• NR 511 CEA EXAM 09/11/2026
NR 511 CEA EXAM CHAMBERLAIN UNIVERSITY | NR
511 COMPREHENSIVE CLINICAL EXAM (CEA) 2026–
2027 QUESTIONS AND 100% VERIFIED ANSWERS
WITH RATIONALES GRADED A+
A 70-year-old man presents with acute onset of right-sided weakness and difficulty speaking. His symptoms
started 2 hours ago. What is the most appropriate initial intervention?
*Administer intravenous tPA
*Start anticoagulation therapy
*Perform a CT scan of the head
*Administer aspirin - Correct Answer :Perform a CT scan of the head
Rationale: A CT scan may be performed in cases of right-sided weakness and difficulty speaking (aphasia) to
assess for possible acute neurological conditions, such as stroke or intracranial hemorrhage. Stroke is a leading
cause of sudden onset right-sided weakness and aphasia. A CT scan of the brain is often the initial imaging test
used to assess for acute ischemic stroke (due to a blocked blood vessel) or hemorrhagic stroke (due to bleeding
into the brain).
P 1
, • NR 511 CEA EXAM 09/11/2026
A 70-year-old man presents with sudden confusion, agitation, and hallucinations. He has a history of
hypertension and diabetes. His laboratory tests reveal hyponatremia. What is the most likely diagnosis?
*Delirium tremens
*Stroke
*Acute renal failure
*Hyponatremic encephalopathy - Correct Answer :Hyponatremic encephalopathy
Rationale: Hyponatremic encephalopathy manifests with neurological symptoms such as confusion, lethargy,
seizures, and in severe cases, coma. These symptoms occur due to the brain's inability to maintain its normal
fluid balance in the presence of low sodium levels. Both hypertension and diabetes often require multiple
medications for management. Some medications used to treat these conditions or their complications can
contribute to electrolyte disturbances, including hyponatremia.
A 45-year-old man presents with episodes of feeling extremely happy and energetic for a few days, followed by
periods of intense sadness and hopelessness. During the high periods, he engages in risky behaviors and has
little need for sleep. What is the most likely diagnosis?
*Cyclothymic disorder
*Bipolar II disorder
*Bipolar I disorder
*Major depressive disorder - Correct Answer :Bipolar I disorder
Rationale: Bipolar I Disorder is characterized by extreme mood swings, including manic, depressive, and
sometimes mixed episodes. Recognizing the symptoms and seeking early intervention is crucial for effective
management. Treatment typically involves a combination of medications, psychotherapy, and lifestyle
modifications to stabilize mood and improve quality of life.
First line therapy for patients with a new diagnosis of anxiety includes which of the following strategies?
*Treating with twice a day low-dose lorazepam prophylactically
*Providing a 90-day prescription of moderate-dose valium PRN for anxiety
*Consulting a counselor for evaluation in 3 months
*Prescribing a low-dose SSRI - Correct Answer :Prescribing a low-dose SSRI
Rationale: The safest choice provided is to prescribe a low-dose SSRI. Many patients with anxiety are primarily
suffering from depression. A 90-day prescription of a benzodiazepine is not prudent prescription practice, nor is
a prophylactic scheduled treatment strategy with benzodiazepines. Consultation for a counselor should be as
soon as possible, within a few days at most if possible.
P 2
, • NR 511 CEA EXAM 09/11/2026
While rounding, your patient is experiencing visual hallucinations. The patient should be responded to in which of
the following ways?
*Do not address that they are hallucination whatsoever
*Encourage the patient to get out of the chair to show you where the hallucination is located in more detail
*Play into the hallucination to bond with the patient
*Reorient the patient to the fact that you do not see the hallucination and that they are in fact seeing things that
are not real - Correct Answer :Reorient the patient to the fact that you do not see the hallucination and that
they are in fact seeing things that are not real
Rationale: Although it may be uncomfortable, it is important to reorient the patient that they are experiencing a
hallucination for both reorienting them and helping provide a safe environment. It is not useful to confuse the
patient by pretending you see the hallucination and the patient should not get out of their chair since they
represent an increased fall risk due to their altered sensorium.
The nurse practitioner prescribes amitriptyline (Elavil) for a patient with neuropathic pain secondary to diabetes
mellitus. On follow-up, the patient presents with urine retention and dry mouth. The practitioner should:
*discontinue amitriptyline (Elavil) and begin gabapentin (Neurontin).
*discontinue amitriptyline (Elavil) and begin ibuprofen (Motrin).
*refer to physical therapy.
*start methocarbamol (Robaxin). - Correct Answer :discontinue amitriptyline (Elavil) and begin gabapentin
(Neurontin).
