CEA Exam
During a post-hospital discharge visit, you notice your 71 Diastole
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
The point of maximum impulse (PMI) is MOST often Left 5th intercostal space, midclavicular line
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.
The nurse practitioner assessing the patient with a rapid Peak of the R wave.
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?
*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.
Michael, a 72 year old male patient who previously Check for thyroid dysfunction
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
While examining a 53 year old female patient, you Positive for egophony
auscultate abnormal breath sounds over all fields, and now
assess transmission of voice sounds by having the patient
say "ee" while auscultating the chest with the diaphragm of
your stethoscope. Normally, you should auscultate a
muffled "e" sound, however, you hear hear a nasally "a"
sound. Which one of the following will you document is
present?
*Positive stereognosis.
*Positive for egophony.
*Negative for bronchophony.
*Negative for egophony
While assessing the 19 year old patient for a new onset To identify if underlying tissue are air-filled, fluid-filled or consolidated
cough, the nurse practitioner may inspect, auscultate,
palpate, and/or percuss.
How does performing percussion of the thorax assist the
provider during the physical examination?
*To assist with the confirmation of cardiac origin of angina.
*To assess for deep-seated lesion and tumors.
*To assess for any pain or discomfort prior to palpitation of
the chest wall.
*To identify if underlying tissue are air-filled, fluid-filled or
consolidated
, CEA Exam
Your 42 year old male patient has been referred to your Approximately equal level of change in the descent of the diaphragm bilaterally
clinic for establishing care and on his intake survey, you during maximal inspiration and expiration. with a decreased overall inspiratory
note he has documented diagnosis of interstitial lung capacity
disease. You have decided to perform a diaphragmatic
excursion test on the patient. Which one of the following
results would you expect to see in this patient?
*Approximately equal level of change in the descent of the
diaphragm bilaterally during maximal inspiration and
expiration. with a decreased overall inspiratory capacity.
*Ascension of 8-12 inches of the diaphragm noted
bilaterally on expiration, though often much less on the
right side due to the location of the heart and great
vessels.
*Much greater descent of the diaphragm on the right side
due to the liver present (two-three times larger).
*Absent or no change in movement of the diaphragm
noted between full inspiration and full expiration
measurement.
Your 50 year old Caucasian male patient has not seen a Severe hypothyroidism
primary care giver in 20+ years and is here for a history
and physical examination. While examining the head and
face, you see your patient has nonpitting periorbital
edema, particularly underneath their eyes and very dry,
thinned hair, including the lateral third of eyebrows (as
pictured below: Sparse hairline, thin lateral eyebrows,
Periobital edema). Which one of the folowing would you
expect to cause this finding?
*Severe hypothyroidism
*Addison's disease
*Grave's disease
*Alzhemiers.
A40 year old, female, African American patient presents for Hyperthyroidism.
history and physical. Upon your initial assessment, you
notice she has severe exophthalmos as pictured below.
Which one of the following diagnoses below would be the
highest on your differential diagnose of this physical
examination finding? (eyes bulging out of her head)
*Bilateral conjunctivitis.
*Hyperthyroidism.
*hypothyroidism
*myexedma
Your patient with a suspected diagnosis of COPD has Forced Vital Capacity.
been seen by pulmonology and has underwent a
pulmonary function test (PFT) with spirometry. As the
patient's primary healthcare provider, you have been
asked to explain the findings of the PFT to the patient in a
follow-up visit at which time the patient asks what the study
was evaluating. To describe the PFT to the patient in more
useful terms, you state that the large inspiration of air to
the furthest extent they could reasonably accomplish
followed by a full exhalation is referred to as which of the
following measurements during the PFT?
*Forced Expiratory Volume over 1 second (FEV1).
*Functional Reserve Capacity.
*Inspiratory Reserve
*Forced Vital Capacity.
Your newly established patient states in the past year, they ?
have progressively developed a noticeable bump on their
neck and when asked about symptoms, they report feeling
very anxious, have developed a tremor, and are commonly
feeling palpitations in their chest.
On examination, you identify an enlarged thyroid gland
suspicious for a goiter. Of the following diagnoses, which is
most likely for the patient to develop based on these
findings above?
*Thyrotoxicosis.
*lodine Excess.
*Myxedema Coma.
