CEA EXAM 150 COMPREHENSIVE CERTIFIED
ENERGY AUDITOR STUDY GUIDE 2026
◉ The inability to fully relax the myocardium during relaxation is a
trademark of which of the following diagnoses.
Answer: Diastolic dysfunction
Rationale: The inability for the heart to relax is a trademark of the
diagnosis of diastolic dysfunction and is common in patients with
thickened hypertrophic myocardium.
◉ An otherwise healthy African American adult male has been
diagnosed with hypertension. He has been restricting his salt intake,
eating a DASH (Dietary Approaches to Stop Hypertension) diet, and
exercising more, but his blood pressure is still elevated. Which is the
BEST medication to prescribe him?.
Answer: Calcium channel blocker
Rationale: African American patients per JNC8 Hypertension
Guidelines should be managed with a dihydropyridine calcium
channel blocker such as amlodipine (Norvasc) as first line
management therapy for hypertension not at goal with DASH and
lifestyle modifications.
◉ Your patient has been diagnosed with a 4.5cm ascending aortic
aneurysm. Which medical imaging is considered standard of care for
serial surveillance?.
,Answer: CT angiography of the chest
Rationale: CT angiography is considered the standard of care for
measuring vascular luminal dimensions with contrast. CT PE
protocol is not timed properly for the aorta (it's timed for the
pulmonary artery). Although a plain film is able to catch large
aneurysms at times, they are not able to provide multi-axis
reconstruction needed to accurately measure the size.
Transesophageal echo is not needed to accurately measure the aorta
and requires the patient to undergo sedation which is unnecessary.
◉ Which of the following medications does not cause beta 1
stimulation?.
Answer: phenylephrine
Rationale: Phenylephrine only stimulates alpha 1 receptors. The
remaining three all have beta receptor activity.
◉ A 50-year-old woman with a history of hypertension presents
with dyspnea on exertion and orthopnea. On examination, she has
jugular venous distention and bilateral crackles on lung
auscultation. What is the most likely diagnosis?.
Answer: Congestive heart failure
Rationale: Of the available options, the most accurate response is
congestive heart failure as it is signifying both a right ventricular
back up with jugular venous extension and crackles on lung assault,
which are suggestive of left ventricular back up. it is possible the
patient may have an acute myocardial infarction that precipitated
,this, however, a patient has not described that, rather is only
describing dyspnea on exertion and orthopnea, which both speak to
a state of fluid overload. The only appropriate response of these
available is congestive heart failure.
◉ Your patient with a history of HFrEF (heart failure with reduced
ejection fraction) with an ejection fraction of 40% who is also not on
optimal medical therapy has been diagnosed with a myocardial
infarction this admission and received emergent placement of a
drug-eluting stent to the left anterior descending artery. As the
medical home who will manage this patient after discharge, which
medication strategy would you expect to be a priority in the
patient's care?.
Answer: Ordering a transthoracic echocardiogram and order a
Lifevest if EF is less than 35%
Rationale: The patient should have a protective mechanism such as
an implantable automated cardioverter defibrillator (AICD) or a
Lifevest if the EF is less than 35% due to the increased risk of
sudden cardiac death with low EF states. Since most patients are not
eligible for 90 days for an AICD in this state, optimizing their
medication regimen and repeating an echo in 2-3 months to re-
evaluate for improvement in their EF is required by most insurance
companies. A baseline echo is needed at discharge to provide a
baseline for improvement vs their repeat echo in 2-3 months.
Dual anti-platelet therapy is required for 12 months minimum post-
MI.
, A Holter monitor does not provide any conceivable benefit for this
patient as presented.
◉ Which of the following people groups represent the least risk of
cardiac disease?.
Answer: Caucasians
Rationale: Statistically African Americans, Native Hawaiians, and
American Indians are at at increased risk of cardiac disease due to
higher rates of hypertension, diabetes, and obesity than Caucasians.
◉ A 65-year-old woman presents for a follow-up examination. She is
a smoker, and her hypertension is now adequately controlled with
medication. Her mother died at age 40 from a heart attack. The
fasting lipid profile shows cholesterol = 240 mg/dL, HDL = 30, and
LDL = 200. In addition to starting therapeutic lifestyle changes, the
nurse practitioner should start the patient on:.
Answer: a statin drug.
Rationale: Bile acid sequestrants and cholesterol absorption
inhibitors may be useful in reducing ASVD risk, but for a patient who
is an active smoker with premature coronary disease history (less
than age 65 for women), has hypertension and is far from an LDL
goal, this patient is most certainly a candidate for statin therapy,
which represents the most aggressive therapy option of these four
listed.
