CEA EXAM FULL PRACTICE QUESTION BANK NEWEST
2025/2026 LATEST TESTING EXAM WITH 450+ The inability to fully relax the myocardium during relaxation is a trademark of
which of the following diagnoses? - Diastolic dysfunction
QUESTIONS AND CORRECT DETAILED ANSWERS
Rationale:
ALREADY GRADED A+ / CEA EXAM PREP (BRAND NEW)
The inability for the heart to relax is a trademark of the diagnosis of diastolic
dysfunction and is common in patients with thickened hypertrophic
myocardium.
A 28-year-old woman in her first trimester of pregnancy presents with nausea and
vomiting. What is the most appropriate initial management? A 50-year-old woman with a history of hypertension presents with dyspnea on
*Prescribe ondansetron exertion and orthopnea. On examination, she has jugular venous distention and
bilateral crackles on lung auscultation. What is the most likely diagnosis? -
*Recommend small, frequent meals Congestive heart failure
*Prescribe metoclopramide Rationale:
*Advise bed rest - Prescribe ondansetron Of the available options, the most accurate response is congestive heart failure
Rationale: as it is signifying both a right ventricular back up with jugular venous extension
and crackles on lung assault, which are suggestive of left ventricular back up. it
Zofran (Ondansetron) is a medication commonly used to treat nausea and
is possible the patient may have an acute myocardial infarction that
vomiting. It works by blocking the action of serotonin, a natural substance that
precipitated this, however, a patient has not described that, rather is only
may cause nausea and vomiting
describing dyspnea on exertion and orthopnea, which both speak to a state of
fluid overload. The only appropriate response of these available is congestive
heart failure.
An older adult has a follow-up fasting lipid panel 6 months after making
therapeutic lifestyle changes. LDL=205mg/dL (Normal=<100mg/dL),
HDL=44mg/dL, and triglycerides=180mg/dL (Normal-<150mg/dL). The patient is
An otherwise healthy African American adult male has been diagnosed with
placed on statin therapy. Two months later, the patient presents for follow-up
hypertension. He has been restricting his salt intake, eating a DASH (Dietary
and complains of body aches. In addition to creatine phosphokinase (CPK), which
Approaches to Stop Hypertension) diet, and exercising more, but his blood
of the following tests should the nurse practitioner order? - Liver transaminase
pressure is still elevated. Which is the BEST medication to prescribe him? -
(AST and ALT) levels
Calcium channel blocker
Rationale:
Rationale:
Due to the potential liver function test elevation found with statin use, LFTs of
African American patients per JNC8 Hypertension Guidelines should be
AST/ALT should be checked routinely after initiation of therapy
managed with a dihydropyridine calcium channel blocker such as amlodipine
,(Norvasc) as first line management therapy for hypertension not at goal with The patient should have a protective mechanism such as an implantable
DASH and lifestyle modifications. automated cardioverter defibrillator (AICD) or a Lifevest if the EF is less than
35% due to the increased risk of sudden cardiac death with low EF states. Since
most patients are not eligible for 90 days for an AICD in this state, optimizing
Your patient has been diagnosed with a 4.5cm ascending aortic aneurysm. Which their medication regimen and repeating an echo in 2-3 months to re-evaluate
medical imaging is considered standard of care for serial surveillance? - CT for improvement in their EF is required by most insurance companies. A
angiography of the chest baseline echo is needed at discharge to provide a baseline for improvement vs
Rationale: their repeat echo in 2-3 months.