*Hashimotos Thyroiditis...not this one
, CEA Exam
Your 32 year old female patient presented for a routine Tachycardia
health exam states they have a diagnoses of
hyperthyroidism by another
provider a year ago. In addition to evaluation with TSH and
T4 labwork, which of the following represent typical signs
of hyperthyroidism expected on your exam of this patient?
*Hypersomnia
*Tachycardia.
*Lethargy.
*Recent unplanned weight gain.
Your patient has a diagnosis of Addison's disease. Which ?
of the following might you expect to find during
examination?
*Abdominal striae.
*Dowager hump.
*Low body temperature.
*Moon face...not this one
The nurse practitioner's evaluation of apatient with All of these are appropriate options.
Diabetes Mellitus type 2 should include which of the
folowing while evaluating
for end organ dysfunction of the disease?
*Renal function panel.
*Urinalysis.
*Non-dilated eye exam.
*All of these are appropriate options.
Your patient with a diagnosis of autoimmune hepatitis is ?
being
seen in your clinic for routine liver serology and follow-up
examination. Which of the following correctly identifies the
normal liver span when percussing the liver of a HEALTHY
adult?
*6-12 cm in the midsternal line
*4-8 in the left midclavicular line...not this one
*4-8 cm in the right midclavicular line
*6-12 cm in the right midclavicular line.
The 33 year old male patient presents with complaints of Inspection, auscultation, palpation, percussion
abdominal pain after a recent birthday party where other
guests also
suspected food borne illness and gastroenteritis. To elicit
the most accurate evaluation of this patient, which is the
order of assessment which should be done for the
abdomen?
*Inspection, auscultation, palpation, percussion.
*Inspection, auscultation, percussion, palpation.
*Percussion, auscultation, palpation, inspection.
*Auscultation, palpation, percussion, inspection
The 19 year old male patient presents with acute ?Absence of pain with withdrawal of palpation.
symptoms
of abdominal pain and a history of intermittent heartburn
and spicy food
intolerance, as well as anxiety due to his college athletic
performance. You have a concern the patient may have a
perforated gastric ulcer and is experiencing peritonitis.
Which of the following exam findings is NOT supportive of
this diagnosis?
*Guarding.
*Rebound tenderness.
*Absence of pain with withdrawal of palpation.
*Rigidity.
During a post-hospital discharge visit, you notice your 71 Diastole
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
The point of maximum impulse (PMI) is MOST often Left 5th intercostal space, midclavicular line
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.
The nurse practitioner assessing the patient with a rapid Peak of the R wave.
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?
*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.
Michael, a 72 year old male patient who previously Check for thyroid dysfunction
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
While examining a 53 year old female patient, you Positive for egophony
auscultate abnormal breath sounds over all fields, and now
assess transmission of voice sounds by having the patient
say "ee" while auscultating the chest with the diaphragm of
your stethoscope. Normally, you should auscultate a
muffled "e" sound, however, you hear hear a nasally "a"
sound. Which one of the following will you document is
present?
*Positive stereognosis.
*Positive for egophony.
*Negative for bronchophony.
*Negative for egophony
While assessing the 19 year old patient for a new onset To identify if underlying tissue are air-filled, fluid-filled or consolidated
cough, the nurse practitioner may inspect, auscultate,
palpate, and/or percuss.
How does performing percussion of the thorax assist the
provider during the physical examination?
*To assist with the confirmation of cardiac origin of angina.
*To assess for deep-seated lesion and tumors.
*To assess for any pain or discomfort prior to palpitation of
the chest wall.
*To identify if underlying tissue are air-filled, fluid-filled or
consolidated
, CEA Exam
Your 42 year old male patient has been referred to your Approximately equal level of change in the descent of the diaphragm bilaterally
clinic for establishing care and on his intake survey, you during maximal inspiration and expiration. with a decreased overall inspiratory
note he has documented diagnosis of interstitial lung capacity
disease. You have decided to perform a diaphragmatic
excursion test on the patient. Which one of the following
results would you expect to see in this patient?
*Approximately equal level of change in the descent of the
diaphragm bilaterally during maximal inspiration and
expiration. with a decreased overall inspiratory capacity.
*Ascension of 8-12 inches of the diaphragm noted
bilaterally on expiration, though often much less on the
right side due to the location of the heart and great
vessels.
*Much greater descent of the diaphragm on the right side
due to the liver present (two-three times larger).
*Absent or no change in movement of the diaphragm
noted between full inspiration and full expiration
measurement.
