NR 603 CEA Final Exam - Advanced Clinical Diagnosis 2026/2027
Chamberlain
1. A 55-year-old male with a history of diabetes presents with a blood pressure
of 152/94 mmHg. Which of the following is the most appropriate first-line
treatment?
A. Amlodipine
B. Hydrochlorothiazide
C. Lisinopril
D. Metoprolol
Answer: C
Rationale: In patients with diabetes, ACE inhibitors like Lisinopril are first-line to protect
renal function.
2. Which heart sound is most commonly associated with fluid overload in a
patient with Heart Failure?
A. S1
B. S2
C. S3
D. S4
Answer: C
Rationale: S3 is a ventricular gallop often indicating fluid overload or heart failure in
adults.
,3. A patient presents with a TSH level of 12.5 mIU/L and a low Free T4 level.
What is the most likely diagnosis?
A. Subclinical Hypothyroidism
B. Primary Hypothyroidism
C. Hyperthyroidism
D. Secondary Hypothyroidism
Answer: B
Rationale: Elevated TSH and low Free T4 are classic indicators of primary hypothyroidism.
4. Which of the following physical exam findings is most specific for Acute
Appendicitis?
A. Murphy’s sign
B. Lloyd’s sign
C. McBurney’s point tenderness
D. Chvostek’s sign
Answer: C
Rationale: Tenderness at McBurney’s point (1/3 the distance from the ASIS to the
umbilicus) is highly specific for appendicitis.
5. A 68-year-old female has a T-score of -2.6 on her DEXA scan. This result is
categorized as:
A. Normal
B. Osteopenia
C. Osteoporosis
D. Severe Osteopenia
Answer: C
Rationale: A T-score of -2.5 or lower is diagnostic for osteoporosis.
, 6. Which antibiotic is the first-line treatment for an adult with uncomplicated
Community-Acquired Pneumonia and no comorbidities?
A. Vancomycin
B. Levofloxacin
C. Ciprofloxacin
D. Amoxicillin
Answer: D
Rationale: High-dose Amoxicillin is now a first-line recommendation for uncomplicated
CAP per recent guidelines.
7. A patient presents with ‘honey-colored crusts’ around the mouth. What is the
most likely diagnosis?
A. Impetigo
B. Herpes Simplex
C. Eczema
D. Cellulitis
Answer: A
Rationale: Honey-colored crusts are the hallmark clinical finding for non-bullous impetigo.
8. What is the first-line medication for a patient newly diagnosed with Type 2
Diabetes and a GFR of 55?
A. Glyburide
B. Sitagliptin
C. Metformin
D. Liraglutide
Answer: C
Rationale: Metformin is the first-line agent unless contraindicated (GFR < 30).
Chamberlain
1. A 55-year-old male with a history of diabetes presents with a blood pressure
of 152/94 mmHg. Which of the following is the most appropriate first-line
treatment?
A. Amlodipine
B. Hydrochlorothiazide
C. Lisinopril
D. Metoprolol
Answer: C
Rationale: In patients with diabetes, ACE inhibitors like Lisinopril are first-line to protect
renal function.
2. Which heart sound is most commonly associated with fluid overload in a
patient with Heart Failure?
A. S1
B. S2
C. S3
D. S4
Answer: C
Rationale: S3 is a ventricular gallop often indicating fluid overload or heart failure in
adults.
,3. A patient presents with a TSH level of 12.5 mIU/L and a low Free T4 level.
What is the most likely diagnosis?
A. Subclinical Hypothyroidism
B. Primary Hypothyroidism
C. Hyperthyroidism
D. Secondary Hypothyroidism
Answer: B
Rationale: Elevated TSH and low Free T4 are classic indicators of primary hypothyroidism.
4. Which of the following physical exam findings is most specific for Acute
Appendicitis?
A. Murphy’s sign
B. Lloyd’s sign
C. McBurney’s point tenderness
D. Chvostek’s sign
Answer: C
Rationale: Tenderness at McBurney’s point (1/3 the distance from the ASIS to the
umbilicus) is highly specific for appendicitis.
5. A 68-year-old female has a T-score of -2.6 on her DEXA scan. This result is
categorized as:
A. Normal
B. Osteopenia
C. Osteoporosis
D. Severe Osteopenia
Answer: C
Rationale: A T-score of -2.5 or lower is diagnostic for osteoporosis.
, 6. Which antibiotic is the first-line treatment for an adult with uncomplicated
Community-Acquired Pneumonia and no comorbidities?
A. Vancomycin
B. Levofloxacin
C. Ciprofloxacin
D. Amoxicillin
Answer: D
Rationale: High-dose Amoxicillin is now a first-line recommendation for uncomplicated
CAP per recent guidelines.
7. A patient presents with ‘honey-colored crusts’ around the mouth. What is the
most likely diagnosis?
A. Impetigo
B. Herpes Simplex
C. Eczema
D. Cellulitis
Answer: A
Rationale: Honey-colored crusts are the hallmark clinical finding for non-bullous impetigo.
8. What is the first-line medication for a patient newly diagnosed with Type 2
Diabetes and a GFR of 55?
A. Glyburide
B. Sitagliptin
C. Metformin
D. Liraglutide
Answer: C
Rationale: Metformin is the first-line agent unless contraindicated (GFR < 30).
