NR 603 CEA Final Exam (2026) - Advanced Clinical Diagnosis
Chamberlain College
1. According to the GOLD guidelines for COPD, which of the following is the
definitive diagnostic requirement for airflow limitation?
A. Post-bronchodilator FEV1/FVC ratio < 0.80
B. Pre-bronchodilator FEV1 < 80% predicted
C. Post-bronchodilator FEV1/FVC ratio < 0.70
D. Total Lung Capacity > 120% predicted
Answer: C
Rationale: The GOLD criteria state that a post-bronchodilator FEV1/FVC < 0.70 confirms
the presence of persistent airflow limitation, which is diagnostic for COPD.
2. A 55-year-old patient presents with a TSH of 12.5 mIU/L and a low Free T4.
What is the most likely diagnosis?
A. Secondary Hypothyroidism
B. Subclinical Hypothyroidism
C. Hyperthyroidism
D. Primary Hypothyroidism
Answer: D
Rationale: Primary hypothyroidism is characterized by an elevated TSH (usually > 10) and
a low free T4 level.
,3. In the management of Heart Failure with Reduced Ejection Fraction (HFrEF),
which medication class is prioritized to reduce mortality and morbidity?
A. Loop Diuretics
B. Calcium Channel Blockers
C. ACE Inhibitors or ARNI
D. Short-acting Nitrates
Answer: C
Rationale: ACE inhibitors, ARBs, and specifically ARNIs (Sacubitril/Valsartan) are
foundational therapies that have been shown to reduce mortality in HFrEF.
4. Which of the following physical exam findings is most suggestive of Acute
Cholecystitis?
A. McBurney’s sign
B. Murphy’s sign
C. Rovsing’s sign
D. Psoas sign
Answer: B
Rationale: Murphy’s sign (pain and inspiratory arrest upon palpation of the right upper
quadrant) is highly associated with acute cholecystitis.
5. A 68-year-old male with a history of smoking presents for his annual wellness
visit. Per USPSTF, what screening is recommended regarding Abdominal Aortic
Aneurysm (AAA)?
A. Annual CT scan
B. Screening with MRI every 5 years
C. One-time screening with ultrasound
D. No screening is recommended for smokers
Answer: C
, Rationale: The USPSTF recommends a one-time screening for AAA with ultrasonography
in men aged 65 to 75 years who have ever smoked.
6. What is the first-line pharmacologic treatment for a patient newly diagnosed
with Type 2 Diabetes and an A1C of 7.5%, assuming no contraindications?
A. Metformin
B. Glipizide
C. Insulin Glargine
D. Pioglitazone
Answer: A
Rationale: Metformin is the first-line medication for Type 2 Diabetes due to its efficacy,
safety, and low cost.
7. A patient presents with a ‘curtain coming down’ over their vision in one eye.
This symptom is most characteristic of:
A. Cataracts
B. Acute Angle Closure Glaucoma
C. Retinal Detachment
D. Macular Degeneration
Answer: C
Rationale: A ‘curtain’ or ‘shadow’ over the visual field is a classic description of retinal
detachment, which is an ocular emergency.
8. Which lab value is the most sensitive indicator for diagnosing Iron Deficiency
Anemia?
A. Serum Iron
B. Total Iron Binding Capacity (TIBC)
C. Hemoglobin level
D. Serum Ferritin
Answer: D
Chamberlain College
1. According to the GOLD guidelines for COPD, which of the following is the
definitive diagnostic requirement for airflow limitation?
A. Post-bronchodilator FEV1/FVC ratio < 0.80
B. Pre-bronchodilator FEV1 < 80% predicted
C. Post-bronchodilator FEV1/FVC ratio < 0.70
D. Total Lung Capacity > 120% predicted
Answer: C
Rationale: The GOLD criteria state that a post-bronchodilator FEV1/FVC < 0.70 confirms
the presence of persistent airflow limitation, which is diagnostic for COPD.
2. A 55-year-old patient presents with a TSH of 12.5 mIU/L and a low Free T4.
What is the most likely diagnosis?
A. Secondary Hypothyroidism
B. Subclinical Hypothyroidism
C. Hyperthyroidism
D. Primary Hypothyroidism
Answer: D
Rationale: Primary hypothyroidism is characterized by an elevated TSH (usually > 10) and
a low free T4 level.
,3. In the management of Heart Failure with Reduced Ejection Fraction (HFrEF),
which medication class is prioritized to reduce mortality and morbidity?
A. Loop Diuretics
B. Calcium Channel Blockers
C. ACE Inhibitors or ARNI
D. Short-acting Nitrates
Answer: C
Rationale: ACE inhibitors, ARBs, and specifically ARNIs (Sacubitril/Valsartan) are
foundational therapies that have been shown to reduce mortality in HFrEF.
4. Which of the following physical exam findings is most suggestive of Acute
Cholecystitis?
A. McBurney’s sign
B. Murphy’s sign
C. Rovsing’s sign
D. Psoas sign
Answer: B
Rationale: Murphy’s sign (pain and inspiratory arrest upon palpation of the right upper
quadrant) is highly associated with acute cholecystitis.
5. A 68-year-old male with a history of smoking presents for his annual wellness
visit. Per USPSTF, what screening is recommended regarding Abdominal Aortic
Aneurysm (AAA)?
A. Annual CT scan
B. Screening with MRI every 5 years
C. One-time screening with ultrasound
D. No screening is recommended for smokers
Answer: C
, Rationale: The USPSTF recommends a one-time screening for AAA with ultrasonography
in men aged 65 to 75 years who have ever smoked.
6. What is the first-line pharmacologic treatment for a patient newly diagnosed
with Type 2 Diabetes and an A1C of 7.5%, assuming no contraindications?
A. Metformin
B. Glipizide
C. Insulin Glargine
D. Pioglitazone
Answer: A
Rationale: Metformin is the first-line medication for Type 2 Diabetes due to its efficacy,
safety, and low cost.
7. A patient presents with a ‘curtain coming down’ over their vision in one eye.
This symptom is most characteristic of:
A. Cataracts
B. Acute Angle Closure Glaucoma
C. Retinal Detachment
D. Macular Degeneration
Answer: C
Rationale: A ‘curtain’ or ‘shadow’ over the visual field is a classic description of retinal
detachment, which is an ocular emergency.
8. Which lab value is the most sensitive indicator for diagnosing Iron Deficiency
Anemia?
A. Serum Iron
B. Total Iron Binding Capacity (TIBC)
C. Hemoglobin level
D. Serum Ferritin
Answer: D