Your 50 year old Caucasian male patient has not seen a Severe hypothyroidism
primary care giver in 20+ years and is here for a history
and physical examination. While examining the head and
face, you see your patient has nonpitting periorbital
edema, particularly underneath their eyes and very dry,
thinned hair, including the lateral third of eyebrows (as
pictured below: Sparse hairline, thin lateral eyebrows,
Periobital edema). Which one of the folowing would you
expect to cause this finding?
*Severe hypothyroidism
*Addison's disease
*Grave's disease
*Alzhemiers.
A40 year old, female, African American patient presents for Hyperthyroidism.
history and physical. Upon your initial assessment, you
notice she has severe exophthalmos as pictured below.
Which one of the following diagnoses below would be the
highest on your differential diagnose of this physical
examination finding? (eyes bulging out of her head)
*Bilateral conjunctivitis.
*Hyperthyroidism.
*hypothyroidism
*myexedma
Your patient with a suspected diagnosis of COPD has Forced Vital Capacity.
been seen by pulmonology and has underwent a
pulmonary function test (PFT) with spirometry. As the
patient's primary healthcare provider, you have been
asked to explain the findings of the PFT to the patient in a
follow-up visit at which time the patient asks what the study
was evaluating. To describe the PFT to the patient in more
useful terms, you state that the large inspiration of air to
the furthest extent they could reasonably accomplish
followed by a full exhalation is referred to as which of the
following measurements during the PFT?
*Forced Expiratory Volume over 1 second (FEV1).
*Functional Reserve Capacity.
*Inspiratory Reserve
*Forced Vital Capacity.
Your newly established patient states in the past year, they ?
have progressively developed a noticeable bump on their
neck and when asked about symptoms, they report feeling
very anxious, have developed a tremor, and are commonly
feeling palpitations in their chest.
On examination, you identify an enlarged thyroid gland
suspicious for a goiter. Of the following diagnoses, which is
most likely for the patient to develop based on these
findings above?
*Thyrotoxicosis.
*lodine Excess.
*Myxedema Coma.
*Hashimotos Thyroiditis...not this one
, CEA Exam
Your 32 year old female patient presented for a routine Tachycardia
health exam states they have a diagnoses of
hyperthyroidism by another
provider a year ago. In addition to evaluation with TSH and
T4 labwork, which of the following represent typical signs
of hyperthyroidism expected on your exam of this patient?
*Hypersomnia
*Tachycardia.
*Lethargy.
*Recent unplanned weight gain.
Your patient has a diagnosis of Addison's disease. Which ?
of the following might you expect to find during
examination?
*Abdominal striae.
*Dowager hump.
*Low body temperature.
*Moon face...not this one
The nurse practitioner's evaluation of apatient with All of these are appropriate options.
Diabetes Mellitus type 2 should include which of the
folowing while evaluating
for end organ dysfunction of the disease?
*Renal function panel.
*Urinalysis.
*Non-dilated eye exam.
*All of these are appropriate options.
Your patient with a diagnosis of autoimmune hepatitis is ?
being
seen in your clinic for routine liver serology and follow-up
examination. Which of the following correctly identifies the
normal liver span when percussing the liver of a HEALTHY
adult?
*6-12 cm in the midsternal line
*4-8 in the left midclavicular line...not this one
*4-8 cm in the right midclavicular line
*6-12 cm in the right midclavicular line.
The 33 year old male patient presents with complaints of Inspection, auscultation, palpation, percussion
abdominal pain after a recent birthday party where other
guests also
suspected food borne illness and gastroenteritis. To elicit
the most accurate evaluation of this patient, which is the
order of assessment which should be done for the
abdomen?
*Inspection, auscultation, palpation, percussion.
*Inspection, auscultation, percussion, palpation.
*Percussion, auscultation, palpation, inspection.
*Auscultation, palpation, percussion, inspection
The 19 year old male patient presents with acute ?Absence of pain with withdrawal of palpation.
symptoms
of abdominal pain and a history of intermittent heartburn
and spicy food
intolerance, as well as anxiety due to his college athletic
performance. You have a concern the patient may have a
perforated gastric ulcer and is experiencing peritonitis.
Which of the following exam findings is NOT supportive of
this diagnosis?
*Guarding.
*Rebound tenderness.
*Absence of pain with withdrawal of palpation.
*Rigidity.