CT angiography is considered the standard of care for measuring vascular Dual anti-platelet therapy is required for 12 months minimum post-MI.
luminal dimensions with contrast. CT PE protocol is not timed properly for the A Holter monitor does not provide any conceivable benefit for this patient as
aorta (it's timed for the pulmonary artery). Although a plain film is able to catch presented.
large aneurysms at times, they are not able to provide multi-axis reconstruction
needed to accurately measure the size. Transesophageal echo is not needed to
accurately measure the aorta and requires the patient to undergo sedation A 65-year-old woman presents for a follow-up examination. She is a smoker, and
which is unnecessary. her hypertension is now adequately controlled with medication. Her mother died
at age 40 from a heart attack. The fasting lipid profile shows cholesterol = 240
mg/dL, HDL = 30, and LDL = 200. In addition to starting therapeutic lifestyle
Which of the following medications does not cause beta 1 stimulation? - changes, the nurse practitioner should start the patient on: - a statin drug.
phenylephrine
Rationale:
Rationale:
Bile acid sequestrants and cholesterol absorption inhibitors may be useful in
Phenylephrine only stimulates alpha 1 receptors. The remaining three all have reducing ASVD risk, but for a patient who is an active smoker with premature
beta receptor activity. coronary disease history (less than age 65 for women), has hypertension and is
far from an LDL goal, this patient is most certainly a candidate for statin
therapy, which represents the most aggressive therapy option of these four
Your patient with a history of HFrEF (heart failure with reduced ejection fraction) listed.
with an ejection fraction of 40% who is also not on optimal medical therapy has
been diagnosed with a myocardial infarction this admission and received
emergent placement of a drug-eluting stent to the left anterior descending artery. Which of the following end-organ sequelae is not directly caused by uncontrolled
As the medical home who will manage this patient after discharge, which hypertension? - Peripheral neuropathy
medication strategy would you expect to be a priority in the patient's care? -
Rationale:
Ordering a transthoracic echocardiogram and order a Lifevest if EF is less than
35% Although patients with hypertension frequently have peripheral neuropathy, it
is only directly attributed to patients who are also diabetic and is commonly
Rationale:
,found in non-hypertensive diabetic patients. Proteinuria, AV nicking, and options might describe macro-organ function (such as BUN/Creat from a BMP, a
hemorrhagic stroke are all caused by uncontrolled hypertension. renal biopsy which is not indicated for routine diabetic nephropathy testing,
and a Abd CT, which is more akin to evaluation of less subtle findings), but at
the functional level of the nephron, namely the glomerulus, evidence of
A 33-year-old woman presents with irregular menstrual cycles, hirsutism, and glucose-related damage is easily identified with proteinuria from a UA.
obesity. Laboratory tests reveal elevated serum testosterone and LH ratio > 2:1.
What is the most appropriate initial treatment? - Oral contraceptives
A starting dose for a elderly adult patient with a BMI of 20 needing levothryoxine -
Rationale:
25 mcg
These are classic symptoms of polycystic ovarian syndrome and the patient
Rationale:
should be treated with oral contraceptives to help stabilize their estrogen and
progesterone. Additionally, they may be managed on metformin and/or The widely considered best practice for treatment of hypothyroidism in the
spironolactone for their PCOS. elderly is to "go slow and start low". 25 mcg is the most appropriate low dose to
start with of these options. It is possible that over time the dose will be
Oral contraceptive pills (OCPs) are often the first pharmacological treatment for
increased until therapeutic levels are obtained, but the risk of over-dosing the
polycystic ovary syndrome (PCOS) because they help manage in several ways:
patient outweighs the desire to quickly achieve this state.
Menstrual irregularities: OCPs can help regulate menstrual cycles, making
periods lighter and more regular. This is important because irregular ovulation
can lead to endometrial hyperplasia, which is a buildup of uterine tissue that An adult female who recently returned for a recheck appointment. The only
can increase the risk of uterine cancer. 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
Androgen excess: OCPs can reduce androgen production and increase sex
hurts; examination reveals thyroid tenderness. Which of the following laboratory
hormone-binding globulin (SHBG), which binds androgens. This can help reduce
tests should the nurse practitioner order now? - Triiodothyronine (T3) and free
symptoms like acne, hirsutism (unwanted body and facial hair), and androgenic
thyroxine (FT4)
alopecia (male pattern baldness).
