NR 603 CEA Midterm Exam - Advanced Clinical Diagnosis 2026
Chamberlain College
1. A 65-year-old patient presents with a systolic murmur heard best at the
second right intercostal space that radiates to the neck. Which condition is most
likely?
A. Aortic Stenosis
B. Mitral Regurgitation
C. Aortic Regurgitation
D. Mitral Stenosis
Answer: A
Rationale: Aortic stenosis is characterized by a systolic crescendo-decrescendo murmur at
the right upper sternal border radiating to the carotids.
2. Which physical exam maneuver is most sensitive for diagnosing an ACL tear?
A. McMurray test
B. Valgus stress test
C. Posterior drawer test
D. Lachman test
Answer: D
Rationale: The Lachman test is considered the most sensitive physical examination
maneuver for detecting an anterior cruciate ligament (ACL) injury.
,3. A patient presents with a ‘curtain coming down’ over their vision in one eye.
This is a classic symptom of:
A. Glaucoma
B. Cataracts
C. Retinal Detachment
D. Macular Degeneration
Answer: C
Rationale: A painless loss of vision described as a ‘shadow’ or ‘curtain’ is highly suggestive
of retinal detachment, a medical emergency.
4. Which lab finding is most consistent with iron deficiency anemia?
A. High MCV, high Ferritin
B. Normal MCV, low Ferritin
C. Low MCV, low Ferritin
D. Low MCV, high Ferritin
Answer: C
Rationale: Iron deficiency anemia is typically microcytic (low MCV) and is characterized
by low iron stores (low ferritin).
5. The presence of Murphy’s sign is highly suggestive of which condition?
A. Acute Cholecystitis
B. Pancreatitis
C. Appendicitis
D. Diverticulitis
Answer: A
Rationale: Murphy’s sign (arrest of inspiration on palpation of the gallbladder area) is a
specific indicator for acute cholecystitis.
, 6. In a patient with suspected Hypothyroidism, what is the initial screening test
of choice?
A. TSH
B. Total T3
C. Free T4
D. Thyroid Ultrasound
Answer: A
Rationale: TSH (Thyroid Stimulating Hormone) is the most sensitive screening test for
primary thyroid dysfunction.
7. What is the primary diagnostic criteria for Diabetes Mellitus based on HbA1c?
A. Greater than or equal to 5.7%
B. Greater than or equal to 6.5%
C. Greater than or equal to 6.0%
D. Greater than or equal to 7.0%
Answer: B
Rationale: According to ADA guidelines, an HbA1c level of 6.5% or higher is a diagnostic
criterion for diabetes.
8. Which of the following is a classic physical sign of heart failure?
A. S4 heart sound
B. Absent breath sounds
C. Hyperresonance on percussion
D. S3 heart sound
Answer: D
Rationale: An S3 gallop is an early sign of ventricular filling into a non-compliant or
volume-overloaded ventricle, often seen in heart failure.
Chamberlain College
1. A 65-year-old patient presents with a systolic murmur heard best at the
second right intercostal space that radiates to the neck. Which condition is most
likely?
A. Aortic Stenosis
B. Mitral Regurgitation
C. Aortic Regurgitation
D. Mitral Stenosis
Answer: A
Rationale: Aortic stenosis is characterized by a systolic crescendo-decrescendo murmur at
the right upper sternal border radiating to the carotids.
2. Which physical exam maneuver is most sensitive for diagnosing an ACL tear?
A. McMurray test
B. Valgus stress test
C. Posterior drawer test
D. Lachman test
Answer: D
Rationale: The Lachman test is considered the most sensitive physical examination
maneuver for detecting an anterior cruciate ligament (ACL) injury.
,3. A patient presents with a ‘curtain coming down’ over their vision in one eye.
This is a classic symptom of:
A. Glaucoma
B. Cataracts
C. Retinal Detachment
D. Macular Degeneration
Answer: C
Rationale: A painless loss of vision described as a ‘shadow’ or ‘curtain’ is highly suggestive
of retinal detachment, a medical emergency.
4. Which lab finding is most consistent with iron deficiency anemia?
A. High MCV, high Ferritin
B. Normal MCV, low Ferritin
C. Low MCV, low Ferritin
D. Low MCV, high Ferritin
Answer: C
Rationale: Iron deficiency anemia is typically microcytic (low MCV) and is characterized
by low iron stores (low ferritin).
5. The presence of Murphy’s sign is highly suggestive of which condition?
A. Acute Cholecystitis
B. Pancreatitis
C. Appendicitis
D. Diverticulitis
Answer: A
Rationale: Murphy’s sign (arrest of inspiration on palpation of the gallbladder area) is a
specific indicator for acute cholecystitis.
, 6. In a patient with suspected Hypothyroidism, what is the initial screening test
of choice?
A. TSH
B. Total T3
C. Free T4
D. Thyroid Ultrasound
Answer: A
Rationale: TSH (Thyroid Stimulating Hormone) is the most sensitive screening test for
primary thyroid dysfunction.
7. What is the primary diagnostic criteria for Diabetes Mellitus based on HbA1c?
A. Greater than or equal to 5.7%
B. Greater than or equal to 6.5%
C. Greater than or equal to 6.0%
D. Greater than or equal to 7.0%
Answer: B
Rationale: According to ADA guidelines, an HbA1c level of 6.5% or higher is a diagnostic
criterion for diabetes.
8. Which of the following is a classic physical sign of heart failure?
A. S4 heart sound
B. Absent breath sounds
C. Hyperresonance on percussion
D. S3 heart sound
Answer: D
Rationale: An S3 gallop is an early sign of ventricular filling into a non-compliant or
volume-overloaded ventricle, often seen in heart failure.
