LATEST NR603 CEA FINAL EXAM STUDY GUIDE: HIGH-YIELD
PRACTICE QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) GRADED A+| NR603 CEA FINAL EXAM
PREP (MOST RECENT!!)
1. A 68-year-old female presents with dyspnea on exertion and a grade III/VI
systolic murmur at the right 2nd intercostal space that radiates to the neck.
What is your top differential?
A) Mitral Regurgitation
B) Aortic Stenosis
C) Mitral Valve Prolapse
D) Aortic Regurgitation
Aortic Stenosis is a "systolic" murmur at the "base" (right upper sternal border)
that radiates to the carotids.
2. You are assessing a patient with a history of Heart Failure. You hear a low-
pitched extra heart sound early in diastole (just after S2). This is most likely:
A) S4 (Atrial Gallop)
B) S3 (Ventricular Gallop)
C) A physiological split S2
D) An ejection click
S3 is often a sign of fluid overload or ventricular non-compliance in HF patients
("Kentucky" gallop).
3. Which medication class is the first-line treatment for an African American
patient with hypertension and no other comorbidities?
A) ACE Inhibitors
B) Beta-Blockers
C) Thiazide Diuretics or Calcium Channel Blockers (CCBs)
D) ARBs
Per JNC 8, thiazides and CCBs are more effective as monotherapy in the Black
population.
,4. A patient with COPD has a FEV1/FVC ratio of <0.70 and an FEV1 of 65%
predicted. According to GOLD guidelines, what is their classification?
A) GOLD 1 (Mild)
B) GOLD 2 (Moderate)
C) GOLD 3 (Severe)
D) GOLD 4 (Very Severe)
GOLD 2 is defined as an FEV1 between 50% and 79%.
5. A 19-year-old college student presents with a non-productive cough, low-
grade fever, and "patchy" infiltrates on a chest X-ray. What is the most likely
pathogen?
A) Streptococcus pneumoniae
B) Mycoplasma pneumoniae
C) Haemophilus influenzae
D) Klebsiella pneumoniae
This is "walking pneumonia," common in young adults and characterized by
milder symptoms than typical lobar pneumonia.
6. Which of the following murmurs is considered "Diastolic" and always
pathological?
A) Mitral Stenosis
B) Aortic Stenosis
C) Mitral Regurgitation
D) Ventricular Septal Defect
Diastolic murmurs (MS AR) are never innocent.
7. A patient presents with a BP of 162/94. This is their first elevated reading.
What is the appropriate next step?
A) Start Lisinopril 10mg daily
B) Start Hydrochlorothiazide 12.5mg daily
C) Have the patient keep a BP log and return in 1-2 weeks for re-evaluation
D) Order a Stat EKG and refer to cardiology
Diagnosis of HTN requires at least two elevated readings on separate occasions.
8. When evaluating a patient for Peripheral Artery Disease (PAD), you calculate
an Ankle-Brachial Index (ABI) of 0.7. This indicates:
A) Normal arterial flow
, B) Mild to moderate PAD
C) Severe PAD
D) Venous insufficiency
An ABI < 0.9 is diagnostic for PAD.
9. A patient taking an ACE inhibitor develops a dry, persistent cough. What is
the mechanism behind this side effect?
A) Increased production of Angiotensin II
B) Accumulation of Bradykinin
C) Bronchoconstriction from Beta-receptors
D) Pulmonary edema
ACE inhibitors block the enzyme that breaks down bradykinin, leading to its
buildup in the lungs.
10. What is the most common cause of Right-Sided Heart Failure?
A) Tricuspid regurgitation
B) Pulmonary hypertension
C) Left-Sided Heart Failure
D) Chronic obstructive pulmonary disease
Fluid backing up from the left side eventually puts strain on the right ventricle.
11. A 72-year-old male presents with sudden onset of "the worst headache of
my life." You should immediately suspect:
A) Migraine with aura
B) Temporal Arteritis
C) Subarachnoid Hemorrhage
D) Cluster headache
The "thunderclap" headache is a classic presentation of a subarachnoid bleed.
12. Which physical exam maneuver is used to assess for a Meniscus tear?
A) Lachman Test
B) McMurray Test
C) Drawer Test
D) Phalen's Sign
McMurray involves rotation of the knee with flexion/extension.
