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NR 511 CEA Exam | 150 Comprehensive Practice
Questions with Verified Answers and Detailed
Rationales 2026–2027 | Differential Diagnosis &
Primary Care | Nurse Practitioner Primary Care
Exam Prep | Graded A+ | 100% Pass Guaranteed
CARDIOVASCULAR SYSTEM (Questions 1-25)
1. A grade III/VI, low-pitched, diastolic, rumbling murmur heard at the
apex, best heard in the left lateral decubitus position, is most indicative
of which valve problem?
a) Aortic stenosis
b) Mitral regurgitation
c) Mitral stenosis
d) Aortic regurgitation
Answer: c
Rationale: As a general rule, left chest wall murmurs are mitral in
etiology, right chest and neck murmurs are aortic in nature. A diastolic
low-pitch mitral murmur represents the sound of blood filling the left
ventricle through a restriction (stenosis), which is by definition mitral
stenosis [citation:8].
2. A patient presents with a diastolic murmur best heard at the left sternal
border. This is most consistent with:
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a) Mitral stenosis
b) Aortic regurgitation
c) Mitral regurgitation
d) Aortic stenosis
Answer: b
Rationale: Aortic regurgitation produces a diastolic murmur heard best at
the left sternal border. Mitral stenosis produces a diastolic murmur at the
apex. Mitral regurgitation and aortic stenosis are systolic murmurs
[citation:8].
3. A patient with suspected infective endocarditis should have which
diagnostic test performed?
a) Transesophageal echocardiogram (TEE)
b) Transthoracic echocardiogram (TTE)
c) Nuclear stress test
d) Tilt table test
Answer: a
Rationale: TEE is more sensitive than TTE for detecting vegetations in
infective endocarditis and is the preferred imaging modality. The patient
undergoing TEE requires procedural sedation [citation:8].
4. On palpation over the carotid artery, you do not feel a pulse. The
cardiac monitor shows a normal rhythm with a rate of 80. What is the
most likely rhythm?
a) Idioventricular rhythm
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b) Junctional tachycardia
c) Wandering atrial pacemaker
d) Pulseless electrical activity (PEA)
Answer: d
Rationale: PEA appears as a normal rhythm without a pulse.
Idioventricular rhythm is very slow (20-40 bpm). Junctional tachycardia
and WAP without pulses are also considered PEA [citation:8].
5. A patient presents with a systolic ejection murmur best heard at the
right upper sternal border. What is the most likely diagnosis?
a) Aortic stenosis
b) Mitral regurgitation
c) Mitral stenosis
d) Aortic regurgitation
Answer: a
Rationale: Aortic stenosis produces a systolic ejection murmur heard
best at the right upper sternal border (2nd intercostal space) with
radiation to the carotids [citation:8].
6. Which murmur is best heard in the left lateral decubitus position?
a) Aortic stenosis
b) Mitral stenosis
c) Aortic regurgitation
d) Pulmonic stenosis
Answer: b
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Rationale: Mitral stenosis is best heard in the left lateral decubitus
position at the apex. This position brings the mitral valve closer to the
chest wall [citation:8].
7. A patient with mitral stenosis would most likely present with:
a) Dyspnea on exertion and atrial fibrillation
b) Chest pain and syncope
c) Murmur that radiates to the carotids
d) Holosystolic murmur
Answer: a
Rationale: Mitral stenosis causes left atrial enlargement and can lead to
atrial fibrillation. Patients typically present with dyspnea on exertion due
to pulmonary congestion [citation:8].
8. A patient with aortic regurgitation may present with:
a) Wide pulse pressure and bounding pulses
b) Narrow pulse pressure
c) Syncope
d) Angina
Answer: a
Rationale: Aortic regurgitation causes a wide pulse pressure (high
systolic, low diastolic) and bounding pulses (Corrigan's pulse, water
hammer pulse) due to the rapid runoff of blood from the aorta
[citation:8].
