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NR 603 CEA EXAM /ACTUAL NR 603 CEA FINAL EXAM
2026/2027 PRACTICE QUESTIONS AND STUDY GUIDE
COMPLETE ACCURATE EXAM REAL QUESTIONS AND
CORRECT DETAILED SOLUTIONS WITH RATIONALES
(100% EXPERT VERIFIED ANSWERS)
1. A 58-year-old man presents to an outpatient clinic with crushing substernal chest
pressure radiating to his left arm, diaphoresis, and nausea that began 30 minutes
ago. Which diagnostic test should the clinician prioritize immediately?
A. Exercise treadmill stress test
B. 12-lead electrocardiogram
C. Transthoracic echocardiogram
D. Coronary CT angiography
Answer: B
Rationale: A 12-lead ECG should be obtained promptly in a patient with
suspected acute coronary syndrome because it can rapidly identify ST-segment
elevation requiring emergent reperfusion. Cardiac biomarkers are also important
but should not delay the initial ECG.
2. A 67-year-old woman presents with exertional substernal chest pressure that
resolves after several minutes of rest. She has hypertension, diabetes, and
hyperlipidemia. Her symptoms have remained predictable for several months.
Which diagnosis is most consistent with this presentation?
A. Stable angina
B. Acute pericarditis
C. Aortic dissection
D. Pulmonary embolism
Answer: A
Rationale: Predictable exertional chest discomfort that improves with rest is
characteristic of stable angina. The clinician should nevertheless assess
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cardiovascular risk and determine whether additional ischemic evaluation is
indicated.
3. A 72-year-old patient with heart failure with reduced ejection fraction presents
with worsening dyspnea, orthopnea, elevated jugular venous pressure, pulmonary
crackles, and bilateral lower-extremity edema. Which medication class is most
directly useful for rapidly relieving the patient's volume-overload symptoms?
A. Loop diuretic
B. Statin
C. Proton-pump inhibitor
D. Bisphosphonate
Answer: A
Rationale: Loop diuretics reduce intravascular and extravascular volume and are
central to relieving congestion in acute decompensated heart failure. Long-term
guideline-directed therapy remains important but does not provide the same
immediate relief of fluid overload.
4. A 64-year-old man with hypertension has an office blood pressure of 168/96
mm Hg on two separate visits. He has no acute symptoms or evidence of
hypertensive emergency. Which approach is most appropriate?
A. Immediate IV antihypertensive therapy
B. Confirm persistent hypertension and initiate appropriate outpatient management
C. Discontinue all antihypertensive therapy
D. Restrict all oral fluids for 24 hours
Answer: B
Rationale: Severe blood pressure elevation without acute target-organ injury is
generally managed with appropriate outpatient evaluation and treatment rather than
rapid IV reduction. Hypertensive emergency requires evidence of acute target-
organ damage.
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5. A 45-year-old woman reports episodic palpitations, tremulousness, heat
intolerance, weight loss despite increased appetite, and anxiety. Examination
reveals a fine tremor and tachycardia. Laboratory testing shows suppressed TSH
and elevated free T4. Which diagnosis is most likely?
A. Primary hypothyroidism
B. Hyperthyroidism
C. Addison disease
D. Cushing syndrome
Answer: B
Rationale: Suppressed TSH with elevated free T4 indicates primary
hyperthyroidism. The clinical findings of heat intolerance, weight loss, tremor, and
tachycardia are consistent with thyroid hormone excess.
6. A 54-year-old patient with type 2 diabetes has an HbA1c of 9.2% despite
adherence to metformin and lifestyle modification. The patient has established
atherosclerotic cardiovascular disease. Which medication class may provide both
glucose-lowering and cardiovascular benefit?
A. GLP-1 receptor agonist
B. Short-acting sulfonylurea only
C. Alpha-glucosidase inhibitor only
D. Meglitinide only
Answer: A
Rationale: Certain GLP-1 receptor agonists have demonstrated cardiovascular
benefit in patients with type 2 diabetes and established cardiovascular disease.
Treatment should be individualized according to comorbidities, contraindications,
adverse effects, and patient preferences.
7. A 61-year-old man with diabetes presents with burning pain and decreased
sensation in both feet. Examination demonstrates reduced vibration and
monofilament sensation bilaterally. Which complication is most consistent with
these findings?
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A. Diabetic peripheral neuropathy
B. Acute arterial occlusion
C. Myasthenia gravis
D. Guillain-Barré syndrome
Answer: A
Rationale: Symmetric distal sensory loss and burning or tingling sensations are
typical of diabetic distal symmetric polyneuropathy. Routine foot assessment is
important because sensory loss increases the risk of unnoticed trauma and
ulceration.
8. A 59-year-old smoker presents with chronic cough, progressive exertional
dyspnea, and prolonged expiration. Spirometry demonstrates a reduced FEV1/FVC
ratio that does not normalize after bronchodilator administration. Which diagnosis
is most likely?
A. COPD
B. Restrictive lung disease
C. Pleural effusion
D. Acute pulmonary edema
Answer: A
Rationale: Persistent airflow obstruction on spirometry in a patient with chronic
respiratory symptoms and significant smoking exposure is characteristic of COPD.
9. A patient with asthma reports using a rescue albuterol inhaler almost every day
and waking at night because of wheezing several times each week. What does this
pattern suggest?