Rationale:
Endometrium protection: OCPs can protect the endometrium by ensuring
regular ovulation Remember that a patient with low TSH is suspicious of hyperthyroidism with a
corresponding finding of elevated T3/T4 and clinical symptoms of a goiter,
tremulousness, anxiety, palpitations, weight loss, insomnia, diarrhea, etc. This
A 50-year-old woman with hypertension and diabetes comes in for a routine patient is describing a sore neck as well, which is suggestive of Graves disease
check-up. What screening test should be regularly performed to monitor for early (hyperthyroid state).
signs of diabetic nephropathy? - Urine dipstick for protein
Rationale:
All the following are symptoms of hypocalcemia except: - Visual field deficits
The most sensitive indicator of diabetic nephropathy would be the evidence of
small proteins in the urine (proteinuria) as found on urinalysis. The other
, Rationale: Visual field deficits is a potential symptom of pituitary adenoma. All An adult female presents with a chief complaint of fatigue and weight gain. She
other are symptoms related to hypocalcemia. states that she doesn't feel like herself. A diagnosis of hypothyroidism is
suspected. Which of the following physical findings would support this diagnosis?
- Dry skin, bradycardia, and hypoactive deep tendon reflexes
An adult patient diagnosed with type 2 diabetes mellitus presents for a recheck.
Rationale: Dry skin, bradycardia, and hypoactive deep tendon reflexes are all fairly
The patient follows a carbohydrate counting diet and walks 30 minutes 5 times
classic signs of hypothyroidism. To further substantiate these concerns, the
weekly. Current fasting blood glucose = 116 mg/dL [normal = less than 99 mg/dL]
patient should have their TSH and T3 and Free T4 checked, and it is likely their
and A1c = 6.3% [normal = less than 7.0%]. In accordance with the American
TSH would be elevated, T3/T4 low.
Diabetes Association, the nurse practitioner would recommend that the next
follow-up appointment be scheduled for: - 6 months.
Rationale: Based off of the ADA recommendation, this patient should be An older adult patient with new onset GERD, cough, heartburn. Initial tx - Antacid
evaluated in six months. They are actually showing good control and excellent and lifestyle modification/weight loss
compliance with diet and exercise management strategies. If there compliance
Rationale: Before initiating a PPI or H2RA, it would always be wise to initiate
was worse or they were not controlled with their A1c, this would likely be a three
diet/exercise and symptom management when present with an antacid. Loss of
month follow up.
weight/dieting is most likely to deal with obesity as the most common underlying
cause of GERD.
Your patient has a diagnosis of Hashimoto's and is on Levothyroxine 75 mcg daily.
Her recent TSH was elevated at 15 uU/mL. Your next best action is to: - Increase
A 59-year-old male presents with symptoms of abdominal pain, jaundice, and
Levothyroxine to 100 mcg daily
weight loss which he has not been trying to lose weight. What would be a
Rationale: When the TSH is elevated the patient needs more thyroid hormone. malignancy associated with these symptoms? - Pancreatic cancer
Once diagnosed with Hashimoto's there is no clinical need/benefit to repeating
Raionale: Pancreatic cancer, the most typically presentation includes abdominal
anti bodies.
pain, jaundice, and weight loss. Although weight loss and abdominal pain may be
present with adenocarcinoma it is unlikely to present with jaundice, and you're
unlikely to have abdominal pain or jaundice with any esophageal malignancy.
A patient has a 3 cm pituitary mass noted on CT. What is your next step in
evaluating the patient? - Screen for hormone deficiencies
Rationale: Initial work up includes hormone testing. Cabergoline is the treatment A 39-year-old female is being seen by your service for diarrhea. Patient reports 3-
for prolactinoma. Surgery consult is indicated when there are VF deficits and/or 4 loose stools a day. She also reports mild cramping. Which labs would be helpful
abutment/compression on optic nerves or chiasm or if adenoma is in further workup of a diagnosis? - ESR, fecal occult, Stool culture
hyperfunctioning. Adenomas >1 cm with no VF deficit or abutment/compression
Rationale: ESR, Fecal occult, and stool culture would be the biggest benefit to
of optic nerves or chiasm require a follow up MRI at 6 months.
determine the potential cause of her symptoms.