ENERGY AUDITOR STUDY GUIDE 2026
◉ The inability to fully relax the myocardium during relaxation is a
trademark of which of the following diagnoses.
Answer: Diastolic dysfunction
Rationale: The inability for the heart to relax is a trademark of the
diagnosis of diastolic dysfunction and is common in patients with
thickened hypertrophic myocardium.
◉ An otherwise healthy African American adult male has been
diagnosed with hypertension. He has been restricting his salt intake,
eating a DASH (Dietary Approaches to Stop Hypertension) diet, and
exercising more, but his blood pressure is still elevated. Which is the
BEST medication to prescribe him?.
Answer: Calcium channel blocker
Rationale: African American patients per JNC8 Hypertension
Guidelines should be managed with a dihydropyridine calcium
channel blocker such as amlodipine (Norvasc) as first line
management therapy for hypertension not at goal with DASH and
lifestyle modifications.
◉ Your patient has been diagnosed with a 4.5cm ascending aortic
aneurysm. Which medical imaging is considered standard of care for
serial surveillance?.
,Answer: CT angiography of the chest
Rationale: CT angiography is considered the standard of care for
measuring vascular luminal dimensions with contrast. CT PE
protocol is not timed properly for the aorta (it's timed for the
pulmonary artery). Although a plain film is able to catch large
aneurysms at times, they are not able to provide multi-axis
reconstruction needed to accurately measure the size.
Transesophageal echo is not needed to accurately measure the aorta
and requires the patient to undergo sedation which is unnecessary.
◉ Which of the following medications does not cause beta 1
stimulation?.
Answer: phenylephrine
Rationale: Phenylephrine only stimulates alpha 1 receptors. The
remaining three all have beta receptor activity.
◉ A 50-year-old woman with a history of hypertension presents
with dyspnea on exertion and orthopnea. On examination, she has
jugular venous distention and bilateral crackles on lung
auscultation. What is the most likely diagnosis?.
Answer: Congestive heart failure
Rationale: Of the available options, the most accurate response is
congestive heart failure as it is signifying both a right ventricular
back up with jugular venous extension and crackles on lung assault,
which are suggestive of left ventricular back up. it is possible the
patient may have an acute myocardial infarction that precipitated
,this, however, a patient has not described that, rather is only
describing dyspnea on exertion and orthopnea, which both speak to
a state of fluid overload. The only appropriate response of these
available is congestive heart failure.
◉ Your patient with a history of HFrEF (heart failure with reduced
ejection fraction) with an ejection fraction of 40% who is also not on
optimal medical therapy has been diagnosed with a myocardial
infarction this admission and received emergent placement of a
drug-eluting stent to the left anterior descending artery. As the
medical home who will manage this patient after discharge, which
medication strategy would you expect to be a priority in the
patient's care?.
Answer: Ordering a transthoracic echocardiogram and order a
Lifevest if EF is less than 35%
Rationale: The patient should have a protective mechanism such as
an implantable automated cardioverter defibrillator (AICD) or a
Lifevest if the EF is less than 35% due to the increased risk of
sudden cardiac death with low EF states. Since most patients are not
eligible for 90 days for an AICD in this state, optimizing their
medication regimen and repeating an echo in 2-3 months to re-
evaluate for improvement in their EF is required by most insurance
companies. A baseline echo is needed at discharge to provide a
baseline for improvement vs their repeat echo in 2-3 months.
Dual anti-platelet therapy is required for 12 months minimum post-
MI.
, A Holter monitor does not provide any conceivable benefit for this
patient as presented.
◉ Which of the following people groups represent the least risk of
cardiac disease?.
Answer: Caucasians
Rationale: Statistically African Americans, Native Hawaiians, and
American Indians are at at increased risk of cardiac disease due to
higher rates of hypertension, diabetes, and obesity than Caucasians.
◉ A 65-year-old woman presents for a follow-up examination. She is
a smoker, and her hypertension is now adequately controlled with
medication. Her mother died at age 40 from a heart attack. The
fasting lipid profile shows cholesterol = 240 mg/dL, HDL = 30, and
LDL = 200. In addition to starting therapeutic lifestyle changes, the
nurse practitioner should start the patient on:.
Answer: a statin drug.
Rationale: Bile acid sequestrants and cholesterol absorption
inhibitors may be useful in reducing ASVD risk, but for a patient who
is an active smoker with premature coronary disease history (less
than age 65 for women), has hypertension and is far from an LDL
goal, this patient is most certainly a candidate for statin therapy,
which represents the most aggressive therapy option of these four
listed.
