1|Page
NR 603 CEA MIDTERM EXAM NEWEST 2026 ACTUAL
EXAM TEST BANK| NR603 COMPREHENSIVE EXIT
ASSESSMENT (CEA) MID-TERM EXAM REVIEW
WITH COMPLETE REAL EXAM QUESTIONS AND
CORRECT VERIFIED ANSWERS/ ALREADY GRADED
A+ (MOST RECENT!!)
A 74-year-old man presents after his wife witnessed him grab his head in
pain and fall to the floor. He has not regained consciousness. His current
blood pressure is 150/96 mm Hg, and his heart rate is 65 bpm. Emergent
head CT shows a subarachnoid hemorrhage.
In addition to life saving interventions, what prescription medication
will most benefit this patient at this time?
1. Furosemide (loop diuretic)
2. Prednisone (glucocorticoid)
3. Tranexamic acid (antifibrinolytic agent)
4. Labetolol (beta blocker)
5. Nimodipine (calcium channel blocker) - Correct Answer - Nimodipine
(CCB)
Nimodipine, a calcium channel blocker, has been shown to improve
outcomes in patients following aneurysmal SAH. The mechanism of
action is thought to be prevention of ischemia.
A 37-year-old woman presents to her GP surgery with a history of right-
sided facial weakness and peri-auricular discomfort since she awoke this
morning. She is afebrile.
What is the most likely diagnosis?
pg. 1
,2|Page
1. Trigeminal neuralgia
2. Bell's Palsy
3. Multiple sclerosis
4. Myasthenia gravis
5. Primary lateral sclerosis - Correct Answer - Bell's Palsy
The answer is Bell's palsy, which is a condition typically with sudden
onset that affects the facial nerve, causing unilateral facial weakness.
A 62-year-old man presents with vision problems and difficulty
swallowing. Over the last week, he has had a constellation of symptoms;
they began with numbness and tingling in his feet and progressed to
weakness that now affects both lower and upper extremities. Within the
last day, he has started to notice difficulty swallowing and double vision.
He also feels it is difficult for him to take a big breath. His past medical
history is noncontributory, and he takes no medications. Exam reveals
bilateral absence of patellar and ulnar reflexes. A lumbar puncture is
performed to confirm the diagnosis. What cerebrospinal fluid (CSF)
finding is most likely?
1. Decreased CSF glucose content
2. Decreased CSF protein content
3. Elevated CSF polymorphonuclear cell count
4. Elevated CSF protein content
5. Elevated CSF lymphocyte count - Correct Answer - Elevated CSF
proteins content.
Symmetrical ascending paralysis as described in this patient is indicative
of Guillain-Barré syndrome (GBS). The cause of GBS is unknown, but it
is generally thought to be an inflammatory autoimmune process. More
than half of patients with GBS report an antecedent illness. The
antibodies produced in response to antigens present in the infectious
pg. 2
,3|Page
agent are thought to cross-react with components of human neurons,
prompting an acute postinfectious demyelinating process.
Lumbar puncture characteristically reveals elevated CSF protein content.
Other results are normal, although the white blood cell count may be
somewhat elevated.
A 48-year-old woman presents after a seizure. Prior to the seizure, she
experienced confusion and disorientation preceded by nausea, vomiting,
and blurred vision. Symptoms appeared after working for several hours
in the garden under the sun. Her medical history is significant for the
presence of schizophrenia, for which she takes chlorpromazine at
bedtime. Her temperature is 41 C; BUN and creatinine are elevated; and
there is neutrophilia, hemoconcentration, and lactic acidosis. You think
that the event is possibly drug-related. What is the most likely
diagnosis?
1. Heat cramps
2. Neuroleptic malignant syndrome
3. Heat stroke
4. Malignant hyperthermia
5. Heat exhaustion - Correct Answer - Heat stroke
Heat disorders can be exertional and nonexertional. Both can be drug-
related. Neuroleptics (e.g., phenothiazines, thioxanthenes) may impair
thermoregulation due to both anticholinergic and antidopaminergics
effects. Anticholinergics inhibit sweating, therefore disturbing
thermoregulation during exercise or under conditions of environmental
heat stress. Antidopaminergics elevate the set point of the temperature
regulation center in hypothalamus.