2025/2026 LATEST TESTING EXAM WITH 450+ The inability to fully relax the myocardium during relaxation is a trademark of
which of the following diagnoses? - Diastolic dysfunction
QUESTIONS AND CORRECT DETAILED ANSWERS
Rationale:
ALREADY GRADED A+ / CEA EXAM PREP (BRAND NEW)
The inability for the heart to relax is a trademark of the diagnosis of diastolic
dysfunction and is common in patients with thickened hypertrophic
myocardium.
A 28-year-old woman in her first trimester of pregnancy presents with nausea and
vomiting. What is the most appropriate initial management? A 50-year-old woman with a history of hypertension presents with dyspnea on
*Prescribe ondansetron exertion and orthopnea. On examination, she has jugular venous distention and
bilateral crackles on lung auscultation. What is the most likely diagnosis? -
*Recommend small, frequent meals Congestive heart failure
*Prescribe metoclopramide Rationale:
*Advise bed rest - Prescribe ondansetron Of the available options, the most accurate response is congestive heart failure
Rationale: as it is signifying both a right ventricular back up with jugular venous extension
and crackles on lung assault, which are suggestive of left ventricular back up. it
Zofran (Ondansetron) is a medication commonly used to treat nausea and
is possible the patient may have an acute myocardial infarction that
vomiting. It works by blocking the action of serotonin, a natural substance that
precipitated this, however, a patient has not described that, rather is only
may cause nausea and vomiting
describing dyspnea on exertion and orthopnea, which both speak to a state of
fluid overload. The only appropriate response of these available is congestive
heart failure.
An older adult has a follow-up fasting lipid panel 6 months after making
therapeutic lifestyle changes. LDL=205mg/dL (Normal=<100mg/dL),
HDL=44mg/dL, and triglycerides=180mg/dL (Normal-<150mg/dL). The patient is
An otherwise healthy African American adult male has been diagnosed with
placed on statin therapy. Two months later, the patient presents for follow-up
hypertension. He has been restricting his salt intake, eating a DASH (Dietary
and complains of body aches. In addition to creatine phosphokinase (CPK), which
Approaches to Stop Hypertension) diet, and exercising more, but his blood
of the following tests should the nurse practitioner order? - Liver transaminase
pressure is still elevated. Which is the BEST medication to prescribe him? -
(AST and ALT) levels
Calcium channel blocker
Rationale:
Rationale:
Due to the potential liver function test elevation found with statin use, LFTs of
African American patients per JNC8 Hypertension Guidelines should be
AST/ALT should be checked routinely after initiation of therapy
managed with a dihydropyridine calcium channel blocker such as amlodipine
,(Norvasc) as first line management therapy for hypertension not at goal with The patient should have a protective mechanism such as an implantable
DASH and lifestyle modifications. automated cardioverter defibrillator (AICD) or a Lifevest if the EF is less than
35% due to the increased risk of sudden cardiac death with low EF states. Since
most patients are not eligible for 90 days for an AICD in this state, optimizing
Your patient has been diagnosed with a 4.5cm ascending aortic aneurysm. Which their medication regimen and repeating an echo in 2-3 months to re-evaluate
medical imaging is considered standard of care for serial surveillance? - CT for improvement in their EF is required by most insurance companies. A
angiography of the chest baseline echo is needed at discharge to provide a baseline for improvement vs
Rationale: their repeat echo in 2-3 months.
