NR511 CEA EXAM STUDY GUIDE WITH
ACTUAL CORRECT QUESTIONS AND
VERIFIED DETAILED ANSWERS| CURRENTLY
TESTING VERSION | ALREADY GRADED
A+|EXPERT VERIFIED FOR GUARANTEED
PASS 2026-2027
A 58-year-old man with hypertension and hyperlipidemia presents with substernal
chest pressure that occurs while climbing stairs and resolves after several minutes of
rest. He has experienced similar episodes over the past 4 months without progression.
His resting ECG is normal.
Which diagnosis is most likely?
A. Acute pericarditis
B. Stable angina
C. Acute myocardial infarction
D. Pulmonary embolism
B. Stable angina
Rationale
Stable angina results from fixed atherosclerotic coronary artery disease causing
predictable ischemia with exertion. Symptoms are reproducible, relieved by rest or
nitroglycerin, and remain unchanged over time.
A 32-year-old woman presents with dysuria, urinary frequency, and urgency for two
days. She is afebrile and has no flank pain. Urinalysis reveals positive nitrites, positive
leukocyte esterase, and numerous white blood cells.
1|Page
,Which organism is the most likely cause?
A. Staphylococcus aureus
B. Escherichia coli
C. Candida albicans
D. Enterococcus faecalis
B. Escherichia coli
Rationale
Escherichia coli causes approximately 75–95% of uncomplicated urinary tract
infections. Nitrite-positive urine strongly suggests infection with Enterobacterales
such as E. coli.
A 48-year-old woman reports fatigue, constipation, cold intolerance, weight gain, and
dry skin. Laboratory results show:
• TSH: 11.2 mIU/L
• Free T4: Low
Which diagnosis is most likely?
A. Hyperthyroidism
B. Secondary hypothyroidism
C. Primary hypothyroidism
D. Euthyroid sick syndrome
C. Primary hypothyroidism
Rationale
Primary hypothyroidism results from thyroid gland dysfunction and is
characterized by elevated TSH and low free T4. Hashimoto thyroiditis is the most
common cause in iodine-sufficient regions.
2|Page
,A 67-year-old man presents with sudden right facial droop, right arm weakness, and
expressive aphasia that began 40 minutes ago.
What is the most appropriate initial imaging study?
A. MRI brain with contrast
B. CT angiography
C. Non-contrast CT head
D. Carotid ultrasound
C. Non-contrast CT head
Rationale
The first imaging study in suspected acute stroke is a non-contrast CT head to
rapidly exclude intracranial hemorrhage and guide eligibility for reperfusion
therapy.
A patient with type 2 diabetes has an HbA1c of 9.4% despite adherence to metformin
and lifestyle modification.
What is the best next step?
A. Continue current therapy unchanged
B. Intensify therapy by adding another glucose-lowering medication based on
comorbidities and patient factors
C. Stop metformin
D. Repeat the HbA1c in one year
B. Intensify therapy by adding another glucose-lowering medication based on
comorbidities and patient factors
Rationale
3|Page
, Persistent HbA1c above target indicates the need for treatment intensification.
Choice of medication should consider cardiovascular disease, heart failure,
chronic kidney disease, weight, hypoglycemia risk, and patient preferences.
A 70-year-old smoker reports painless hematuria.
Which diagnosis should be excluded first?
A. Urinary tract infection
B. Bladder cancer
C. Benign prostatic hyperplasia
D. Nephrolithiasis
B. Bladder cancer
Rationale
Visible painless hematuria in an older smoker is concerning for urothelial
carcinoma until proven otherwise and warrants prompt urologic evaluation.
A 28-year-old woman presents with unilateral facial weakness involving the forehead,
inability to close her eye completely, and drooping of the mouth. She has no limb
weakness.
What is the most likely diagnosis?