Your patient most probably suffered heat stroke. It is a life-threatening
condition characterized by elevated body temperature with nausea,
blurred vision, confusion, disorientation, and seizures.
pg. 3
, 4|Page
Hemoconcentration, anuria, rhabdomyolysis, kidney dysfunction, lactic
acidosis, and even disseminated intravascular coagulation may result.
A 17-year-old adolescent male presents with unexplained neurological
symptoms. His liver is enlarged on palpation, and he has other
symptoms of hepatitis. Blood work reveals depressed ceruloplasmin
levels. An ophthalmological examination reveals Kayser-Fleischer rings.
What is the most likely diagnosis?
1. Krabbe disease
2. Lesch-Nyan syndrome
3. Marfan syndrome
4. Wilson disease
5. Hunter syndrome - Correct Answer - Wilson Disease
This young man is suffering from Wilson's disease, a genetic disorder of
copper metabolism. It is inherited as an autosomal recessive mutation in
the ATP7B genes located on chromosome 13. The protein of the ATP7B
gene is a copper-transporting ATPase The frequency of the heterozygous
carriers is relatively high (1/90). The incidence of homozygous recessive
affected individuals is about 1/30,000. It affects all ethnic groups and
both sexes equally.
Neurological symptoms, hepatitis, and Kayser-Fleisher rings, greenish-
brown deposits of copper in the corneal endothelial (Descemet
membrane) basement membrane near the peripheral cornea where it
meets the iris (limbus), are characteristic of Wilson's disease.
A 46-year-old man recently recovered from a bout of influenza, and he
now presents due to an 8-hour history of right-sided facial paralysis. He
is having trouble closing his right eye, cannot raise his right eyebrow,
and cannot smile with the right side of his mouth.
What medication(s) should this patient be started on?
pg. 4
NR 603 CEA MIDTERM EXAM NEWEST 2026 ACTUAL
EXAM TEST BANK| NR603 COMPREHENSIVE EXIT
ASSESSMENT (CEA) MID-TERM EXAM REVIEW
WITH COMPLETE REAL EXAM QUESTIONS AND
CORRECT VERIFIED ANSWERS/ ALREADY GRADED
A+ (MOST RECENT!!)
A 74-year-old man presents after his wife witnessed him grab his head in
pain and fall to the floor. He has not regained consciousness. His current
blood pressure is 150/96 mm Hg, and his heart rate is 65 bpm. Emergent
head CT shows a subarachnoid hemorrhage.
In addition to life saving interventions, what prescription medication
will most benefit this patient at this time?
1. Furosemide (loop diuretic)
2. Prednisone (glucocorticoid)
3. Tranexamic acid (antifibrinolytic agent)
4. Labetolol (beta blocker)
5. Nimodipine (calcium channel blocker) - Correct Answer - Nimodipine
(CCB)
Nimodipine, a calcium channel blocker, has been shown to improve
outcomes in patients following aneurysmal SAH. The mechanism of
action is thought to be prevention of ischemia.
A 37-year-old woman presents to her GP surgery with a history of right-
sided facial weakness and peri-auricular discomfort since she awoke this
morning. She is afebrile.
What is the most likely diagnosis?
pg. 1
,2|Page
1. Trigeminal neuralgia
2. Bell's Palsy
3. Multiple sclerosis
4. Myasthenia gravis
5. Primary lateral sclerosis - Correct Answer - Bell's Palsy
The answer is Bell's palsy, which is a condition typically with sudden
onset that affects the facial nerve, causing unilateral facial weakness.
A 62-year-old man presents with vision problems and difficulty
swallowing. Over the last week, he has had a constellation of symptoms;
they began with numbness and tingling in his feet and progressed to
weakness that now affects both lower and upper extremities. Within the
last day, he has started to notice difficulty swallowing and double vision.
