NR574 CEA PRE-DIAGNOSTIC ASSESSMENT PRACTICE 250 QUESTIONS AND CORRECT
ANSWERS
CORE DOMAINS
Cardiovascular and Hemodynamic Disorders
Pulmonary and Respiratory Emergencies
Neurologic and Neurosurgical Emergencies
Gastrointestinal and Hepatobiliary Disorders
Renal, Electrolyte, and Acid-Base Disorders
Endocrine and Metabolic Emergencies
Hematologic and Oncologic Emergencies
Infectious Disease and Sepsis
Musculoskeletal and Traumatic Injuries
Professionalism, Ethics, and Clinical Documentation
INTRODUCTION
This comprehensive pre-diagnostic assessment is designed to evaluate the advanced clinical
knowledge and decision-making skills required of the acute care nurse practitioner. It covers high-
acuity, multisystem conditions across the lifespan, emphasizing evidence-based assessment,
diagnostic reasoning, and initial management. The examination employs multiple-choice and
scenario-based questions to simulate realistic clinical encounters. Emphasis is placed on critical
thinking, prioritization, and the application of national guidelines in acute care settings. This
assessment prepares candidates for the rigor of the CEA and real-world clinical practice.
,SECTION ONE: QUESTIONS 1–250
1. Evidence-based health screening is utilized with an understanding of the limits of
interpreting the results. In this context, the term sensitivity refers to the ability of a test to:
A. Detect the prevalence of a given condition
B. Provide reproducible results
C. Identify the specific condition
D. Detect an abnormal condition when it exists
🟢 D. Detect an abnormal condition when it exists
🔴 RATIONALE: Detecting an abnormal condition when it DOES exist is by definition sensitivity.
Specificity refers to the ability to rule out those who do NOT have that abnormal condition.
2. An 87-year-old female with a history of ovarian cancer has completed ten of 26
chemotherapy treatments. She informs the nurse practitioner that she plans to stop
chemotherapy; she has lived a good life and is ready to die. She is alert and very active, and
lives with her son. The family is determined that the patient will complete the chemotherapy.
The nurse practitioner's most appropriate action is to:
A. Encourage treatment
B. Support the patient's decision
C. Refer the family for counseling
D. Follow the family's requests
,🟢 B. Support the patient's decision
🔴 RATIONALE: Good nursing practice supports advocacy at all times for the patient, even when
the patient's family disagrees. Supporting their decision to self-direct their care is your primary
obligation.
3. A patient on rivaroxaban presents to urgent care with a right nare bleeding through self-
packed gauze for 30 minutes without evidence of stopping. Which is the most appropriate
next action?
A. Attempt blind cautery with silver nitrate sticks around the packing
B. Remove packing and apply direct pressure
C. Insert a nasal tampon
D. Apply a topical thrombin agent
🟢 B. Remove packing and apply direct pressure
🔴 RATIONALE: The patient is on a potent novel oral anticoagulant and has persistent epistaxis.
The immediate next step is to remove the packing and apply direct pressure to the site, ensuring
proper visualization. Blind cautery can cause further mucosal damage. Nasal tampons and topical
thrombin may be considered if direct pressure fails.
4. Patients presenting with globe rupture should be sent to immediate surgery due to which
of the following reasons?
A. Delay in surgery can increase incidence of choroidal hemorrhage
B. Loss of vision is worse if surgery is immediate
, C. Rapid surgery can increase incidence of endophthalmitis
D. Pain associated to the traumatic event is less when surgery is performed immediately
🟢 A. Delay in surgery can increase incidence of choroidal hemorrhage
🔴 RATIONALE: Delay in surgery can increase the incidence of both choroidal hemorrhage as
well as endophthalmitis. Loss of vision is likely less if surgical intervention is immediate.
5. A patient with a large bump on their cheek should be evaluated and ruled out for which
cardiac complication-linked diagnosis?
A. Perioral abscess
B. Impacted molar
C. Dental caries
D. Ludwig's angina
🟢 A. Perioral abscess
🔴 RATIONALE: Perioral abscesses are linked to complications since the bloodstream access is so
easy for pathogens, including potential cardiac involvement such as endocarditis. The remainder
do not represent any cardiac risk.
6. A 24-year-old male patient was recently in a motor vehicle collision. A CT head reveals a
pyramidal fracture involving the lateral walls of the maxillary sinuses and inferior orbital rim.