13. A patient has a positive Homan's sign (pain in calf upon dorsiflexion). While
not highly specific, this traditionally suggests:
PRACTICE QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) GRADED A+| NR603 CEA FINAL EXAM
PREP (MOST RECENT!!)
1. A 68-year-old female presents with dyspnea on exertion and a grade III/VI
systolic murmur at the right 2nd intercostal space that radiates to the neck.
What is your top differential?
A) Mitral Regurgitation
B) Aortic Stenosis
C) Mitral Valve Prolapse
D) Aortic Regurgitation
Aortic Stenosis is a "systolic" murmur at the "base" (right upper sternal border)
that radiates to the carotids.
2. You are assessing a patient with a history of Heart Failure. You hear a low-
pitched extra heart sound early in diastole (just after S2). This is most likely:
A) S4 (Atrial Gallop)
B) S3 (Ventricular Gallop)
C) A physiological split S2
D) An ejection click
S3 is often a sign of fluid overload or ventricular non-compliance in HF patients
("Kentucky" gallop).
3. Which medication class is the first-line treatment for an African American
patient with hypertension and no other comorbidities?
A) ACE Inhibitors
B) Beta-Blockers
C) Thiazide Diuretics or Calcium Channel Blockers (CCBs)
D) ARBs
Per JNC 8, thiazides and CCBs are more effective as monotherapy in the Black
population.
,4. A patient with COPD has a FEV1/FVC ratio of <0.70 and an FEV1 of 65%
predicted. According to GOLD guidelines, what is their classification?
A) GOLD 1 (Mild)
B) GOLD 2 (Moderate)
C) GOLD 3 (Severe)
D) GOLD 4 (Very Severe)
GOLD 2 is defined as an FEV1 between 50% and 79%.
5. A 19-year-old college student presents with a non-productive cough, low-
grade fever, and "patchy" infiltrates on a chest X-ray. What is the most likely
pathogen?
A) Streptococcus pneumoniae
B) Mycoplasma pneumoniae
C) Haemophilus influenzae
D) Klebsiella pneumoniae
This is "walking pneumonia," common in young adults and characterized by
milder symptoms than typical lobar pneumonia.
6. Which of the following murmurs is considered "Diastolic" and always
pathological?
A) Mitral Stenosis
B) Aortic Stenosis
C) Mitral Regurgitation
D) Ventricular Septal Defect
Diastolic murmurs (MS AR) are never innocent.
7. A patient presents with a BP of 162/94. This is their first elevated reading.
What is the appropriate next step?
A) Start Lisinopril 10mg daily
B) Start Hydrochlorothiazide 12.5mg daily
C) Have the patient keep a BP log and return in 1-2 weeks for re-evaluation
D) Order a Stat EKG and refer to cardiology
Diagnosis of HTN requires at least two elevated readings on separate occasions.
8. When evaluating a patient for Peripheral Artery Disease (PAD), you calculate
an Ankle-Brachial Index (ABI) of 0.7. This indicates:
A) Normal arterial flow
, B) Mild to moderate PAD
C) Severe PAD
D) Venous insufficiency
An ABI < 0.9 is diagnostic for PAD.
9. A patient taking an ACE inhibitor develops a dry, persistent cough. What is
the mechanism behind this side effect?
A) Increased production of Angiotensin II
B) Accumulation of Bradykinin
C) Bronchoconstriction from Beta-receptors
D) Pulmonary edema
ACE inhibitors block the enzyme that breaks down bradykinin, leading to its
buildup in the lungs.
10. What is the most common cause of Right-Sided Heart Failure?
A) Tricuspid regurgitation
B) Pulmonary hypertension
C) Left-Sided Heart Failure
D) Chronic obstructive pulmonary disease
Fluid backing up from the left side eventually puts strain on the right ventricle.
11. A 72-year-old male presents with sudden onset of "the worst headache of
my life." You should immediately suspect:
A) Migraine with aura
B) Temporal Arteritis
C) Subarachnoid Hemorrhage
D) Cluster headache
The "thunderclap" headache is a classic presentation of a subarachnoid bleed.
12. Which physical exam maneuver is used to assess for a Meniscus tear?
A) Lachman Test
B) McMurray Test
C) Drawer Test
D) Phalen's Sign
McMurray involves rotation of the knee with flexion/extension.
13. A patient has a positive Homan's sign (pain in calf upon dorsiflexion). While
not highly specific, this traditionally suggests:
