CEA/FNP Actual Exam Reviewed 2026/2027|
Test Bank With 324 Real Exam Questions
and Correct Verified Answers/ Solutions with
Detailed Rationale| (Brand New!!)
A 50-year-old woman with a history of hypertension presents with dyspnea on
exertion and orthopnea. On examination, she has jugular venous distention and
bilateral crackles on lung auscultation. What is the most likely diagnosis? -
ANSWER✔️-Congestive heart failure
Rationale: Of the available options, the most accurate response is congestive heart
failure as it is signifying both a right ventricular back up with jugular venous
extension and crackles on lung assault, which are suggestive of left ventricular
back up. it is possible the patient may have an acute myocardial infarction that
precipitated this, however, a patient has not described that, rather is only describing
dyspnea on exertion and orthopnea, which both speak to a state of fluid overload.
The only appropriate response of these available is congestive heart failure.
Your patient with a history of HFrEF (heart failure with reduced ejection fraction)
with an ejection fraction of 40% who is also not on optimal medical therapy has
been diagnosed with a myocardial infarction this admission and received emergent
placement of a drug-eluting stent to the left anterior descending artery. As the
medical home who will manage this patient after discharge, which medication
strategy would you expect to be a priority in the patient's care? - ANSWER✔️-
Ordering a transthoracic echocardiogram and order a Life vest if EF is less than
35%
Rationale: The patient should have a protective mechanism such as an implantable
automated cardioverter defibrillator (AICD) or a Life vest if the EF is less than
35% due to the increased risk of sudden cardiac death with low EF states. Since
most patients are not eligible for 90 days for an AICD in this state, optimizing their
medication regimen and repeating an echo in 2-3 months to re-evaluate for
improvement in their EF is required by most insurance companies. A baseline echo
is needed at discharge to provide a baseline for improvement vs their repeat echo in
2-3 months.
Dual anti-platelet therapy is required for 12 months minimum post-MI.
A Holter monitor does not provide any conceivable benefit for this patient as
presented.
,Which of the following people groups represent the least risk of cardiac disease? -
ANSWER✔️-Caucasians
Rationale: Statistically African Americans, Native Hawaiians, and American
Indians are at increased risk of cardiac disease due to higher rates of hypertension,
diabetes, and obesity than Caucasians.
A 65-year-old woman presents for a follow-up examination. She is a smoker, and
her hypertension is now adequately controlled with medication. Her mother died at
age 40 from a heart attack. The fasting lipid profile shows cholesterol = 240
mg/dL, HDL = 30, and LDL = 200. In addition to starting therapeutic lifestyle
changes, the nurse practitioner should start the patient on: - ANSWER✔️-a statin
drug.
Rationale: Bile acid sequestrants and cholesterol absorption inhibitors may be
useful in reducing ASVD risk, but for a patient who is an active smoker with
premature coronary disease history (less than age 65 for women), has hypertension
and is far from an LDL goal, this patient is most certainly a candidate for statin
therapy, which represents the most aggressive therapy option of these four listed.
Which of the following end-organ sequelae is not directly caused by uncontrolled
hypertension? - ANSWER✔️-Peripheral neuropathy
Rationale: Although patients with hypertension frequently have peripheral
neuropathy, it is only directly attributed to patients who are also diabetic and is
commonly found in non-hypertensive diabetic patients. Proteinuria, AV nicking,
and hemorrhagic stroke are all caused by uncontrolled hypertension.
Preventive cardiac care should focus primarily on addressing all the following
except? - ANSWER✔️-Genetic predisposition
Rationale: Smoking cessation, exercise, and medication compliance all represent
modifiable risk factors and should be the focus of preventive care. Non-modifiable
risk factors such as age, gender, genetic/family history should not be the primary
focus of prevention.
A 33-year-old woman presents with irregular menstrual cycles, hirsutism, and
obesity. Laboratory tests reveal elevated serum testosterone and LH ratio > 2:1.
What is the most appropriate initial treatment? - ANSWER✔️-Oral contraceptives
Rationale: These are classic symptoms of polycystic ovarian syndrome and the
patient should be treated with oral contraceptives to help stabilize their estrogen
and progesterone. Additionally, they may be managed on metformin and/or
spironolactone for their PCOS.
,Oral contraceptive pills (OCPs) are often the first pharmacological treatment for
polycystic ovary syndrome (PCOS) because they help manage in several ways:
Menstrual irregularities: OCPs can help regulate menstrual cycles, making periods
lighter and more regular. This is important because irregular ovulation can lead to
endometrial hyperplasia, which is a buildup of uterine tissue that can increase the
risk of uterine cancer.