A. Poorly controlled asthma requiring reassessment of controller therapy
B. Completely controlled asthma
C. Resolved asthma
D. Restrictive pulmonary disease
Answer: A
NR 603 CEA EXAM /ACTUAL NR 603 CEA FINAL EXAM
2026/2027 PRACTICE QUESTIONS AND STUDY GUIDE
COMPLETE ACCURATE EXAM REAL QUESTIONS AND
CORRECT DETAILED SOLUTIONS WITH RATIONALES
(100% EXPERT VERIFIED ANSWERS)
1. A 58-year-old man presents to an outpatient clinic with crushing substernal chest
pressure radiating to his left arm, diaphoresis, and nausea that began 30 minutes
ago. Which diagnostic test should the clinician prioritize immediately?
A. Exercise treadmill stress test
B. 12-lead electrocardiogram
C. Transthoracic echocardiogram
D. Coronary CT angiography
Answer: B
Rationale: A 12-lead ECG should be obtained promptly in a patient with
suspected acute coronary syndrome because it can rapidly identify ST-segment
elevation requiring emergent reperfusion. Cardiac biomarkers are also important
but should not delay the initial ECG.
2. A 67-year-old woman presents with exertional substernal chest pressure that
resolves after several minutes of rest. She has hypertension, diabetes, and
hyperlipidemia. Her symptoms have remained predictable for several months.
Which diagnosis is most consistent with this presentation?
A. Stable angina
B. Acute pericarditis
C. Aortic dissection
D. Pulmonary embolism
Answer: A
Rationale: Predictable exertional chest discomfort that improves with rest is
characteristic of stable angina. The clinician should nevertheless assess
,2|Page
cardiovascular risk and determine whether additional ischemic evaluation is
indicated.
3. A 72-year-old patient with heart failure with reduced ejection fraction presents
with worsening dyspnea, orthopnea, elevated jugular venous pressure, pulmonary
crackles, and bilateral lower-extremity edema. Which medication class is most
directly useful for rapidly relieving the patient's volume-overload symptoms?
A. Loop diuretic
B. Statin
C. Proton-pump inhibitor
D. Bisphosphonate
Answer: A
Rationale: Loop diuretics reduce intravascular and extravascular volume and are
central to relieving congestion in acute decompensated heart failure. Long-term
guideline-directed therapy remains important but does not provide the same
immediate relief of fluid overload.
4. A 64-year-old man with hypertension has an office blood pressure of 168/96
mm Hg on two separate visits. He has no acute symptoms or evidence of
hypertensive emergency. Which approach is most appropriate?
A. Immediate IV antihypertensive therapy
B. Confirm persistent hypertension and initiate appropriate outpatient management
C. Discontinue all antihypertensive therapy
D. Restrict all oral fluids for 24 hours
Answer: B
Rationale: Severe blood pressure elevation without acute target-organ injury is
generally managed with appropriate outpatient evaluation and treatment rather than
rapid IV reduction. Hypertensive emergency requires evidence of acute target-
organ damage.
,3|Page
5. A 45-year-old woman reports episodic palpitations, tremulousness, heat
intolerance, weight loss despite increased appetite, and anxiety. Examination
reveals a fine tremor and tachycardia. Laboratory testing shows suppressed TSH
and elevated free T4. Which diagnosis is most likely?
A. Primary hypothyroidism
B. Hyperthyroidism
C. Addison disease
D. Cushing syndrome
Answer: B
Rationale: Suppressed TSH with elevated free T4 indicates primary
hyperthyroidism. The clinical findings of heat intolerance, weight loss, tremor, and
tachycardia are consistent with thyroid hormone excess.
6. A 54-year-old patient with type 2 diabetes has an HbA1c of 9.2% despite
adherence to metformin and lifestyle modification. The patient has established
atherosclerotic cardiovascular disease. Which medication class may provide both
glucose-lowering and cardiovascular benefit?
A. GLP-1 receptor agonist
B. Short-acting sulfonylurea only
C. Alpha-glucosidase inhibitor only
D. Meglitinide only
Answer: A
Rationale: Certain GLP-1 receptor agonists have demonstrated cardiovascular
benefit in patients with type 2 diabetes and established cardiovascular disease.
Treatment should be individualized according to comorbidities, contraindications,
adverse effects, and patient preferences.
7. A 61-year-old man with diabetes presents with burning pain and decreased
sensation in both feet. Examination demonstrates reduced vibration and
monofilament sensation bilaterally. Which complication is most consistent with
these findings?
, 4|Page
A. Diabetic peripheral neuropathy
B. Acute arterial occlusion
C. Myasthenia gravis
D. Guillain-Barré syndrome
Answer: A
Rationale: Symmetric distal sensory loss and burning or tingling sensations are
typical of diabetic distal symmetric polyneuropathy. Routine foot assessment is
important because sensory loss increases the risk of unnoticed trauma and
ulceration.
8. A 59-year-old smoker presents with chronic cough, progressive exertional
dyspnea, and prolonged expiration. Spirometry demonstrates a reduced FEV1/FVC
ratio that does not normalize after bronchodilator administration. Which diagnosis
is most likely?
A. COPD
B. Restrictive lung disease
C. Pleural effusion
D. Acute pulmonary edema
Answer: A
Rationale: Persistent airflow obstruction on spirometry in a patient with chronic
respiratory symptoms and significant smoking exposure is characteristic of COPD.
9. A patient with asthma reports using a rescue albuterol inhaler almost every day
and waking at night because of wheezing several times each week. What does this
pattern suggest?
A. Poorly controlled asthma requiring reassessment of controller therapy
B. Completely controlled asthma
C. Resolved asthma
D. Restrictive pulmonary disease
Answer: A