CT angiography is considered the standard of care for measuring vascular Dual anti-platelet therapy is required for 12 months minimum post-MI.
luminal dimensions with contrast. CT PE protocol is not timed properly for the A Holter monitor does not provide any conceivable benefit for this patient as
aorta (it's timed for the pulmonary artery). Although a plain film is able to catch presented.
large aneurysms at times, they are not able to provide multi-axis reconstruction
needed to accurately measure the size. Transesophageal echo is not needed to
accurately measure the aorta and requires the patient to undergo sedation A 65-year-old woman presents for a follow-up examination. She is a smoker, and
which is unnecessary. her hypertension is now adequately controlled with medication. Her mother died
at age 40 from a heart attack. The fasting lipid profile shows cholesterol = 240
mg/dL, HDL = 30, and LDL = 200. In addition to starting therapeutic lifestyle
Which of the following medications does not cause beta 1 stimulation? - changes, the nurse practitioner should start the patient on: - a statin drug.
phenylephrine
Rationale:
Rationale:
Bile acid sequestrants and cholesterol absorption inhibitors may be useful in
Phenylephrine only stimulates alpha 1 receptors. The remaining three all have reducing ASVD risk, but for a patient who is an active smoker with premature
beta receptor activity. coronary disease history (less than age 65 for women), has hypertension and is
far from an LDL goal, this patient is most certainly a candidate for statin
therapy, which represents the most aggressive therapy option of these four
Your patient with a history of HFrEF (heart failure with reduced ejection fraction) listed.
with an ejection fraction of 40% who is also not on optimal medical therapy has
been diagnosed with a myocardial infarction this admission and received
emergent placement of a drug-eluting stent to the left anterior descending artery. Which of the following end-organ sequelae is not directly caused by uncontrolled
As the medical home who will manage this patient after discharge, which hypertension? - Peripheral neuropathy
medication strategy would you expect to be a priority in the patient's care? -
Rationale:
Ordering a transthoracic echocardiogram and order a Lifevest if EF is less than
35% Although patients with hypertension frequently have peripheral neuropathy, it
is only directly attributed to patients who are also diabetic and is commonly
Rationale:
,found in non-hypertensive diabetic patients. Proteinuria, AV nicking, and options might describe macro-organ function (such as BUN/Creat from a BMP, a
hemorrhagic stroke are all caused by uncontrolled hypertension. renal biopsy which is not indicated for routine diabetic nephropathy testing,
and a Abd CT, which is more akin to evaluation of less subtle findings), but at
the functional level of the nephron, namely the glomerulus, evidence of
A 33-year-old woman presents with irregular menstrual cycles, hirsutism, and glucose-related damage is easily identified with proteinuria from a UA.
obesity. Laboratory tests reveal elevated serum testosterone and LH ratio > 2:1.
What is the most appropriate initial treatment? - Oral contraceptives
A starting dose for a elderly adult patient with a BMI of 20 needing levothryoxine -
Rationale:
25 mcg
These are classic symptoms of polycystic ovarian syndrome and the patient
Rationale:
should be treated with oral contraceptives to help stabilize their estrogen and
progesterone. Additionally, they may be managed on metformin and/or The widely considered best practice for treatment of hypothyroidism in the
spironolactone for their PCOS. elderly is to "go slow and start low". 25 mcg is the most appropriate low dose to
start with of these options. It is possible that over time the dose will be
Oral contraceptive pills (OCPs) are often the first pharmacological treatment for
increased until therapeutic levels are obtained, but the risk of over-dosing the
polycystic ovary syndrome (PCOS) because they help manage in several ways:
patient outweighs the desire to quickly achieve this state.
Menstrual irregularities: OCPs can help regulate menstrual cycles, making
periods lighter and more regular. This is important because irregular ovulation
can lead to endometrial hyperplasia, which is a buildup of uterine tissue that An adult female who recently returned for a recheck appointment. The only
can increase the risk of uterine cancer. 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
Androgen excess: OCPs can reduce androgen production and increase sex
hurts; examination reveals thyroid tenderness. Which of the following laboratory
hormone-binding globulin (SHBG), which binds androgens. This can help reduce
tests should the nurse practitioner order now? - Triiodothyronine (T3) and free
symptoms like acne, hirsutism (unwanted body and facial hair), and androgenic
thyroxine (FT4)
alopecia (male pattern baldness).