Androgen excess: OCPs can reduce androgen production and increase sex
hormone-binding globulin (SHBG), which binds androgens. This can help reduce
symptoms like acne, hirsutism (unwanted body and facial hair), and androgenic
alopecia (male pattern baldness).
Endometrium protection: OCPs can protect the endometrium by ensuring regular
ovulation
A 50-year-old woman with hypertension and diabetes comes in for a routine check-
up. What screening test should be regularly performed to monitor for early signs of
diabetic nephropathy? - ANSWER✔️-Urine dipstick for protein
Rationale: The most sensitive indicator of diabetic nephropathy would be the
evidence of small proteins in the urine (proteinuria) as found on urinalysis. The
other options might describe macro-organ function (such as BUN/Create from a
BMP, a renal biopsy which is not indicated for routine diabetic nephropathy
testing, and a Abd CT, which is more akin to evaluation of less subtle findings), but
at the functional level of the nephron, namely the glomerulus, evidence of glucose-
related damage is easily identified with proteinuria from a UA.
Which of the following is at highest risk for DMII? - ANSWER✔️-An adult
woman with a BMI of 27 who just delivered a baby weighing 9 1/2 lbs
Rationale: Of these options, an adult woman with a BMI of 27 who just delivered a
baby weighing 9 1/2 lbs is the most likely due to their increased BMI and the large
size of the baby. giving birth to a large baby, also known as a large-for-gestational-
age (LGA) baby, can increase the risk of developing type 2 diabetes later in life.
Women who give birth to a LGA baby are 10% more likely to develop DMII 10-14
years after pregnancy compared to women who give birth to babies of average
gestational age (AGA). This increased risk is even after adjusting for other risk
factors, such as age, obesity, high blood pressure, and family history of diabetes.
A starting dose for a elderly adult patient with a BMI of 20 needing levothyroxine -
ANSWER✔️-25 mcg
Rationale: The widely considered best practice for treatment of hypothyroidism in
the elderly is to "go slow and start low". 25 mcg is the most appropriate low dose
, to start with of these options. It is possible that over time the dose will be increased
until therapeutic levels are obtained, but the risk of over-dosing the patient
outweighs the desire to quickly achieve this state.
An adult female who recently returned for a recheck appointment. The only
remarkable laboratory result is for thyroid-stimulating hormone (TSH), at 0.3
microunits/mL (normal = 0.4-6 microunits/mL). The patient reports that her neck
hurts; examination reveals thyroid tenderness. Which of the following laboratory
tests should the nurse practitioner order now? - ANSWER✔️-Triiodothyronine
(T3) and free thyroxine (FT4)
Rationale: Remember that a patient with low TSH is suspicious of hyperthyroidism
with a corresponding finding of elevated T3/T4 and clinical symptoms of a goiter,
tremulousness, anxiety, palpitations, weight loss, insomnia, diarrhea, etc. This
patient is describing a sore neck as well, which is suggestive of Graves disease
(hyperthyroid state).
All the following are symptoms of hypocalcemia except: - ANSWER✔️-Visual
field deficits
Rationale: Visual field deficits is a potential symptom of pituitary adenoma. All
other are symptoms related to hypocalcemia.
An adult patient diagnosed with type 2 diabetes mellitus presents for a recheck.
The patient follows a carbohydrate counting diet and walks 30 minutes 5 times
weekly. Current fasting blood glucose = 116 mg/dL [normal = less than 99 mg/dL]
and A1c = 6.3% [normal = less than 7.0%]. In accordance with the American
Diabetes Association, the nurse practitioner would recommend that the next
follow-up appointment be scheduled for: - ANSWER✔️-6 months.
Rationale: Based off of the ADA recommendation, this patient should be evaluated
in six months. They are actually showing good control and excellent compliance
with diet and exercise management strategies. If there compliance was worse or
they were not controlled with their A1c, this would likely be a three month follow
up.
Your patient has a diagnosis of Hashimoto's and is on Levothyroxine 75 mcg daily.
Her recent TSH was elevated at 15 uU/mL. Your next best action is to: -
ANSWER✔️-Increase Levothyroxine to 100 mcg daily
Rationale: When the TSH is elevated the patient needs more thyroid hormone.
Once diagnosed with Hashimoto's there is no clinical need/benefit to repeating anti
bodies.
