NR511 CEA Exam 2025–
2026//Complete -Question Practice
Bank with Evidence-Based Rationales
for Nurse Practitioners
Section I: Primary Care Fundamentals & Clinical Reasoning
A 55-year-old male presents with fatigue, unintentional weight loss, and
low-grade fever for 3 weeks. What is the most appropriate initial approach?
A) Reassure the patient and schedule follow-up in 3 months
B) Order a comprehensive metabolic panel, CBC with differential, and
ESR/CRP
C) Prescribe antibiotics for presumed infection
D) Refer immediately to oncology
Answer: B
Rationale: Unexplained weight loss with constitutional symptoms (fever,
night sweats, fatigue) warrants initial laboratory evaluation to screen for
infection, chronic inflammation, or malignancy.
,Which of the following is a key component of the "5 A's" model for
behavioral counseling in primary care?
A) Ask, Advise, Assess, Assist, Arrange
B) Assess, Advise, Agree, Assist, Arrange
C) Admit, Advise, Agree, Assist, Arrange
D) Assess, Advise, Administer, Arrange, Adhere
Answer: B
Rationale: The 5 A's model (Assess, Advise, Agree, Assist, Arrange) is an
evidence-based framework for health behavior counseling in primary care
settings, covering smoking cessation, weight management, and physical
activity.
A 68-year-old female presents with a chief complaint of "dizziness." Which
question is most important to differentiate between vertigo and
lightheadedness?
A) "Do you feel like the room is spinning?"
B) "Do you feel faint or like you might pass out?"
C) "Do you have a headache?"
D) "Do you have chest pain?"
Answer: A
Rationale: Differentiating the quality of dizziness directs the differential
diagnosis. Vertigo is characterized by a sensation of movement (room
spinning), while lightheadedness is a feeling of faintness or near-syncope.
,A 62-year-old male with hypertension and diabetes is being evaluated for
cardiovascular risk. According to USPSTF guidelines, which statin therapy
recommendation is most appropriate?
A) No statin therapy needed
B) Moderate-intensity statin
C) High-intensity statin
D) Refer to cardiology for further evaluation
Answer: C
Rationale: Patients with diabetes and hypertension who have an elevated
10-year ASCVD risk should receive high-intensity statin therapy for primary
prevention.
Which physical examination finding is most consistent with orthostatic
hypotension?
A) Systolic BP drop of 15 mm Hg within 3 minutes of standing
B) Systolic BP drop of 20 mm Hg or diastolic drop of 10 mm Hg within
3 minutes of standing
C) Heart rate increase of 10 bpm upon standing
D) Systolic BP drop of 30 mm Hg upon standing
Answer: B
, Rationale: Orthostatic hypotension is defined as a systolic blood pressure
drop of ≥20 mm Hg or a diastolic drop of ≥10 mm Hg within 3 minutes of
standing.
A patient presents with a skin lesion that is asymmetric, has irregular
borders, varied color, and a diameter greater than 6 mm. What is the most
concerning diagnosis?
A) Seborrheic keratosis
B) Actinic keratosis
C) Melanoma
D) Basal cell carcinoma
Answer: C
Rationale: The ABCDEs of melanoma (Asymmetry, Border irregularity, Color
variation, Diameter >6 mm, Evolution) are key warning signs. This
presentation is highly suspicious for melanoma.
Which immunization is recommended for all adults aged 65 years and
older?
A) Standard-dose influenza vaccine
B) High-dose influenza vaccine
C) Pneumococcal vaccine only
D) No influenza vaccine needed
Answer: B
2026//Complete -Question Practice
Bank with Evidence-Based Rationales
for Nurse Practitioners
Section I: Primary Care Fundamentals & Clinical Reasoning
A 55-year-old male presents with fatigue, unintentional weight loss, and
low-grade fever for 3 weeks. What is the most appropriate initial approach?
A) Reassure the patient and schedule follow-up in 3 months
B) Order a comprehensive metabolic panel, CBC with differential, and
ESR/CRP
C) Prescribe antibiotics for presumed infection
D) Refer immediately to oncology
Answer: B
Rationale: Unexplained weight loss with constitutional symptoms (fever,
night sweats, fatigue) warrants initial laboratory evaluation to screen for
infection, chronic inflammation, or malignancy.
,Which of the following is a key component of the "5 A's" model for
behavioral counseling in primary care?
A) Ask, Advise, Assess, Assist, Arrange
B) Assess, Advise, Agree, Assist, Arrange
C) Admit, Advise, Agree, Assist, Arrange
D) Assess, Advise, Administer, Arrange, Adhere
Answer: B
Rationale: The 5 A's model (Assess, Advise, Agree, Assist, Arrange) is an
evidence-based framework for health behavior counseling in primary care
settings, covering smoking cessation, weight management, and physical
activity.
A 68-year-old female presents with a chief complaint of "dizziness." Which
question is most important to differentiate between vertigo and
lightheadedness?
A) "Do you feel like the room is spinning?"
B) "Do you feel faint or like you might pass out?"
C) "Do you have a headache?"
D) "Do you have chest pain?"
Answer: A
Rationale: Differentiating the quality of dizziness directs the differential
diagnosis. Vertigo is characterized by a sensation of movement (room
spinning), while lightheadedness is a feeling of faintness or near-syncope.
,A 62-year-old male with hypertension and diabetes is being evaluated for
cardiovascular risk. According to USPSTF guidelines, which statin therapy
recommendation is most appropriate?
A) No statin therapy needed
B) Moderate-intensity statin
C) High-intensity statin
D) Refer to cardiology for further evaluation
Answer: C
Rationale: Patients with diabetes and hypertension who have an elevated
10-year ASCVD risk should receive high-intensity statin therapy for primary
prevention.
Which physical examination finding is most consistent with orthostatic
hypotension?
A) Systolic BP drop of 15 mm Hg within 3 minutes of standing
B) Systolic BP drop of 20 mm Hg or diastolic drop of 10 mm Hg within
3 minutes of standing
C) Heart rate increase of 10 bpm upon standing
D) Systolic BP drop of 30 mm Hg upon standing
Answer: B
, Rationale: Orthostatic hypotension is defined as a systolic blood pressure
drop of ≥20 mm Hg or a diastolic drop of ≥10 mm Hg within 3 minutes of
standing.
A patient presents with a skin lesion that is asymmetric, has irregular
borders, varied color, and a diameter greater than 6 mm. What is the most
concerning diagnosis?
A) Seborrheic keratosis
B) Actinic keratosis
C) Melanoma
D) Basal cell carcinoma
Answer: C
Rationale: The ABCDEs of melanoma (Asymmetry, Border irregularity, Color
variation, Diameter >6 mm, Evolution) are key warning signs. This
presentation is highly suspicious for melanoma.
Which immunization is recommended for all adults aged 65 years and
older?
A) Standard-dose influenza vaccine
B) High-dose influenza vaccine
C) Pneumococcal vaccine only
D) No influenza vaccine needed
Answer: B
