NR 668 CEA Final Exam (2026) Chamberlain Practicum Actual Questions and
Answers
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📝 Domain 1: Advanced Health Assessment & Clinical Reasoning
1. What is the correct sequence for performing an abdominal examination?
A) Inspection, palpation, percussion, auscultation
B) Auscultation, inspection, palpation, percussion
C) Inspection, auscultation, percussion, palpation
D) Palpation, percussion, auscultation, inspection
Correct Answer: C) Inspection, auscultation, percussion, palpation
Rationale: Auscultation is performed before percussion and palpation because
these maneuvers can alter bowel sounds. Palpation is performed last to avoid
causing discomfort that could interfere with the rest of the examination.
2. A 68-year-old male presents with acute-onset, severe, tearing chest pain
radiating to the back. BP is 100/60 mmHg in the right arm and 80/50 mmHg in the
left arm. What is the most likely diagnosis?
A) Acute myocardial infarction
,B) Pulmonary embolism
C) Aortic dissection
D) Acute pericarditis
Correct Answer: C) Aortic dissection
Rationale: Aortic dissection classically presents with sudden, tearing chest/back
pain and a blood pressure differential (>20 mmHg) between arms, suggesting
aortic arch involvement. This is a surgical emergency.
3. A 45-year-old male presents with right lower quadrant pain, nausea, and fever.
Pain is elicited in the RLQ when palpating the left lower quadrant. This is known
as:
A) Murphy sign
B) Rovsing sign
C) McBurney sign
D) Psoas sign
Correct Answer: B) Rovsing sign
Rationale: Rovsing sign (palpation of the LLQ causing pain in the RLQ) suggests
peritoneal irritation from acute appendicitis. It occurs because palpation displaces
gas/fluid toward the inflamed appendix.
,4. Which physical exam maneuver is most sensitive for detecting a moderate to
large knee effusion?
A) Lachman test
B) Ballottement of the patella
C) McMurray test
D) Anterior drawer test
Correct Answer: B) Ballottement of the patella
Rationale: Ballottement of the patella detects moderate/large effusions; the
patella rebounds or "floats" against the femur when fluid is present. Lachman and
McMurray tests assess ligament and meniscus integrity, respectively.
5. A 28-year-old female presents with episodic palpitations, anxiety, diaphoresis,
and paroxysmal hypertension that resolve spontaneously. What is the most likely
diagnosis?
A) Panic disorder
B) Pheochromocytoma
C) Hyperthyroidism
D) Mitral valve prolapse
, Correct Answer: B) Pheochromocytoma
Rationale: Pheochromocytoma classically presents with episodic hypertension,
palpitations, and diaphoresis that resolve spontaneously, distinguishing it from
sustained hypertension or anxiety disorders.
6. A 58-year-old male with a history of alcohol use disorder presents with
confusion, ataxia, and ophthalmoplegia. This triad is characteristic of:
A) Wernicke encephalopathy
B) Korsakoff syndrome
C) Hepatic encephalopathy
D) Cerebellar degeneration
Correct Answer: A) Wernicke encephalopathy
Rationale: Wernicke encephalopathy is a neurological emergency caused by
thiamine deficiency, commonly in those with alcohol use disorder. Treatment is
immediate IV/IM thiamine.
7. On auscultation of the heart, which valve closures produce the S1 heart sound
("lub")?
A) Aortic and pulmonic valves
Answers
.
📝 Domain 1: Advanced Health Assessment & Clinical Reasoning
1. What is the correct sequence for performing an abdominal examination?
A) Inspection, palpation, percussion, auscultation
B) Auscultation, inspection, palpation, percussion
C) Inspection, auscultation, percussion, palpation
D) Palpation, percussion, auscultation, inspection
Correct Answer: C) Inspection, auscultation, percussion, palpation
Rationale: Auscultation is performed before percussion and palpation because
these maneuvers can alter bowel sounds. Palpation is performed last to avoid
causing discomfort that could interfere with the rest of the examination.
2. A 68-year-old male presents with acute-onset, severe, tearing chest pain
radiating to the back. BP is 100/60 mmHg in the right arm and 80/50 mmHg in the
left arm. What is the most likely diagnosis?
A) Acute myocardial infarction
,B) Pulmonary embolism
C) Aortic dissection
D) Acute pericarditis
Correct Answer: C) Aortic dissection
Rationale: Aortic dissection classically presents with sudden, tearing chest/back
pain and a blood pressure differential (>20 mmHg) between arms, suggesting
aortic arch involvement. This is a surgical emergency.
3. A 45-year-old male presents with right lower quadrant pain, nausea, and fever.
Pain is elicited in the RLQ when palpating the left lower quadrant. This is known
as:
A) Murphy sign
B) Rovsing sign
C) McBurney sign
D) Psoas sign
Correct Answer: B) Rovsing sign
Rationale: Rovsing sign (palpation of the LLQ causing pain in the RLQ) suggests
peritoneal irritation from acute appendicitis. It occurs because palpation displaces
gas/fluid toward the inflamed appendix.
,4. Which physical exam maneuver is most sensitive for detecting a moderate to
large knee effusion?
A) Lachman test
B) Ballottement of the patella
C) McMurray test
D) Anterior drawer test
Correct Answer: B) Ballottement of the patella
Rationale: Ballottement of the patella detects moderate/large effusions; the
patella rebounds or "floats" against the femur when fluid is present. Lachman and
McMurray tests assess ligament and meniscus integrity, respectively.
5. A 28-year-old female presents with episodic palpitations, anxiety, diaphoresis,
and paroxysmal hypertension that resolve spontaneously. What is the most likely
diagnosis?
A) Panic disorder
B) Pheochromocytoma
C) Hyperthyroidism
D) Mitral valve prolapse
, Correct Answer: B) Pheochromocytoma
Rationale: Pheochromocytoma classically presents with episodic hypertension,
palpitations, and diaphoresis that resolve spontaneously, distinguishing it from
sustained hypertension or anxiety disorders.
6. A 58-year-old male with a history of alcohol use disorder presents with
confusion, ataxia, and ophthalmoplegia. This triad is characteristic of:
A) Wernicke encephalopathy
B) Korsakoff syndrome
C) Hepatic encephalopathy
D) Cerebellar degeneration
Correct Answer: A) Wernicke encephalopathy
Rationale: Wernicke encephalopathy is a neurological emergency caused by
thiamine deficiency, commonly in those with alcohol use disorder. Treatment is
immediate IV/IM thiamine.
7. On auscultation of the heart, which valve closures produce the S1 heart sound
("lub")?
A) Aortic and pulmonic valves
