (Thiazolidinedione)
C) Empagliflozin (SGLT2 inhibitor) or Liraglutide (GLP-1 receptor agonist)
D) NPH Insulin at bedtime
For patients with type 2 diabetes and established ASCVD, chronic kidney disease
(CKD), or heart failure, ADA guidelines strongly recommend adding an SGLT2
inhibitor or a GLP-1 receptor agonist with proven cardiovascular benefit, independent
of the baseline A1C level.
7. A 34-year-old female presents with heat intolerance, weight loss, palpitations, and
diffuse enlargement of the thyroid gland. Laboratory results reveal a TSH of <0.01
mIU/L and a free T4 of 2.8 ng/dL. Which of the following is the most likely diagnosis?
A) Hashimoto's thyroiditis
B) Graves' disease
C) Subacute thyroiditis
D) Primary hyperparathyroidism
Graves' disease is the most common cause of primary hyperthyroidism,
characterized by suppressed TSH and elevated free T4 levels, along with
hypermetabolic symptoms such as heat intolerance, weight loss, and goiter.
8. A 45-year-old male is diagnosed with primary hypothyroidism. His weight is 80 kg.
Which of the following is the most appropriate initial daily dose of levothyroxine for a
healthy middle-aged adult?
A) 25 mcg/day
