NR 603 CEA Midterm Exam - Advanced Clinical Diagnosis 2026/2027
Chamberlain
1. A 65-year-old patient presents with a crescendo-decrescendo systolic murmur
heard best at the right second intercostal space that radiates to the carotids.
What is the most likely diagnosis?
A. Mitral Regurgitation
B. Aortic Regurgitation
C. Aortic Stenosis
D. Mitral Stenosis
Answer: C
Rationale: Aortic stenosis typically presents as a systolic ejection murmur at the right
upper sternal border with radiation to the carotid arteries.
2. Which of the following lab findings is most characteristic of Iron Deficiency
Anemia?
A. High Ferritin and Low TIBC
B. High MCV and High Ferritin
C. Low Ferritin and High TIBC
D. Normal MCV and Low TIBC
Answer: C
Rationale: Iron deficiency anemia is characterized by microcytic cells, low serum ferritin
(iron stores), and high Total Iron Binding Capacity (TIBC) as the body attempts to bind
more iron.
,3. A patient with COPD has a FEV1/FVC ratio of less than 0.70 and an FEV1 of
60% predicted. According to GOLD criteria, what is the severity stage?
A. GOLD 1: Mild
B. GOLD 2: Moderate
C. GOLD 3: Severe
D. GOLD 4: Very Severe
Answer: B
Rationale: GOLD 2 (Moderate) COPD is defined by an FEV1 between 50% and 79% of the
predicted value.
4. What is the first-line treatment for a patient diagnosed with uncomplicated
Community-Acquired Pneumonia (CAP) with no comorbidities or recent
antibiotic use?
A. Levofloxacin
B. Amoxicillin or Doxycycline
C. Ciprofloxacin
D. Vancomycin
Answer: B
Rationale: For healthy outpatients without comorbidities, high-dose amoxicillin,
doxycycline, or a macrolide (if local resistance is low) are recommended first-line
treatments.
5. Which physical exam maneuver is used to assess for a torn Anterior Cruciate
Ligament (ACL)?
A. McMurray Test
B. Phalen’s Sign
C. Lachman Test
D. Empty Can Test
Answer: C
, Rationale: The Lachman test is considered the most sensitive physical exam maneuver for
detecting ACL insufficiency.
6. A 45-year-old female presents with fatigue, weight gain, and cold intolerance.
Her TSH is 12.5 mIU/L (High) and Free T4 is low. What is the most likely
diagnosis?
A. Graves’ Disease
B. Hashimoto’s Thyroiditis
C. Secondary Hypothyroidism
D. Subclinical Hypothyroidism
Answer: B
Rationale: High TSH and low Free T4 indicate primary hypothyroidism, most commonly
caused by Hashimoto’s Thyroiditis in developed countries.
7. In the treatment of Type 2 Diabetes, which medication class is known for its
cardiovascular and renal protective benefits?
A. Sulfonylureas
B. DPP-4 Inhibitors
C. Meglitinides
D. SGLT2 Inhibitors
Answer: D
Rationale: SGLT2 inhibitors (e.g., Empagliflozin) have shown significant benefits in
reducing cardiovascular events and slowing the progression of chronic kidney disease.
Chamberlain
1. A 65-year-old patient presents with a crescendo-decrescendo systolic murmur
heard best at the right second intercostal space that radiates to the carotids.
What is the most likely diagnosis?
A. Mitral Regurgitation
B. Aortic Regurgitation
C. Aortic Stenosis
D. Mitral Stenosis
Answer: C
Rationale: Aortic stenosis typically presents as a systolic ejection murmur at the right
upper sternal border with radiation to the carotid arteries.
2. Which of the following lab findings is most characteristic of Iron Deficiency
Anemia?
A. High Ferritin and Low TIBC
B. High MCV and High Ferritin
C. Low Ferritin and High TIBC
D. Normal MCV and Low TIBC
Answer: C
Rationale: Iron deficiency anemia is characterized by microcytic cells, low serum ferritin
(iron stores), and high Total Iron Binding Capacity (TIBC) as the body attempts to bind
more iron.
,3. A patient with COPD has a FEV1/FVC ratio of less than 0.70 and an FEV1 of
60% predicted. According to GOLD criteria, what is the severity stage?
A. GOLD 1: Mild
B. GOLD 2: Moderate
C. GOLD 3: Severe
D. GOLD 4: Very Severe
Answer: B
Rationale: GOLD 2 (Moderate) COPD is defined by an FEV1 between 50% and 79% of the
predicted value.
4. What is the first-line treatment for a patient diagnosed with uncomplicated
Community-Acquired Pneumonia (CAP) with no comorbidities or recent
antibiotic use?
A. Levofloxacin
B. Amoxicillin or Doxycycline
C. Ciprofloxacin
D. Vancomycin
Answer: B
Rationale: For healthy outpatients without comorbidities, high-dose amoxicillin,
doxycycline, or a macrolide (if local resistance is low) are recommended first-line
treatments.
5. Which physical exam maneuver is used to assess for a torn Anterior Cruciate
Ligament (ACL)?
A. McMurray Test
B. Phalen’s Sign
C. Lachman Test
D. Empty Can Test
Answer: C
, Rationale: The Lachman test is considered the most sensitive physical exam maneuver for
detecting ACL insufficiency.
6. A 45-year-old female presents with fatigue, weight gain, and cold intolerance.
Her TSH is 12.5 mIU/L (High) and Free T4 is low. What is the most likely
diagnosis?
A. Graves’ Disease
B. Hashimoto’s Thyroiditis
C. Secondary Hypothyroidism
D. Subclinical Hypothyroidism
Answer: B
Rationale: High TSH and low Free T4 indicate primary hypothyroidism, most commonly
caused by Hashimoto’s Thyroiditis in developed countries.
7. In the treatment of Type 2 Diabetes, which medication class is known for its
cardiovascular and renal protective benefits?
A. Sulfonylureas
B. DPP-4 Inhibitors
C. Meglitinides
D. SGLT2 Inhibitors
Answer: D
Rationale: SGLT2 inhibitors (e.g., Empagliflozin) have shown significant benefits in
reducing cardiovascular events and slowing the progression of chronic kidney disease.