Rationale:
Endometrium protection: OCPs can protect the endometrium by ensuring
regular ovulation Remember that a patient with low TSH is suspicious of hyperthyroidism with a
corresponding finding of elevated T3/T4 and clinical symptoms of a goiter,
tremulousness, anxiety, palpitations, weight loss, insomnia, diarrhea, etc. This
A 50-year-old woman with hypertension and diabetes comes in for a routine patient is describing a sore neck as well, which is suggestive of Graves disease
check-up. What screening test should be regularly performed to monitor for early (hyperthyroid state).
signs of diabetic nephropathy? - Urine dipstick for protein
Rationale:
All the following are symptoms of hypocalcemia except: - Visual field deficits
The most sensitive indicator of diabetic nephropathy would be the evidence of
small proteins in the urine (proteinuria) as found on urinalysis. The other
, Rationale: Visual field deficits is a potential symptom of pituitary adenoma. All An adult female presents with a chief complaint of fatigue and weight gain. She
other are symptoms related to hypocalcemia. states that she doesn't feel like herself. A diagnosis of hypothyroidism is
suspected. Which of the following physical findings would support this diagnosis?
- Dry skin, bradycardia, and hypoactive deep tendon reflexes
An adult patient diagnosed with type 2 diabetes mellitus presents for a recheck.
Rationale: Dry skin, bradycardia, and hypoactive deep tendon reflexes are all fairly
The patient follows a carbohydrate counting diet and walks 30 minutes 5 times
classic signs of hypothyroidism. To further substantiate these concerns, the
weekly. Current fasting blood glucose = 116 mg/dL [normal = less than 99 mg/dL]
patient should have their TSH and T3 and Free T4 checked, and it is likely their
and A1c = 6.3% [normal = less than 7.0%]. In accordance with the American
TSH would be elevated, T3/T4 low.
Diabetes Association, the nurse practitioner would recommend that the next
follow-up appointment be scheduled for: - 6 months.
Rationale: Based off of the ADA recommendation, this patient should be An older adult patient with new onset GERD, cough, heartburn. Initial tx - Antacid
evaluated in six months. They are actually showing good control and excellent and lifestyle modification/weight loss
compliance with diet and exercise management strategies. If there compliance
Rationale: Before initiating a PPI or H2RA, it would always be wise to initiate
was worse or they were not controlled with their A1c, this would likely be a three
diet/exercise and symptom management when present with an antacid. Loss of
month follow up.
weight/dieting is most likely to deal with obesity as the most common underlying
cause of GERD.
Your patient has a diagnosis of Hashimoto's and is on Levothyroxine 75 mcg daily.
Her recent TSH was elevated at 15 uU/mL. Your next best action is to: - Increase
A 59-year-old male presents with symptoms of abdominal pain, jaundice, and
Levothyroxine to 100 mcg daily
weight loss which he has not been trying to lose weight. What would be a
Rationale: When the TSH is elevated the patient needs more thyroid hormone. malignancy associated with these symptoms? - Pancreatic cancer
Once diagnosed with Hashimoto's there is no clinical need/benefit to repeating
Raionale: Pancreatic cancer, the most typically presentation includes abdominal
anti bodies.
pain, jaundice, and weight loss. Although weight loss and abdominal pain may be
present with adenocarcinoma it is unlikely to present with jaundice, and you're
unlikely to have abdominal pain or jaundice with any esophageal malignancy.
A patient has a 3 cm pituitary mass noted on CT. What is your next step in
evaluating the patient? - Screen for hormone deficiencies
Rationale: Initial work up includes hormone testing. Cabergoline is the treatment A 39-year-old female is being seen by your service for diarrhea. Patient reports 3-
for prolactinoma. Surgery consult is indicated when there are VF deficits and/or 4 loose stools a day. She also reports mild cramping. Which labs would be helpful
abutment/compression on optic nerves or chiasm or if adenoma is in further workup of a diagnosis? - ESR, fecal occult, Stool culture
hyperfunctioning. Adenomas >1 cm with no VF deficit or abutment/compression
Rationale: ESR, Fecal occult, and stool culture would be the biggest benefit to
of optic nerves or chiasm require a follow up MRI at 6 months.
determine the potential cause of her symptoms.
