NR 603 CEA Final Exam (2026) - Advanced Clinical Diagnosis
Chamberlain
1. According to the current USPSTF guidelines, at what age should routine
screening for breast cancer with mammography begin for average-risk women?
A. 35 years old
B. 45 years old
C. 40 years old
D. 50 years old
Answer: C
Rationale: The updated 2024 USPSTF guidelines recommend that women of average risk
begin biennial screening mammography starting at age 40.
2. A patient presents with a TSH of 7.2 mIU/L and a normal Free T4 level. How is
this clinical finding classified?
A. Primary Hypothyroidism
B. Secondary Hypothyroidism
C. Subclinical Hypothyroidism
D. Hyperthyroidism
Answer: C
Rationale: Subclinical hypothyroidism is defined as an elevated TSH in the presence of a
normal free thyroxine (T4) level.
,3. Which of the following Hemoglobin A1C levels is the diagnostic threshold for
Diabetes Mellitus?
A. 5.7% or higher
B. 6.0% or higher
C. 7.0% or higher
D. 6.5% or higher
Answer: D
Rationale: An A1C level of 6.5% or higher is one of the diagnostic criteria for Diabetes
Mellitus according to the ADA guidelines.
4. A 55-year-old male with a history of smoking presents with chronic cough and
dyspnea. Spirometry reveals an FEV1/FVC ratio of 0.62. This finding is indicative
of:
A. Restrictive lung disease
B. Normal lung function
C. Obstructive lung disease (COPD)
D. Mixed lung disease
Answer: C
Rationale: A post-bronchodilator FEV1/FVC ratio of less than 0.70 is the diagnostic
hallmark of airflow obstruction, consistent with COPD.
5. A patient’s blood pressure is consistently 134/84 mmHg. According to the
ACC/AHA guidelines, this is classified as:
A. Normal blood pressure
B. Elevated blood pressure
C. Stage 1 Hypertension
D. Stage 2 Hypertension
Answer: C
, Rationale: Stage 1 Hypertension is defined as systolic BP 130–139 mmHg or diastolic BP
80–89 mmHg.
6. Which physical exam finding is most specifically associated with acute
cholecystitis?
A. Murphy’s sign
B. Rovsing’s sign
C. Psoas sign
D. McBurney’s sign
Answer: A
Rationale: Murphy’s sign, which is inspiratory arrest during deep palpation of the right
upper quadrant, is highly suggestive of acute cholecystitis.
7. In the treatment of acute bacterial sinusitis, which of the following is
considered the first-line antibiotic choice for an adult with no allergies?
A. Amoxicillin-clavulanate
B. Azithromycin
C. Doxycycline
D. Levofloxacin
Answer: A
Rationale: Amoxicillin-clavulanate is the recommended first-line agent for acute bacterial
rhinosinusitis to cover H. influenzae and S. pneumoniae.
8. A 30-year-old female presents with fatigue and a lab report showing a low
Hemoglobin, low MCV, and low Ferritin. What is the most likely diagnosis?
A. Vitamin B12 deficiency
B. Folic acid deficiency
C. Anemia of chronic disease
D. Iron deficiency anemia
Answer: D
Chamberlain
1. According to the current USPSTF guidelines, at what age should routine
screening for breast cancer with mammography begin for average-risk women?
A. 35 years old
B. 45 years old
C. 40 years old
D. 50 years old
Answer: C
Rationale: The updated 2024 USPSTF guidelines recommend that women of average risk
begin biennial screening mammography starting at age 40.
2. A patient presents with a TSH of 7.2 mIU/L and a normal Free T4 level. How is
this clinical finding classified?
A. Primary Hypothyroidism
B. Secondary Hypothyroidism
C. Subclinical Hypothyroidism
D. Hyperthyroidism
Answer: C
Rationale: Subclinical hypothyroidism is defined as an elevated TSH in the presence of a
normal free thyroxine (T4) level.
,3. Which of the following Hemoglobin A1C levels is the diagnostic threshold for
Diabetes Mellitus?
A. 5.7% or higher
B. 6.0% or higher
C. 7.0% or higher
D. 6.5% or higher
Answer: D
Rationale: An A1C level of 6.5% or higher is one of the diagnostic criteria for Diabetes
Mellitus according to the ADA guidelines.
4. A 55-year-old male with a history of smoking presents with chronic cough and
dyspnea. Spirometry reveals an FEV1/FVC ratio of 0.62. This finding is indicative
of:
A. Restrictive lung disease
B. Normal lung function
C. Obstructive lung disease (COPD)
D. Mixed lung disease
Answer: C
Rationale: A post-bronchodilator FEV1/FVC ratio of less than 0.70 is the diagnostic
hallmark of airflow obstruction, consistent with COPD.
5. A patient’s blood pressure is consistently 134/84 mmHg. According to the
ACC/AHA guidelines, this is classified as:
A. Normal blood pressure
B. Elevated blood pressure
C. Stage 1 Hypertension
D. Stage 2 Hypertension
Answer: C
, Rationale: Stage 1 Hypertension is defined as systolic BP 130–139 mmHg or diastolic BP
80–89 mmHg.
6. Which physical exam finding is most specifically associated with acute
cholecystitis?
A. Murphy’s sign
B. Rovsing’s sign
C. Psoas sign
D. McBurney’s sign
Answer: A
Rationale: Murphy’s sign, which is inspiratory arrest during deep palpation of the right
upper quadrant, is highly suggestive of acute cholecystitis.
7. In the treatment of acute bacterial sinusitis, which of the following is
considered the first-line antibiotic choice for an adult with no allergies?
A. Amoxicillin-clavulanate
B. Azithromycin
C. Doxycycline
D. Levofloxacin
Answer: A
Rationale: Amoxicillin-clavulanate is the recommended first-line agent for acute bacterial
rhinosinusitis to cover H. influenzae and S. pneumoniae.
8. A 30-year-old female presents with fatigue and a lab report showing a low
Hemoglobin, low MCV, and low Ferritin. What is the most likely diagnosis?
A. Vitamin B12 deficiency
B. Folic acid deficiency
C. Anemia of chronic disease
D. Iron deficiency anemia
Answer: D
