,NR 603 CEA PRE-DIAGNOSTIC WEEK 4 EXAM (2026/2027) FULL 150 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS)
1. A 22-year-old male patient states during his review of systems that his scrotum is very enlarged and
feels like it is full of worms. He is a power lifter and works as a trash collector. You suspect that patient
likely has which of the following diagnosis?
A) Meningocele
B) Varicocele
C) Hydrocele
D) Rectocele
Correct Answer: B) Varicocele
Rationale: This question tests knowledge of scrotal swelling etiologies. A varicocele is an abnormal
enlargement of the veins within the scrotum, often described as feeling like a "bag of worms." The
detailed rationale should explain that varicoceles are more common on the left side due to anatomical
differences in the testicular vein drainage, and that they are associated with increased intra-abdominal
pressure from heavy lifting or prolonged standing, which explains the patient's occupation as a power
lifter and trash collector. Meningocele is a neural tube defect, hydrocele is a fluid collection, and
rectocele is a herniation of the rectum into the vagina.
2. The point of maximum impulse (PMI) is MOST often 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?
A) Left 2nd intercostal space, midaxillary line
B) Left 5th intercostal space, midclavicular line
C) Right 4th intercostal space, midaxillary line
D) Right 2nd intercostal space, midclavicular line
Correct Answer: B) Left 5th intercostal space, midclavicular line
Rationale: This question tests knowledge of cardiac anatomy and physical examination. The PMI
represents the apical impulse of the heart and is normally located at the left 5th intercostal space at the
midclavicular line. The detailed rationale should explain that this corresponds to the apex of the left
ventricle, and that displacement of the PMI can indicate cardiomegaly or other cardiac abnormalities.
3. A 40-year-old female, African American patient presents for history and physical. Upon your initial
assessment, you notice she has severe exophthalmos. Which one of the following diagnoses would be
highest on your differential diagnosis of this physical examination finding?
A) Bilateral conjunctivitis
B) Hyperthyroidism
,C) Hypothyroidism
D) Myxedema
Correct Answer: B) Hyperthyroidism
Rationale: This question tests knowledge of thyroid eye disease. Exophthalmos (protrusion of the
eyeballs) is a classic sign of Graves' disease, which is an autoimmune form of hyperthyroidism. The
detailed rationale should explain that exophthalmos results from infiltration and edema of the orbital
contents, and that it is one of the most distinguishing features of Graves' disease. Hypothyroidism and
myxedema cause periorbital puffiness, not exophthalmos.
4. Your patient with a suspected diagnosis of COPD has been seen by pulmonology and has undergone
a pulmonary function test (PFT) with spirometry. The patient asks what the study was evaluating. 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?
A) Forced Expiratory Volume over 1 second (FEV1)
B) Functional Reserve Capacity
C) Inspiratory Reserve
D) Forced Vital Capacity
Correct Answer: D) Forced Vital Capacity
Rationale: This question tests knowledge of pulmonary function testing. Forced Vital Capacity (FVC) is
the maximum amount of air a person can forcibly exhale from the lungs after taking the deepest breath
possible. The detailed rationale should explain that FVC is a key measurement in diagnosing obstructive
and restrictive lung diseases, and that FEV1 measures the volume exhaled in the first second of the FVC
maneuver.
5. Your patient has a diagnosis of Addison's disease. Which of the following might you expect to find
during examination?
A) Abdominal striae
B) Dowager hump
C) Low body temperature
D) Moon face
Correct Answer: C) Low body temperature
Rationale: This question tests knowledge of Addison's disease manifestations. Addison's disease is
primary adrenal insufficiency characterized by deficient cortisol and aldosterone production. The
detailed rationale should explain that patients with Addison's disease often present with hypotension,
fatigue, hyperpigmentation, salt craving, and low body temperature due to decreased metabolic rate.
Abdominal striae, Dowager hump, and moon face are associated with Cushing's syndrome (excess
cortisol).
, 6. The nurse practitioner's evaluation of a patient with Diabetes Mellitus type 2 should include which
of the following while evaluating for end organ dysfunction of the disease?
A) Renal function panel
B) Urinalysis
C) Non-dilated eye exam
D) All of these are appropriate options
Correct Answer: D) All of these are appropriate options
Rationale: This question tests knowledge of diabetes management and end-organ surveillance. Type 2
diabetes can cause nephropathy, retinopathy, and other complications. The detailed rationale should
explain that the nurse practitioner should evaluate renal function (BUN, creatinine, urine albumin),
perform urinalysis, and conduct regular eye exams (dilated retinal exams) to screen for diabetic
retinopathy.
7. During your visit with a 19-year-old patient for a college health physical, your health history
includes a diagnosis of angioedema. What of the following parts of the body were likely involved?
A) Isolated to the colon
B) Anywhere in the enteral tract
C) Chest
D) Face and Lips
Correct Answer: D) Face and Lips
Rationale: This question tests knowledge of angioedema. Angioedema is a condition characterized by
swelling in the deep layers of the skin, most commonly affecting the face, lips, tongue, and throat. The
detailed rationale should explain that angioedema can be allergic or hereditary, and that involvement of
the airway can be life-threatening.
8. Which of the following dermatologic lesions is precancerous and likely due to prolonged exposure
to UV-B?
A) Actinic Keratosis
B) Basal cell carcinoma
C) Verruca
D) Seborrheic dermatitis
Correct Answer: A) Actinic Keratosis
Rationale: This question tests knowledge of skin lesions. Actinic keratosis is a precancerous lesion caused
by prolonged exposure to ultraviolet B (UV-B) radiation. The detailed rationale should explain that actinic
keratoses appear as rough, scaly patches on sun-exposed areas and can progress to squamous cell
carcinoma if untreated.
CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS)
1. A 22-year-old male patient states during his review of systems that his scrotum is very enlarged and
feels like it is full of worms. He is a power lifter and works as a trash collector. You suspect that patient
likely has which of the following diagnosis?
A) Meningocele
B) Varicocele
C) Hydrocele
D) Rectocele
Correct Answer: B) Varicocele
Rationale: This question tests knowledge of scrotal swelling etiologies. A varicocele is an abnormal
enlargement of the veins within the scrotum, often described as feeling like a "bag of worms." The
detailed rationale should explain that varicoceles are more common on the left side due to anatomical
differences in the testicular vein drainage, and that they are associated with increased intra-abdominal
pressure from heavy lifting or prolonged standing, which explains the patient's occupation as a power
lifter and trash collector. Meningocele is a neural tube defect, hydrocele is a fluid collection, and
rectocele is a herniation of the rectum into the vagina.
2. The point of maximum impulse (PMI) is MOST often 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?
A) Left 2nd intercostal space, midaxillary line
B) Left 5th intercostal space, midclavicular line
C) Right 4th intercostal space, midaxillary line
D) Right 2nd intercostal space, midclavicular line
Correct Answer: B) Left 5th intercostal space, midclavicular line
Rationale: This question tests knowledge of cardiac anatomy and physical examination. The PMI
represents the apical impulse of the heart and is normally located at the left 5th intercostal space at the
midclavicular line. The detailed rationale should explain that this corresponds to the apex of the left
ventricle, and that displacement of the PMI can indicate cardiomegaly or other cardiac abnormalities.
3. A 40-year-old female, African American patient presents for history and physical. Upon your initial
assessment, you notice she has severe exophthalmos. Which one of the following diagnoses would be
highest on your differential diagnosis of this physical examination finding?
A) Bilateral conjunctivitis
B) Hyperthyroidism
,C) Hypothyroidism
D) Myxedema
Correct Answer: B) Hyperthyroidism
Rationale: This question tests knowledge of thyroid eye disease. Exophthalmos (protrusion of the
eyeballs) is a classic sign of Graves' disease, which is an autoimmune form of hyperthyroidism. The
detailed rationale should explain that exophthalmos results from infiltration and edema of the orbital
contents, and that it is one of the most distinguishing features of Graves' disease. Hypothyroidism and
myxedema cause periorbital puffiness, not exophthalmos.
4. Your patient with a suspected diagnosis of COPD has been seen by pulmonology and has undergone
a pulmonary function test (PFT) with spirometry. The patient asks what the study was evaluating. 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?
A) Forced Expiratory Volume over 1 second (FEV1)
B) Functional Reserve Capacity
C) Inspiratory Reserve
D) Forced Vital Capacity
Correct Answer: D) Forced Vital Capacity
Rationale: This question tests knowledge of pulmonary function testing. Forced Vital Capacity (FVC) is
the maximum amount of air a person can forcibly exhale from the lungs after taking the deepest breath
possible. The detailed rationale should explain that FVC is a key measurement in diagnosing obstructive
and restrictive lung diseases, and that FEV1 measures the volume exhaled in the first second of the FVC
maneuver.
5. Your patient has a diagnosis of Addison's disease. Which of the following might you expect to find
during examination?
A) Abdominal striae
B) Dowager hump
C) Low body temperature
D) Moon face
Correct Answer: C) Low body temperature
Rationale: This question tests knowledge of Addison's disease manifestations. Addison's disease is
primary adrenal insufficiency characterized by deficient cortisol and aldosterone production. The
detailed rationale should explain that patients with Addison's disease often present with hypotension,
fatigue, hyperpigmentation, salt craving, and low body temperature due to decreased metabolic rate.
Abdominal striae, Dowager hump, and moon face are associated with Cushing's syndrome (excess
cortisol).
, 6. The nurse practitioner's evaluation of a patient with Diabetes Mellitus type 2 should include which
of the following while evaluating for end organ dysfunction of the disease?
A) Renal function panel
B) Urinalysis
C) Non-dilated eye exam
D) All of these are appropriate options
Correct Answer: D) All of these are appropriate options
Rationale: This question tests knowledge of diabetes management and end-organ surveillance. Type 2
diabetes can cause nephropathy, retinopathy, and other complications. The detailed rationale should
explain that the nurse practitioner should evaluate renal function (BUN, creatinine, urine albumin),
perform urinalysis, and conduct regular eye exams (dilated retinal exams) to screen for diabetic
retinopathy.
7. During your visit with a 19-year-old patient for a college health physical, your health history
includes a diagnosis of angioedema. What of the following parts of the body were likely involved?
A) Isolated to the colon
B) Anywhere in the enteral tract
C) Chest
D) Face and Lips
Correct Answer: D) Face and Lips
Rationale: This question tests knowledge of angioedema. Angioedema is a condition characterized by
swelling in the deep layers of the skin, most commonly affecting the face, lips, tongue, and throat. The
detailed rationale should explain that angioedema can be allergic or hereditary, and that involvement of
the airway can be life-threatening.
8. Which of the following dermatologic lesions is precancerous and likely due to prolonged exposure
to UV-B?
A) Actinic Keratosis
B) Basal cell carcinoma
C) Verruca
D) Seborrheic dermatitis
Correct Answer: A) Actinic Keratosis
Rationale: This question tests knowledge of skin lesions. Actinic keratosis is a precancerous lesion caused
by prolonged exposure to ultraviolet B (UV-B) radiation. The detailed rationale should explain that actinic
keratoses appear as rough, scaly patches on sun-exposed areas and can progress to squamous cell
carcinoma if untreated.