Which classification of fracture is this?
A. Le Fort II
B. Le Fort I
ANSWERS
CORE DOMAINS
Cardiovascular and Hemodynamic Disorders
Pulmonary and Respiratory Emergencies
Neurologic and Neurosurgical Emergencies
Gastrointestinal and Hepatobiliary Disorders
Renal, Electrolyte, and Acid-Base Disorders
Endocrine and Metabolic Emergencies
Hematologic and Oncologic Emergencies
Infectious Disease and Sepsis
Musculoskeletal and Traumatic Injuries
Professionalism, Ethics, and Clinical Documentation
INTRODUCTION
This comprehensive pre-diagnostic assessment is designed to evaluate the advanced clinical
knowledge and decision-making skills required of the acute care nurse practitioner. It covers high-
acuity, multisystem conditions across the lifespan, emphasizing evidence-based assessment,
diagnostic reasoning, and initial management. The examination employs multiple-choice and
scenario-based questions to simulate realistic clinical encounters. Emphasis is placed on critical
thinking, prioritization, and the application of national guidelines in acute care settings. This
assessment prepares candidates for the rigor of the CEA and real-world clinical practice.
,SECTION ONE: QUESTIONS 1–250
1. Evidence-based health screening is utilized with an understanding of the limits of
interpreting the results. In this context, the term sensitivity refers to the ability of a test to:
A. Detect the prevalence of a given condition
B. Provide reproducible results
C. Identify the specific condition
D. Detect an abnormal condition when it exists
🟢 D. Detect an abnormal condition when it exists
🔴 RATIONALE: Detecting an abnormal condition when it DOES exist is by definition sensitivity.
Specificity refers to the ability to rule out those who do NOT have that abnormal condition.
2. An 87-year-old female with a history of ovarian cancer has completed ten of 26
chemotherapy treatments. She informs the nurse practitioner that she plans to stop
chemotherapy; she has lived a good life and is ready to die. She is alert and very active, and
lives with her son. The family is determined that the patient will complete the chemotherapy.
The nurse practitioner's most appropriate action is to:
A. Encourage treatment
B. Support the patient's decision
C. Refer the family for counseling
D. Follow the family's requests
,🟢 B. Support the patient's decision
🔴 RATIONALE: Good nursing practice supports advocacy at all times for the patient, even when
the patient's family disagrees. Supporting their decision to self-direct their care is your primary
obligation.
3. A patient on rivaroxaban presents to urgent care with a right nare bleeding through self-
packed gauze for 30 minutes without evidence of stopping. Which is the most appropriate
next action?
A. Attempt blind cautery with silver nitrate sticks around the packing
B. Remove packing and apply direct pressure
C. Insert a nasal tampon
D. Apply a topical thrombin agent
🟢 B. Remove packing and apply direct pressure
🔴 RATIONALE: The patient is on a potent novel oral anticoagulant and has persistent epistaxis.
The immediate next step is to remove the packing and apply direct pressure to the site, ensuring
proper visualization. Blind cautery can cause further mucosal damage. Nasal tampons and topical
thrombin may be considered if direct pressure fails.
4. Patients presenting with globe rupture should be sent to immediate surgery due to which
of the following reasons?
A. Delay in surgery can increase incidence of choroidal hemorrhage
B. Loss of vision is worse if surgery is immediate
, C. Rapid surgery can increase incidence of endophthalmitis
D. Pain associated to the traumatic event is less when surgery is performed immediately
🟢 A. Delay in surgery can increase incidence of choroidal hemorrhage
🔴 RATIONALE: Delay in surgery can increase the incidence of both choroidal hemorrhage as
well as endophthalmitis. Loss of vision is likely less if surgical intervention is immediate.
5. A patient with a large bump on their cheek should be evaluated and ruled out for which
cardiac complication-linked diagnosis?
A. Perioral abscess
B. Impacted molar
C. Dental caries
D. Ludwig's angina
🟢 A. Perioral abscess
🔴 RATIONALE: Perioral abscesses are linked to complications since the bloodstream access is so
easy for pathogens, including potential cardiac involvement such as endocarditis. The remainder
do not represent any cardiac risk.
6. A 24-year-old male patient was recently in a motor vehicle collision. A CT head reveals a
pyramidal fracture involving the lateral walls of the maxillary sinuses and inferior orbital rim.
Which classification of fracture is this?
A. Le Fort II
B. Le Fort I
