P R O F E S S I O N A L P R A C T I C E M AT E R I A L S
NR 601 CEA Certification Exam
Questions & Answers 2026-2027
(Rationales)
Verified Answers Exam Ready With Rationales
149 QUESTIONS
DOCUMENT OVERVIEW
This document provides 149 questions with their correct answers and detailed rationales, focusing on
advanced practice nursing assessment and management. It is suitable for in-depth study, comprehensive
review, and targeted certification preparation.
CONTENTS
01 02 03
• Cardiovascular Assessment & Conditions
• Pulmonary & Respiratory Assessment • Pharmacology & Therapeutics
04 05 06
• Endocrine & Metabolic Disorders • Gastrointestinal & Hepatic Assessment• Neurological & Sensory Assessment
07 08 09
• Hematologic & Renal Disorders • Infectious Disease & Immunology • Musculoskeletal & Integumentary Asse
10 • Psychiatric & Mental Health 11 • Reproductive & GU Health
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, E XA M Q U EST I O N S
Q1 QUESTION 1 OF 149
During a post-hospital discharge visit, you notice your 71 year old female patient has been diagnosed with a "new murmur"
found by the hospitalist during their recent hospitalization for CHF exacerbation. In evaluating the patient, during which
phase of the cardiac cycle would you anticipate auscultation of a S3 or S4 heart sound?
*Diastole
*53 in systole while S4 in diastole
*Systole
*S4 in diastole while S3 in systole
CORRECT ANSWER
Diastole
RATIONALE
S3 and S4 heart sounds are gallops that occur during diastole, representing rapid ventricular filling (S3) or atrial contraction into a
stiff ventricle (S4). These abnormal sounds indicate impaired ventricular compliance or volume overload, often associated with
conditions like heart failure.
Q2 QUESTION 2 OF 149
The point of maximum impulse (PMI) is MOST often palpable in healthy adults when positioned in the supine or left lateral
decubitus position. Which one of the following locations is most commonly described as the PMI in a healthy adult?
*Left 2nd intercostal space, midaxillary line.
*Left 5th intercostal space, midclavicular line.
*Right 4th intercostal space, midaxillary line.
*Right 2nd intercostal space, midclavicular line.
CORRECT ANSWER
Left 5th intercostal space, midclavicular line
RATIONALE
The point of maximal impulse, representing the apex of the left ventricle's contraction, is typically located at the intersection of the
left midclavicular line and the 5th intercostal space. This anatomical position allows for the most direct palpation of the heart's
forceful impulse against the chest wall.
Q3 QUESTION 3 OF 149
The nurse practitioner assessing the patient with a rapid cardiac rhythm may assess for a pulse deficit by auscultating the
patient's heart while watching the EKG rhythm. Where would the S1 heart sounds correlate with the electrocardiographic
waves?
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,*At the end of the T wave.
*At the start of the T wave.
*Peak of the R wave.
*At the start of the P wave.
CORRECT ANSWER
Peak of the R wave.
RATIONALE
The S1 heart sound, representing mitral and tricuspid valve closure, coincides with ventricular depolarization and is best
approximated by the peak of the R wave on the electrocardiogram. This corresponds to the electrical event initiating ventricular
contraction and subsequent valve closure.
Q4 QUESTION 4 OF 149
Michael, a 72 year old male patient who previously presented with stable cardiac-type chest pain has underwent a stress
test. He presents today to review the stress test results, which show EKG findings of ST segment depression during the
exam in leads V3 and V4 as well as some concurrent chest discomfort. Based on these findings, which of the following are
NOT priority medical decisions?
*Prescribe metoprolol (Lopressor) 12.5mg PO BID
*Prescribe aspirin 81mg PO daily
*Refer to cardiology for angiography
• Check for thyroid dysfunction
CORRECT ANSWER
Check for thyroid dysfunction
RATIONALE
ST segment depression in V3-V4 during a stress test indicates myocardial ischemia, necessitating immediate management with
beta-blockers and antiplatelet agents, and urgent referral for angiography to assess coronary anatomy. Thyroid dysfunction is not a
primary cause of acute ischemic findings on EKG during exertion.
Q5 QUESTION 5 OF 149
Your 22 year old male patient states during his review of systems that
his scrotum is very enlarged and feels like it is full of worms. He is a powerlifter and works as a trash collector. You suspect
the patient likely has which of the following diagnoses?
*Varicocele
*Meningocele
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, *Rectocele.
*Hydrocele.
CORRECT ANSWER
Varicocele
RATIONALE
A varicocele, a dilation of the pampiniform plexus veins within the scrotum, characteristically presents as a scrotal enlargement
perceived as a "bag of worms." This contrasts with meningocele (herniation of meninges), rectocele (rectal herniation into the
vagina), and hydrocele (fluid accumulation in the tunica vaginalis).
Q6 QUESTION 6 OF 149
The patient with congestive heart failure with an ejection fraction of 35% has become symptomatic with shortness of
breath when performing activities of daily living but does not have any symptoms at rest. This is suggestive of New York
Heart Association heart
failure classification?
*Class I
*Class III
*Class IV
*Class I
CORRECT ANSWER
Class III
RATIONALE
New York Heart Association Class III heart failure is characterized by marked limitation of physical activity, with symptoms occurring
during less-than-ordinary exertion. While the patient has symptoms with ADLs, they are asymptomatic at rest, distinguishing it from
Class IV.
Q7 QUESTION 7 OF 149
Your patient has presented with a new onset rapid heart rate that
is irregularly irregular, heart rate 100, BP 120/74, R 16 non labored, and SP02 is 99%. They state this has been going on for a
week or so intermittently, but for the last 4 days straight it hasn't stopped. Your first priority intervention for this patient is
to do which of the following:
Treat with vagal maneuvers for suspected supraventricular tachycardia (SVT) Maintain rate control and anticoagulate prior
to rhythm conversion
*Notify EMS to initiate transport for emergency evaluation
*Ask about their family cardiac history
CORRECT ANSWER
Maintain rate control and anticoagulate prior to rhythm conversion
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