Test Bank With 324 Real Exam Questions
and Correct Verified Answers/ Solutions with
Detailed Rationale| (Brand New!!)
A 50-year-old woman with a history of hypertension presents with dyspnea on
exertion and orthopnea. On examination, she has jugular venous distention and
bilateral crackles on lung auscultation. What is the most likely diagnosis? -
ANSWER✔️-Congestive heart failure
Rationale: Of the available options, the most accurate response is congestive heart
failure as it is signifying both a right ventricular back up with jugular venous
extension and crackles on lung assault, which are suggestive of left ventricular
back up. it is possible the patient may have an acute myocardial infarction that
precipitated this, however, a patient has not described that, rather is only describing
dyspnea on exertion and orthopnea, which both speak to a state of fluid overload.
The only appropriate response of these available is congestive heart failure.
Your patient with a history of HFrEF (heart failure with reduced ejection fraction)
with an ejection fraction of 40% who is also not on optimal medical therapy has
been diagnosed with a myocardial infarction this admission and received emergent
placement of a drug-eluting stent to the left anterior descending artery. As the
medical home who will manage this patient after discharge, which medication
strategy would you expect to be a priority in the patient's care? - ANSWER✔️-
Ordering a transthoracic echocardiogram and order a Life vest if EF is less than
35%
Rationale: The patient should have a protective mechanism such as an implantable
automated cardioverter defibrillator (AICD) or a Life vest if the EF is less than
35% due to the increased risk of sudden cardiac death with low EF states. Since
most patients are not eligible for 90 days for an AICD in this state, optimizing their
medication regimen and repeating an echo in 2-3 months to re-evaluate for
improvement in their EF is required by most insurance companies. A baseline echo
is needed at discharge to provide a baseline for improvement vs their repeat echo in
2-3 months.
Dual anti-platelet therapy is required for 12 months minimum post-MI.
A Holter monitor does not provide any conceivable benefit for this patient as
presented.
,Which of the following people groups represent the least risk of cardiac disease? -
ANSWER✔️-Caucasians
Rationale: Statistically African Americans, Native Hawaiians, and American
Indians are at increased risk of cardiac disease due to higher rates of hypertension,
diabetes, and obesity than Caucasians.
A 65-year-old woman presents for a follow-up examination. She is a smoker, and
her hypertension is now adequately controlled with medication. Her mother died at
age 40 from a heart attack. The fasting lipid profile shows cholesterol = 240
mg/dL, HDL = 30, and LDL = 200. In addition to starting therapeutic lifestyle
changes, the nurse practitioner should start the patient on: - ANSWER✔️-a statin
drug.
Rationale: Bile acid sequestrants and cholesterol absorption inhibitors may be
useful in reducing ASVD risk, but for a patient who is an active smoker with
premature coronary disease history (less than age 65 for women), has hypertension
and is far from an LDL goal, this patient is most certainly a candidate for statin
therapy, which represents the most aggressive therapy option of these four listed.
Which of the following end-organ sequelae is not directly caused by uncontrolled
hypertension? - ANSWER✔️-Peripheral neuropathy
Rationale: Although patients with hypertension frequently have peripheral
neuropathy, it is only directly attributed to patients who are also diabetic and is
commonly found in non-hypertensive diabetic patients. Proteinuria, AV nicking,
and hemorrhagic stroke are all caused by uncontrolled hypertension.
Preventive cardiac care should focus primarily on addressing all the following
except? - ANSWER✔️-Genetic predisposition
Rationale: Smoking cessation, exercise, and medication compliance all represent
modifiable risk factors and should be the focus of preventive care. Non-modifiable
risk factors such as age, gender, genetic/family history should not be the primary
focus of prevention.
A 33-year-old woman presents with irregular menstrual cycles, hirsutism, and
obesity. Laboratory tests reveal elevated serum testosterone and LH ratio > 2:1.
What is the most appropriate initial treatment? - ANSWER✔️-Oral contraceptives
Rationale: These are classic symptoms of polycystic ovarian syndrome and the
patient should be treated with oral contraceptives to help stabilize their estrogen
and progesterone. Additionally, they may be managed on metformin and/or
spironolactone for their PCOS.
,Oral contraceptive pills (OCPs) are often the first pharmacological treatment for
polycystic ovary syndrome (PCOS) because they help manage in several ways:
Menstrual irregularities: OCPs can help regulate menstrual cycles, making periods
lighter and more regular. This is important because irregular ovulation can lead to
endometrial hyperplasia, which is a buildup of uterine tissue that can increase the
risk of uterine cancer.