Rationale: Elavil (Amitriptyline) is a tricyclic antidepressant (TCA) commonly used to treat depression, anxiety
disorders, and certain types of chronic pain. While effective for these conditions, amitriptyline can cause several
side effects, including urinary retention. Amitriptyline has strong anticholinergic properties, meaning it blocks the
action of acetylcholine, a neurotransmitter involved in muscle contractions
The use of which class of anti-anxiety medication should be limited to short duration of lowest dose possible?
*Antihistamines
*Benzodiazepines
*H2 Receptor antagonists
*NSAIDs - Correct Answer :Benzodiazepines
Rationale: Benzodiazepines have a considerable risk for dependence and should be limited to as short of a
duration of therapy as possible at the lowest dose possible. The remaining options are all non-habit forming.
P 3
, • NR 511 CEA EXAM 09/11/2026
Treatment for extrapyramidal symptoms should include which of the following?
*Discontinuing use of Cogentin
*Increasing the dose of the typical antipsychotic
*Switching to an atypical antipsychotic from a typical antipsychotic
*Discontinuing use of diphenhydramine - Correct Answer :Switching to an atypical antipsychotic from a typical
antipsychotic
Rationale: Cogentin and Benadryl are commonly used agents to reduce the expression of EPS. Switching to
atypical antipsychotics from a typical antipsychotic is likely to aid in reduction of symptoms. Another option not
listed is to reduce the dose of the anti-psychotic agent.
Patients with altered mental state should be considered for all the following potential causes except which of
the following?
*Hypertriglyceridemia
*Ecstasy use
*Uremia
*LSD use - Correct Answer :Hypertriglyceridemia
Rationale: Ecstasy use, LSD use, and uremia are all causes of altered mental status. Hypertriglyceridemia is not
considered a cause of altered mental status.
The schizophrenic patient presents to urgent care with an acute episode. Which of the following agents is likely
to be administered?
*Promethazine
*Thiopental
*Olanzapine
*Thiamine - Correct Answer :Olanzapine
Rationale: Antipsychotic agents such as risperidone, haloperidol, or olanzapine are most likely to be used to aid
in stabilization of an acute episode of schizophrenia.
In treating a pregnant female with migraine headaches, which of the following drugs would be contraindicated?
*Ergotamine tartrate (Migergot)
*Sumatriptan succinate (Imitrex)
P 4
NR 511 CEA EXAM CHAMBERLAIN UNIVERSITY | NR
511 COMPREHENSIVE CLINICAL EXAM (CEA) 2026–
2027 QUESTIONS AND 100% VERIFIED ANSWERS
WITH RATIONALES GRADED A+
A 70-year-old man presents with acute onset of right-sided weakness and difficulty speaking. His symptoms
started 2 hours ago. What is the most appropriate initial intervention?
*Administer intravenous tPA
*Start anticoagulation therapy
*Perform a CT scan of the head
*Administer aspirin - Correct Answer :Perform a CT scan of the head
Rationale: A CT scan may be performed in cases of right-sided weakness and difficulty speaking (aphasia) to
assess for possible acute neurological conditions, such as stroke or intracranial hemorrhage. Stroke is a leading
cause of sudden onset right-sided weakness and aphasia. A CT scan of the brain is often the initial imaging test
used to assess for acute ischemic stroke (due to a blocked blood vessel) or hemorrhagic stroke (due to bleeding
into the brain).
P 1
, • NR 511 CEA EXAM 09/11/2026
A 70-year-old man presents with sudden confusion, agitation, and hallucinations. He has a history of
hypertension and diabetes. His laboratory tests reveal hyponatremia. What is the most likely diagnosis?
*Delirium tremens
*Stroke
*Acute renal failure
*Hyponatremic encephalopathy - Correct Answer :Hyponatremic encephalopathy
Rationale: Hyponatremic encephalopathy manifests with neurological symptoms such as confusion, lethargy,
seizures, and in severe cases, coma. These symptoms occur due to the brain's inability to maintain its normal
fluid balance in the presence of low sodium levels. Both hypertension and diabetes often require multiple
medications for management. Some medications used to treat these conditions or their complications can
contribute to electrolyte disturbances, including hyponatremia.
A 45-year-old man presents with episodes of feeling extremely happy and energetic for a few days, followed by
periods of intense sadness and hopelessness. During the high periods, he engages in risky behaviors and has
little need for sleep. What is the most likely diagnosis?
*Cyclothymic disorder
*Bipolar II disorder
*Bipolar I disorder
*Major depressive disorder - Correct Answer :Bipolar I disorder
Rationale: Bipolar I Disorder is characterized by extreme mood swings, including manic, depressive, and
sometimes mixed episodes. Recognizing the symptoms and seeking early intervention is crucial for effective
management. Treatment typically involves a combination of medications, psychotherapy, and lifestyle
modifications to stabilize mood and improve quality of life.
