,NR547 CEA Exam | Pre-Clinical Diagnostic Comprehensive Assessment Actual Questions
& Verified Answers (Latest 2026]]
1. A 68-year-old male with a history of hypertension and diabetes
presents with new-onset exertional dyspnea and bilateral lower
extremity edema. Which finding most strongly supports a diagnosis of
heart failure with reduced ejection fraction (HFrEF)?
A. Loud S2
B. Widened pulse pressure
C. Bounding peripheral pulses
D. S3 heart sound
Rationale: An S3 gallop is associated with volume overload and decreased
ventricular compliance, commonly seen in HFrEF. Loud S2, widened pulse
pressure, and bounding pulses are more characteristic of aortic regurgitation
or other valvular issues .
2. A patient with chronic kidney disease stage 3 is prescribed an ACE
inhibitor. Which laboratory value requires the most immediate follow-
up?
A. Sodium 134 mEq/L
B. Calcium 8.7 mg/dL
C. Hemoglobin 11.8 g/dL
D. Potassium 5.6 mEq/L
Rationale: ACE inhibitors can increase potassium levels; hyperkalemia poses a
risk for life-threatening arrhythmias. Patients with CKD are particularly
vulnerable to this side effect and require close monitoring of potassium
levels .
,3. A 45-year-old female presents with fatigue, weight gain, cold
intolerance, and constipation. Which laboratory pattern is most
consistent with the suspected diagnosis?
A. Low TSH, high T4
B. Normal TSH, high T3
C. Low cortisol, high ACTH
D. High TSH, low T4
Rationale: Primary hypothyroidism presents with decreased thyroid hormone
and compensatory elevation in TSH. Symptoms include fatigue, weight gain,
cold intolerance, and constipation .
4. Which medication is most appropriate as first-line therapy for newly
diagnosed type 2 diabetes mellitus in a patient without
contraindications?
A. Insulin glargine
B. Metformin
C. Sulfonylureas
D. SGLT2 inhibitors
Rationale: Metformin is the first-line pharmacologic therapy for type 2
diabetes due to its efficacy, safety, low hypoglycemia risk, and potential
cardiovascular benefits .
5. A patient with COPD is prescribed a beta-blocker for hypertension.
Which beta-blocker is safest for this patient?
A. Propranolol
B. Metoprolol succinate
C. Nadolol
D. Carvedilol
, Rationale: Nonselective beta-blockers like propranolol can provoke
bronchospasm in COPD and asthma patients. Cardioselective beta-blockers
such as metoprolol are preferred due to reduced bronchospasm risk .
6. A patient taking warfarin presents with an INR of 5.8 and no signs
of bleeding. What is the most appropriate management?
A. Administer vitamin K IV
B. Transfuse fresh frozen plasma
C. Continue current dose
D. Hold warfarin and monitor INR
Rationale: For supratherapeutic INR without bleeding (INR >5 and <9),
holding warfarin and close monitoring is appropriate. IV vitamin K is reserved
for serious bleeding or very high INR .
7. A patient reports epigastric pain that improves with eating. Which
condition is most likely?
A. Gastric ulcer
B. Acute pancreatitis
C. Cholecystitis
D. Duodenal ulcer
Rationale: Duodenal ulcer pain typically improves with food intake, whereas
gastric ulcer pain often worsens with eating. This classic distinction helps
differentiate ulcer types .
& Verified Answers (Latest 2026]]
1. A 68-year-old male with a history of hypertension and diabetes
presents with new-onset exertional dyspnea and bilateral lower
extremity edema. Which finding most strongly supports a diagnosis of
heart failure with reduced ejection fraction (HFrEF)?
A. Loud S2
B. Widened pulse pressure
C. Bounding peripheral pulses
D. S3 heart sound
Rationale: An S3 gallop is associated with volume overload and decreased
ventricular compliance, commonly seen in HFrEF. Loud S2, widened pulse
pressure, and bounding pulses are more characteristic of aortic regurgitation
or other valvular issues .
2. A patient with chronic kidney disease stage 3 is prescribed an ACE
inhibitor. Which laboratory value requires the most immediate follow-
up?
A. Sodium 134 mEq/L
B. Calcium 8.7 mg/dL
C. Hemoglobin 11.8 g/dL
D. Potassium 5.6 mEq/L
Rationale: ACE inhibitors can increase potassium levels; hyperkalemia poses a
risk for life-threatening arrhythmias. Patients with CKD are particularly
vulnerable to this side effect and require close monitoring of potassium
levels .
,3. A 45-year-old female presents with fatigue, weight gain, cold
intolerance, and constipation. Which laboratory pattern is most
consistent with the suspected diagnosis?
A. Low TSH, high T4
B. Normal TSH, high T3
C. Low cortisol, high ACTH
D. High TSH, low T4
Rationale: Primary hypothyroidism presents with decreased thyroid hormone
and compensatory elevation in TSH. Symptoms include fatigue, weight gain,
cold intolerance, and constipation .
4. Which medication is most appropriate as first-line therapy for newly
diagnosed type 2 diabetes mellitus in a patient without
contraindications?
A. Insulin glargine
B. Metformin
C. Sulfonylureas
D. SGLT2 inhibitors
Rationale: Metformin is the first-line pharmacologic therapy for type 2
diabetes due to its efficacy, safety, low hypoglycemia risk, and potential
cardiovascular benefits .
5. A patient with COPD is prescribed a beta-blocker for hypertension.
Which beta-blocker is safest for this patient?
A. Propranolol
B. Metoprolol succinate
C. Nadolol
D. Carvedilol
, Rationale: Nonselective beta-blockers like propranolol can provoke
bronchospasm in COPD and asthma patients. Cardioselective beta-blockers
such as metoprolol are preferred due to reduced bronchospasm risk .
6. A patient taking warfarin presents with an INR of 5.8 and no signs
of bleeding. What is the most appropriate management?
A. Administer vitamin K IV
B. Transfuse fresh frozen plasma
C. Continue current dose
D. Hold warfarin and monitor INR
Rationale: For supratherapeutic INR without bleeding (INR >5 and <9),
holding warfarin and close monitoring is appropriate. IV vitamin K is reserved
for serious bleeding or very high INR .
7. A patient reports epigastric pain that improves with eating. Which
condition is most likely?
A. Gastric ulcer
B. Acute pancreatitis
C. Cholecystitis
D. Duodenal ulcer
Rationale: Duodenal ulcer pain typically improves with food intake, whereas
gastric ulcer pain often worsens with eating. This classic distinction helps
differentiate ulcer types .