Androgen excess: OCPs can reduce androgen production and increase sex
hormone-binding globulin (SHBG), which binds androgens. This can help reduce
symptoms like acne, hirsutism (unwanted body and facial hair), and androgenic
alopecia (male pattern baldness).
Endometrium protection: OCPs can protect the endometrium by ensuring regular
ovulation
A 50-year-old woman with hypertension and diabetes comes in for a routine check-
up. What screening test should be regularly performed to monitor for early signs of
diabetic nephropathy? - ANSWER✔️-Urine dipstick for protein
Rationale: The most sensitive indicator of diabetic nephropathy would be the
evidence of small proteins in the urine (proteinuria) as found on urinalysis. The
other options might describe macro-organ function (such as BUN/Create from a
BMP, a renal biopsy which is not indicated for routine diabetic nephropathy
testing, and a Abd CT, which is more akin to evaluation of less subtle findings), but
at the functional level of the nephron, namely the glomerulus, evidence of glucose-
related damage is easily identified with proteinuria from a UA.
Which of the following is at highest risk for DMII? - ANSWER✔️-An adult
woman with a BMI of 27 who just delivered a baby weighing 9 1/2 lbs
Rationale: Of these options, an adult woman with a BMI of 27 who just delivered a
baby weighing 9 1/2 lbs is the most likely due to their increased BMI and the large
size of the baby. giving birth to a large baby, also known as a large-for-gestational-
age (LGA) baby, can increase the risk of developing type 2 diabetes later in life.
Women who give birth to a LGA baby are 10% more likely to develop DMII 10-14
years after pregnancy compared to women who give birth to babies of average
gestational age (AGA). This increased risk is even after adjusting for other risk
factors, such as age, obesity, high blood pressure, and family history of diabetes.
A starting dose for a elderly adult patient with a BMI of 20 needing levothyroxine -
ANSWER✔️-25 mcg
Rationale: The widely considered best practice for treatment of hypothyroidism in
the elderly is to "go slow and start low". 25 mcg is the most appropriate low dose
, to start with of these options. It is possible that over time the dose will be increased
until therapeutic levels are obtained, but the risk of over-dosing the patient
outweighs the desire to quickly achieve this state.
An adult female who recently returned for a recheck appointment. The only
remarkable laboratory result is for thyroid-stimulating hormone (TSH), at 0.3
microunits/mL (normal = 0.4-6 microunits/mL). The patient reports that her neck
hurts; examination reveals thyroid tenderness. Which of the following laboratory
tests should the nurse practitioner order now? - ANSWER✔️-Triiodothyronine
(T3) and free thyroxine (FT4)
Rationale: Remember that a patient with low TSH is suspicious of hyperthyroidism
with a corresponding finding of elevated T3/T4 and clinical symptoms of a goiter,
tremulousness, anxiety, palpitations, weight loss, insomnia, diarrhea, etc. This
patient is describing a sore neck as well, which is suggestive of Graves disease
(hyperthyroid state).
All the following are symptoms of hypocalcemia except: - ANSWER✔️-Visual
field deficits
Rationale: Visual field deficits is a potential symptom of pituitary adenoma. All
other are symptoms related to hypocalcemia.
An adult patient diagnosed with type 2 diabetes mellitus presents for a recheck.
The patient follows a carbohydrate counting diet and walks 30 minutes 5 times
weekly. Current fasting blood glucose = 116 mg/dL [normal = less than 99 mg/dL]
and A1c = 6.3% [normal = less than 7.0%]. In accordance with the American
Diabetes Association, the nurse practitioner would recommend that the next
follow-up appointment be scheduled for: - ANSWER✔️-6 months.
Rationale: Based off of the ADA recommendation, this patient should be evaluated
in six months. They are actually showing good control and excellent compliance
with diet and exercise management strategies. If there compliance was worse or
they were not controlled with their A1c, this would likely be a three month follow
up.
Your patient has a diagnosis of Hashimoto's and is on Levothyroxine 75 mcg daily.
Her recent TSH was elevated at 15 uU/mL. Your next best action is to: -
ANSWER✔️-Increase Levothyroxine to 100 mcg daily
Rationale: When the TSH is elevated the patient needs more thyroid hormone.
Once diagnosed with Hashimoto's there is no clinical need/benefit to repeating anti
bodies.