First line therapy for patients with a new diagnosis of anxiety includes which of the following strategies?
*Treating with twice a day low-dose lorazepam prophylactically
*Providing a 90-day prescription of moderate-dose valium PRN for anxiety
*Consulting a counselor for evaluation in 3 months
*Prescribing a low-dose SSRI - Correct Answer :Prescribing a low-dose SSRI
Rationale: The safest choice provided is to prescribe a low-dose SSRI. Many patients with anxiety are primarily
suffering from depression. A 90-day prescription of a benzodiazepine is not prudent prescription practice, nor is
a prophylactic scheduled treatment strategy with benzodiazepines. Consultation for a counselor should be as
soon as possible, within a few days at most if possible.
P 2
, • NR 511 CEA EXAM 09/11/2026
While rounding, your patient is experiencing visual hallucinations. The patient should be responded to in which of
the following ways?
*Do not address that they are hallucination whatsoever
*Encourage the patient to get out of the chair to show you where the hallucination is located in more detail
*Play into the hallucination to bond with the patient
*Reorient the patient to the fact that you do not see the hallucination and that they are in fact seeing things that
are not real - Correct Answer :Reorient the patient to the fact that you do not see the hallucination and that
they are in fact seeing things that are not real
Rationale: Although it may be uncomfortable, it is important to reorient the patient that they are experiencing a
hallucination for both reorienting them and helping provide a safe environment. It is not useful to confuse the
patient by pretending you see the hallucination and the patient should not get out of their chair since they
represent an increased fall risk due to their altered sensorium.
The nurse practitioner prescribes amitriptyline (Elavil) for a patient with neuropathic pain secondary to diabetes
mellitus. On follow-up, the patient presents with urine retention and dry mouth. The practitioner should:
*discontinue amitriptyline (Elavil) and begin gabapentin (Neurontin).
*discontinue amitriptyline (Elavil) and begin ibuprofen (Motrin).
*refer to physical therapy.
*start methocarbamol (Robaxin). - Correct Answer :discontinue amitriptyline (Elavil) and begin gabapentin
(Neurontin).
Rationale: Elavil (Amitriptyline) is a tricyclic antidepressant (TCA) commonly used to treat depression, anxiety
disorders, and certain types of chronic pain. While effective for these conditions, amitriptyline can cause several
side effects, including urinary retention. Amitriptyline has strong anticholinergic properties, meaning it blocks the
action of acetylcholine, a neurotransmitter involved in muscle contractions
The use of which class of anti-anxiety medication should be limited to short duration of lowest dose possible?
*Antihistamines
*Benzodiazepines
*H2 Receptor antagonists
*NSAIDs - Correct Answer :Benzodiazepines
Rationale: Benzodiazepines have a considerable risk for dependence and should be limited to as short of a
duration of therapy as possible at the lowest dose possible. The remaining options are all non-habit forming.
P 3
, • NR 511 CEA EXAM 09/11/2026
Treatment for extrapyramidal symptoms should include which of the following?
*Discontinuing use of Cogentin
*Increasing the dose of the typical antipsychotic
*Switching to an atypical antipsychotic from a typical antipsychotic
*Discontinuing use of diphenhydramine - Correct Answer :Switching to an atypical antipsychotic from a typical
antipsychotic
Rationale: Cogentin and Benadryl are commonly used agents to reduce the expression of EPS. Switching to
atypical antipsychotics from a typical antipsychotic is likely to aid in reduction of symptoms. Another option not
listed is to reduce the dose of the anti-psychotic agent.
Patients with altered mental state should be considered for all the following potential causes except which of
the following?
*Hypertriglyceridemia
*Ecstasy use
*Uremia
*LSD use - Correct Answer :Hypertriglyceridemia
Rationale: Ecstasy use, LSD use, and uremia are all causes of altered mental status. Hypertriglyceridemia is not
considered a cause of altered mental status.
The schizophrenic patient presents to urgent care with an acute episode. Which of the following agents is likely
to be administered?
*Promethazine
*Thiopental
*Olanzapine
*Thiamine - Correct Answer :Olanzapine
Rationale: Antipsychotic agents such as risperidone, haloperidol, or olanzapine are most likely to be used to aid
in stabilization of an acute episode of schizophrenia.
In treating a pregnant female with migraine headaches, which of the following drugs would be contraindicated?
*Ergotamine tartrate (Migergot)
*Sumatriptan succinate (Imitrex)
P 4