NR 511 CEA Exam | 150 Comprehensive Practice
Questions with Verified Answers and Detailed
Rationales 2026–2027 | Differential Diagnosis &
Primary Care | Nurse Practitioner Primary Care
Exam Prep | Graded A+ | 100% Pass Guaranteed
CARDIOVASCULAR SYSTEM (Questions 1-25)
1. A grade III/VI, low-pitched, diastolic, rumbling murmur heard at the
apex, best heard in the left lateral decubitus position, is most indicative
of which valve problem?
a) Aortic stenosis
b) Mitral regurgitation
c) Mitral stenosis
d) Aortic regurgitation
Answer: c
Rationale: As a general rule, left chest wall murmurs are mitral in
etiology, right chest and neck murmurs are aortic in nature. A diastolic
low-pitch mitral murmur represents the sound of blood filling the left
ventricle through a restriction (stenosis), which is by definition mitral
stenosis [citation:8].
2. A patient presents with a diastolic murmur best heard at the left sternal
border. This is most consistent with:
,2 | Page
a) Mitral stenosis
b) Aortic regurgitation
c) Mitral regurgitation
d) Aortic stenosis
Answer: b
Rationale: Aortic regurgitation produces a diastolic murmur heard best at
the left sternal border. Mitral stenosis produces a diastolic murmur at the
apex. Mitral regurgitation and aortic stenosis are systolic murmurs
[citation:8].
3. A patient with suspected infective endocarditis should have which
diagnostic test performed?
a) Transesophageal echocardiogram (TEE)
b) Transthoracic echocardiogram (TTE)
c) Nuclear stress test
d) Tilt table test
Answer: a
Rationale: TEE is more sensitive than TTE for detecting vegetations in
infective endocarditis and is the preferred imaging modality. The patient
undergoing TEE requires procedural sedation [citation:8].
4. On palpation over the carotid artery, you do not feel a pulse. The
cardiac monitor shows a normal rhythm with a rate of 80. What is the
most likely rhythm?
a) Idioventricular rhythm
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b) Junctional tachycardia
c) Wandering atrial pacemaker
d) Pulseless electrical activity (PEA)
Answer: d
Rationale: PEA appears as a normal rhythm without a pulse.
Idioventricular rhythm is very slow (20-40 bpm). Junctional tachycardia
and WAP without pulses are also considered PEA [citation:8].
5. A patient presents with a systolic ejection murmur best heard at the
right upper sternal border. What is the most likely diagnosis?
a) Aortic stenosis
b) Mitral regurgitation
c) Mitral stenosis
d) Aortic regurgitation
Answer: a
Rationale: Aortic stenosis produces a systolic ejection murmur heard
best at the right upper sternal border (2nd intercostal space) with
radiation to the carotids [citation:8].
6. Which murmur is best heard in the left lateral decubitus position?
a) Aortic stenosis
b) Mitral stenosis
c) Aortic regurgitation
d) Pulmonic stenosis
Answer: b
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Rationale: Mitral stenosis is best heard in the left lateral decubitus
position at the apex. This position brings the mitral valve closer to the
chest wall [citation:8].
7. A patient with mitral stenosis would most likely present with:
a) Dyspnea on exertion and atrial fibrillation
b) Chest pain and syncope
c) Murmur that radiates to the carotids
d) Holosystolic murmur
Answer: a
Rationale: Mitral stenosis causes left atrial enlargement and can lead to
atrial fibrillation. Patients typically present with dyspnea on exertion due
to pulmonary congestion [citation:8].
8. A patient with aortic regurgitation may present with:
a) Wide pulse pressure and bounding pulses
b) Narrow pulse pressure
c) Syncope
d) Angina
Answer: a
Rationale: Aortic regurgitation causes a wide pulse pressure (high
systolic, low diastolic) and bounding pulses (Corrigan's pulse, water
hammer pulse) due to the rapid runoff of blood from the aorta
[citation:8].
