NR 603 CEA EXAM PRACTICE TEST
QUESTIONS AND ANSWERS WITH
VERIFIED SOLUTIONS 2026/2027
UPDATE
1. A 65-year-old male with a history of hypertension and tobacco use presents with a sudden
onset of sharp, tearing chest pain radiating to the back. His blood pressure is 190/110 mmHg.
What is the most likely diagnosis?
A. Acute Myocardial Infarction
B. Pneumothorax
C. Pulmonary Embolism
D. Aortic Dissection
Answer: D
Conceptual Explanation: The classic presentation of tearing chest pain radiating to the
back in a hypertensive patient is highly suggestive of aortic dissection.
2. Which of the following physical exam findings is most specific for a diagnosis of heart
failure in an older adult?
A. Bilateral pedal edema
B. Third heart sound (S3)
,C. Jugular venous distention (JVD)
D. Pulmonary crackles
Answer: B
Conceptual Explanation: While JVD and edema are common, the presence of an S3 gallop
is highly specific for volume overload and left ventricular failure.
3. A patient presents with a TSH level of 8.5 mIU/L and a normal free T4 level. The patient is
asymptomatic. What is the most appropriate next step in management?
A. Start Levothyroxine 25 mcg daily
B. Start Liothyronine
C. Order a thyroid ultrasound
D. Recheck TSH in 3 to 6 months
Answer: D
Conceptual Explanation: This represents subclinical hypothyroidism. In asymptomatic
patients with TSH below 10, the recommendation is often to monitor rather than treat
immediately.
4. Which antidepressant is preferred in an elderly patient with depression and insomnia due
to its sedative properties and low risk of anticholinergic effects?
A. Amitriptyline
B. Fluoxetine
, C. Paroxetine
D. Mirtazapine
Answer: D
Conceptual Explanation: Mirtazapine is often used in the elderly because it helps with
sleep and appetite without the heavy anticholinergic load of TCAs.
5. A 72-year-old female presents with acute onset of unilateral vision loss and jaw
claudication. What is the gold standard for diagnosing this condition?
A. Temporal artery biopsy
B. ESR and CRP levels
C. Head CT scan
D. Fluorescein angiography
Answer: A
Conceptual Explanation: The symptoms suggest Giant Cell Arteritis (Temporal Arteritis).
A temporal artery biopsy is the definitive diagnostic test.
6. In the management of COPD, which of the following is the primary indicator for long-term
oxygen therapy?
A. FEV1 < 50% predicted
B. Frequent exacerbations requiring steroids
C. PaO2 ≤ 55 mmHg or SaO2 ≤ 88%
QUESTIONS AND ANSWERS WITH
VERIFIED SOLUTIONS 2026/2027
UPDATE
1. A 65-year-old male with a history of hypertension and tobacco use presents with a sudden
onset of sharp, tearing chest pain radiating to the back. His blood pressure is 190/110 mmHg.
What is the most likely diagnosis?
A. Acute Myocardial Infarction
B. Pneumothorax
C. Pulmonary Embolism
D. Aortic Dissection
Answer: D
Conceptual Explanation: The classic presentation of tearing chest pain radiating to the
back in a hypertensive patient is highly suggestive of aortic dissection.
2. Which of the following physical exam findings is most specific for a diagnosis of heart
failure in an older adult?
A. Bilateral pedal edema
B. Third heart sound (S3)
,C. Jugular venous distention (JVD)
D. Pulmonary crackles
Answer: B
Conceptual Explanation: While JVD and edema are common, the presence of an S3 gallop
is highly specific for volume overload and left ventricular failure.
3. A patient presents with a TSH level of 8.5 mIU/L and a normal free T4 level. The patient is
asymptomatic. What is the most appropriate next step in management?
A. Start Levothyroxine 25 mcg daily
B. Start Liothyronine
C. Order a thyroid ultrasound
D. Recheck TSH in 3 to 6 months
Answer: D
Conceptual Explanation: This represents subclinical hypothyroidism. In asymptomatic
patients with TSH below 10, the recommendation is often to monitor rather than treat
immediately.
4. Which antidepressant is preferred in an elderly patient with depression and insomnia due
to its sedative properties and low risk of anticholinergic effects?
A. Amitriptyline
B. Fluoxetine
, C. Paroxetine
D. Mirtazapine
Answer: D
Conceptual Explanation: Mirtazapine is often used in the elderly because it helps with
sleep and appetite without the heavy anticholinergic load of TCAs.
5. A 72-year-old female presents with acute onset of unilateral vision loss and jaw
claudication. What is the gold standard for diagnosing this condition?
A. Temporal artery biopsy
B. ESR and CRP levels
C. Head CT scan
D. Fluorescein angiography
Answer: A
Conceptual Explanation: The symptoms suggest Giant Cell Arteritis (Temporal Arteritis).
A temporal artery biopsy is the definitive diagnostic test.
6. In the management of COPD, which of the following is the primary indicator for long-term
oxygen therapy?
A. FEV1 < 50% predicted
B. Frequent exacerbations requiring steroids
C. PaO2 ≤ 55 mmHg or SaO2 ≤ 88%
