NR 603 CEA EXAM PRACTICE -
COMPREHENSIVE CHRONIC &
ENDOCRINE ASSESSMENT QUESTIONS
AND ANSWERS WITH VERIFIED
SOLUTIONS 2026/2027 UPDATE
1. A 55-year-old patient with Type 2 Diabetes presents with a morning fasting blood glucose
of 210 mg/dL. The patient reports experiencing nightmares and night sweats. What is the
most likely physiological phenomenon occurring?
A. Dawn Phenomenon
B. Insulin Resistance
C. Somogyi Effect
D. Diabetic Ketoacidosis
Answer: C
Conceptual Explanation: The Somogyi Effect occurs when hypoglycemia during the night
causes a rebound hyperglycemia in the morning due to counter-regulatory hormones.
Nightmares and sweats are signs of nocturnal hypoglycemia.
2. Which of the following laboratory findings is most characteristic of primary
hypothyroidism?
A. High TSH, Low Free T4
,B. High TSH, High Free T4
C. Low TSH, Low Free T4
D. Low TSH, High Free T4
Answer: A
Conceptual Explanation: Primary hypothyroidism is characterized by an elevated TSH (as
the pituitary tries to stimulate the thyroid) and a low Free T4 (indicating thyroid failure).
3. According to the ACC/AHA guidelines, what is the blood pressure threshold for diagnosing
Stage 2 Hypertension?
A. 120/80 mmHg
B. 130/80 mmHg
C. 150/95 mmHg
D. 140/90 mmHg
Answer: D
Conceptual Explanation: Stage 2 Hypertension is defined as a systolic pressure of at least
140 mmHg or a diastolic pressure of at least 90 mmHg.
4. In a patient with Chronic Kidney Disease (CKD), at which GFR level should a referral to a
nephrologist typically be initiated?
A. Less than 60 mL/min/1.73m2
B. Less than 45 mL/min/1.73m2
, C. Less than 30 mL/min/1.73m2
D. Less than 15 mL/min/1.73m2
Answer: C
Conceptual Explanation: Referral to nephrology is generally recommended when the GFR
drops below 30 (Stage 4 CKD) to prepare for renal replacement therapy or manage
complications.
5. Which of the following is the first-line treatment for a patient newly diagnosed with mild-
to-moderate COPD (Group A)?
A. Inhaled Corticosteroids (ICS)
B. Short-acting bronchodilator (SABA or SAMA)
C. Long-acting Beta-Agonist (LABA)
D. Oral Prednisone
Answer: B
Conceptual Explanation: For GOLD Group A (low risk, fewer symptoms), a short-acting
bronchodilator used as needed is the recommended starting therapy.
6. A patient presents with central obesity, ‘moon face’, and purple striae on the abdomen.
Which test is most appropriate for initial screening of Cushing’s Syndrome?
A. Serum ACTH level
B. Random serum cortisol
COMPREHENSIVE CHRONIC &
ENDOCRINE ASSESSMENT QUESTIONS
AND ANSWERS WITH VERIFIED
SOLUTIONS 2026/2027 UPDATE
1. A 55-year-old patient with Type 2 Diabetes presents with a morning fasting blood glucose
of 210 mg/dL. The patient reports experiencing nightmares and night sweats. What is the
most likely physiological phenomenon occurring?
A. Dawn Phenomenon
B. Insulin Resistance
C. Somogyi Effect
D. Diabetic Ketoacidosis
Answer: C
Conceptual Explanation: The Somogyi Effect occurs when hypoglycemia during the night
causes a rebound hyperglycemia in the morning due to counter-regulatory hormones.
Nightmares and sweats are signs of nocturnal hypoglycemia.
2. Which of the following laboratory findings is most characteristic of primary
hypothyroidism?
A. High TSH, Low Free T4
,B. High TSH, High Free T4
C. Low TSH, Low Free T4
D. Low TSH, High Free T4
Answer: A
Conceptual Explanation: Primary hypothyroidism is characterized by an elevated TSH (as
the pituitary tries to stimulate the thyroid) and a low Free T4 (indicating thyroid failure).
3. According to the ACC/AHA guidelines, what is the blood pressure threshold for diagnosing
Stage 2 Hypertension?
A. 120/80 mmHg
B. 130/80 mmHg
C. 150/95 mmHg
D. 140/90 mmHg
Answer: D
Conceptual Explanation: Stage 2 Hypertension is defined as a systolic pressure of at least
140 mmHg or a diastolic pressure of at least 90 mmHg.
4. In a patient with Chronic Kidney Disease (CKD), at which GFR level should a referral to a
nephrologist typically be initiated?
A. Less than 60 mL/min/1.73m2
B. Less than 45 mL/min/1.73m2
, C. Less than 30 mL/min/1.73m2
D. Less than 15 mL/min/1.73m2
Answer: C
Conceptual Explanation: Referral to nephrology is generally recommended when the GFR
drops below 30 (Stage 4 CKD) to prepare for renal replacement therapy or manage
complications.
5. Which of the following is the first-line treatment for a patient newly diagnosed with mild-
to-moderate COPD (Group A)?
A. Inhaled Corticosteroids (ICS)
B. Short-acting bronchodilator (SABA or SAMA)
C. Long-acting Beta-Agonist (LABA)
D. Oral Prednisone
Answer: B
Conceptual Explanation: For GOLD Group A (low risk, fewer symptoms), a short-acting
bronchodilator used as needed is the recommended starting therapy.
6. A patient presents with central obesity, ‘moon face’, and purple striae on the abdomen.
Which test is most appropriate for initial screening of Cushing’s Syndrome?
A. Serum ACTH level
B. Random serum cortisol