He also feels it is difficult for him to take a big breath. His past medical
history is noncontributory, and he takes no medications. Exam reveals
bilateral absence of patellar and ulnar reflexes. A lumbar puncture is
performed to confirm the diagnosis. What cerebrospinal fluid (CSF)
finding is most likely?
1. Decreased CSF glucose content
2. Decreased CSF protein content
3. Elevated CSF polymorphonuclear cell count
4. Elevated CSF protein content
5. Elevated CSF lymphocyte count - Correct Answer - Elevated CSF
proteins content.
Symmetrical ascending paralysis as described in this patient is indicative
of Guillain-Barré syndrome (GBS). The cause of GBS is unknown, but it
is generally thought to be an inflammatory autoimmune process. More
than half of patients with GBS report an antecedent illness. The
antibodies produced in response to antigens present in the infectious
pg. 2
,3|Page
agent are thought to cross-react with components of human neurons,
prompting an acute postinfectious demyelinating process.
Lumbar puncture characteristically reveals elevated CSF protein content.
Other results are normal, although the white blood cell count may be
somewhat elevated.
A 48-year-old woman presents after a seizure. Prior to the seizure, she
experienced confusion and disorientation preceded by nausea, vomiting,
and blurred vision. Symptoms appeared after working for several hours
in the garden under the sun. Her medical history is significant for the
presence of schizophrenia, for which she takes chlorpromazine at
bedtime. Her temperature is 41 C; BUN and creatinine are elevated; and
there is neutrophilia, hemoconcentration, and lactic acidosis. You think
that the event is possibly drug-related. What is the most likely
diagnosis?
1. Heat cramps
2. Neuroleptic malignant syndrome
3. Heat stroke
4. Malignant hyperthermia
5. Heat exhaustion - Correct Answer - Heat stroke
Heat disorders can be exertional and nonexertional. Both can be drug-
related. Neuroleptics (e.g., phenothiazines, thioxanthenes) may impair
thermoregulation due to both anticholinergic and antidopaminergics
effects. Anticholinergics inhibit sweating, therefore disturbing
thermoregulation during exercise or under conditions of environmental
heat stress. Antidopaminergics elevate the set point of the temperature
regulation center in hypothalamus.
Your patient most probably suffered heat stroke. It is a life-threatening
condition characterized by elevated body temperature with nausea,
blurred vision, confusion, disorientation, and seizures.
pg. 3
, 4|Page
Hemoconcentration, anuria, rhabdomyolysis, kidney dysfunction, lactic
acidosis, and even disseminated intravascular coagulation may result.
A 17-year-old adolescent male presents with unexplained neurological
symptoms. His liver is enlarged on palpation, and he has other
symptoms of hepatitis. Blood work reveals depressed ceruloplasmin
levels. An ophthalmological examination reveals Kayser-Fleischer rings.
What is the most likely diagnosis?
1. Krabbe disease
2. Lesch-Nyan syndrome
3. Marfan syndrome
4. Wilson disease
5. Hunter syndrome - Correct Answer - Wilson Disease
This young man is suffering from Wilson's disease, a genetic disorder of
copper metabolism. It is inherited as an autosomal recessive mutation in
the ATP7B genes located on chromosome 13. The protein of the ATP7B
gene is a copper-transporting ATPase The frequency of the heterozygous
carriers is relatively high (1/90). The incidence of homozygous recessive
affected individuals is about 1/30,000. It affects all ethnic groups and
both sexes equally.
Neurological symptoms, hepatitis, and Kayser-Fleisher rings, greenish-
brown deposits of copper in the corneal endothelial (Descemet
membrane) basement membrane near the peripheral cornea where it
meets the iris (limbus), are characteristic of Wilson's disease.
A 46-year-old man recently recovered from a bout of influenza, and he
now presents due to an 8-hour history of right-sided facial paralysis. He
is having trouble closing his right eye, cannot raise his right eyebrow,
and cannot smile with the right side of his mouth.
What medication(s) should this patient be started on?
pg. 4