A. Ischemic stroke
B. Bell palsy
C. Trigeminal neuralgia
D. Multiple sclerosis
B. Bell palsy
Rationale
4|Page
ACTUAL CORRECT QUESTIONS AND
VERIFIED DETAILED ANSWERS| CURRENTLY
TESTING VERSION | ALREADY GRADED
A+|EXPERT VERIFIED FOR GUARANTEED
PASS 2026-2027
A 58-year-old man with hypertension and hyperlipidemia presents with substernal
chest pressure that occurs while climbing stairs and resolves after several minutes of
rest. He has experienced similar episodes over the past 4 months without progression.
His resting ECG is normal.
Which diagnosis is most likely?
A. Acute pericarditis
B. Stable angina
C. Acute myocardial infarction
D. Pulmonary embolism
B. Stable angina
Rationale
Stable angina results from fixed atherosclerotic coronary artery disease causing
predictable ischemia with exertion. Symptoms are reproducible, relieved by rest or
nitroglycerin, and remain unchanged over time.
A 32-year-old woman presents with dysuria, urinary frequency, and urgency for two
days. She is afebrile and has no flank pain. Urinalysis reveals positive nitrites, positive
leukocyte esterase, and numerous white blood cells.
1|Page
,Which organism is the most likely cause?
A. Staphylococcus aureus
B. Escherichia coli
C. Candida albicans
D. Enterococcus faecalis
B. Escherichia coli
Rationale
Escherichia coli causes approximately 75–95% of uncomplicated urinary tract
infections. Nitrite-positive urine strongly suggests infection with Enterobacterales
such as E. coli.
A 48-year-old woman reports fatigue, constipation, cold intolerance, weight gain, and
dry skin. Laboratory results show:
• TSH: 11.2 mIU/L
• Free T4: Low
Which diagnosis is most likely?
A. Hyperthyroidism
B. Secondary hypothyroidism
C. Primary hypothyroidism
D. Euthyroid sick syndrome
C. Primary hypothyroidism
Rationale
Primary hypothyroidism results from thyroid gland dysfunction and is
characterized by elevated TSH and low free T4. Hashimoto thyroiditis is the most
common cause in iodine-sufficient regions.
2|Page
,A 67-year-old man presents with sudden right facial droop, right arm weakness, and
expressive aphasia that began 40 minutes ago.
What is the most appropriate initial imaging study?
A. MRI brain with contrast
B. CT angiography
C. Non-contrast CT head
D. Carotid ultrasound
C. Non-contrast CT head
Rationale
The first imaging study in suspected acute stroke is a non-contrast CT head to
rapidly exclude intracranial hemorrhage and guide eligibility for reperfusion
therapy.
A patient with type 2 diabetes has an HbA1c of 9.4% despite adherence to metformin
and lifestyle modification.
What is the best next step?
A. Continue current therapy unchanged
B. Intensify therapy by adding another glucose-lowering medication based on
comorbidities and patient factors
C. Stop metformin
D. Repeat the HbA1c in one year
B. Intensify therapy by adding another glucose-lowering medication based on
comorbidities and patient factors
Rationale
3|Page
, Persistent HbA1c above target indicates the need for treatment intensification.
Choice of medication should consider cardiovascular disease, heart failure,
chronic kidney disease, weight, hypoglycemia risk, and patient preferences.
A 70-year-old smoker reports painless hematuria.
Which diagnosis should be excluded first?
A. Urinary tract infection
B. Bladder cancer
C. Benign prostatic hyperplasia
D. Nephrolithiasis
B. Bladder cancer
Rationale
Visible painless hematuria in an older smoker is concerning for urothelial
carcinoma until proven otherwise and warrants prompt urologic evaluation.
A 28-year-old woman presents with unilateral facial weakness involving the forehead,
inability to close her eye completely, and drooping of the mouth. She has no limb
weakness.
What is the most likely diagnosis?
A. Ischemic stroke
B. Bell palsy
C. Trigeminal neuralgia
D. Multiple sclerosis
B. Bell palsy
Rationale
4|Page
