NR 667 CEA EXAM 2026/2027| ACTUAL TESTBANK
QUESTIONS AND CORRECT ANSWERS WITH
EXPLANATIONS FOR GUARANTEED PASS
Your anxious 73-year-old male patient who presents to urgent care after a panic attack notices he
has a rapid cyclical rate tremor and is concerned he has undiagnosed Parkinson's disease since
his family history includes this diagnosis in his father. Which of the following clinical findings
noted above suggest this is an unlikely diagnosis?
- Rapid rate of tremor
- Age
- Gender
Rapid rate of tremor
Explanation: Parkinson's disease is most frequently associated with male patients (1.5-2x more
likely than women) of advanced age with a family history of Parkinson's disease. Tremors
traditionally associated with Parkinsonism are slower rate. Rapid cyclical rate tremors are
typically either situational from stress or medications, or benign essential tremors.
Family history of Parkinson's disease
Medication overuse (analgesia rebound) headaches occur:
- in approximately half of all patients with chronic daily headaches.
- infrequently in patients who use analgesics regularly.
- in the majority of patients using analgesics.
- occasionally during switching from one type of analgesic to another.
in approximately half of all patients with chronic daily headaches.
Explanation: Analgesic rebound, also known as medication-overuse headache (MOH), is a
phenomenon where frequent use of pain-relieving medications, such as analgesics or migraine
medications, leads to worsening headaches. The frequency of analgesic rebound headaches can
vary depending on several factors, including the type of medication used, dosage, and individual
susceptibility. In occurs in approximately half of all patients with chronic daily headaches.
1st line treatment for generalized anxiety disorder:
- buspar
- zoloft
,- wellbutrin
- remeron
zoloft
Explanation: SSRIs increase serotonin levels in the brain, which helps improve mood and reduce
anxiety. Serotonin is a neurotransmitter associated with mood regulation and anxiety reduction.
By blocking the reabsorption (reuptake) of serotonin into neurons, Zoloft allows more serotonin
to be available in the brain, which can help improve mood and reduce anxiety.
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).
- refer to physical therapy.
- start methocarbamol (Robaxin).
discontinue amitriptyline (Elavil) and begin gabapentin (Neurontin)
Explanation: 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
An adult male presents with general malaise and concerns about delayed ejaculation. His
medication regimen consists of quinapril (Accupril) 20 mg daily; paroxetine (Paxil) 20 mg daily;
loratadine (Claritin) 10 mg daily; hydrochlorothiazide (HCTZ) 25 mg daily. The delayed
ejaculation is most likely caused by the:
- quinapril (Accupril).
- loratadine (Claritin).
- hydrochlorothiazide (HCTZ).
- paroxetine (Paxil).
paroxetine (Paxil).
A 22-year-old has ASCAS on Pap smear and negative for HPV. The next step is:
- No follow up is needed.
- Repeat HPV in 3 months
- Colposcopy
- Repeat Pap in 6 months
,Repeat Pap in 6 months
Explanation: For a 22-year-old with ASC-US on Pap smear and a negative HPV test, the next
appropriate step is to repeat the cytology in six months. This approach minimizes unnecessary
interventions while ensuring ongoing monitoring for any potential progression of cervical cell
abnormalities.
A pap smear report for a 24-year-old indicates atypical squamous cells of undetermined
significance (ASCUS). The patient's previous Pap smears were normal. The nurse practitioner
should next:
- Refer for colposcopy
- Repeat the Pap smear in 1 month
- Have the patient return for a Pap smear in 1 year
- Request HPV testing
Request HPV testing
Explanation: Managing an abnormal Pap smear involves a combination of further diagnostic
evaluations, patient communication, and appropriate follow-up actions. For cases of other
uncertain results, HPV testing can help determine the need for further investigation.
Which of the following tests is the most effective in differentiating between solid and cystic
breast lesions?
- Ultrasonography
- Xeromammographic
- Screening mammography
- Fine needle aspiration
Ultrasonography
Explanation: Ultrasound is the most effective and widely used imaging technique for
distinguishing between solid and cystic breast lesions.
A female patient was sexually assaulted within the past 120 hours and is concerned about
unwanted pregnancy. The correct prescription would be:
- misprostol
- medroxprogesterone, 5mg every 6 hours times 4
- norgestrel
- levonorgestrel 1.5 mg as a single dose
levonorgestrel 1.5 mg as a single dose
Explanation:
, Levonorgestrel is a type of emergency contraception, commonly known as the morning-after pill.
Levonorgestrel works in the following ways:
Prevention of Ovulation: Levonorgestrel primarily works by preventing ovulation, meaning it
stops the release of an egg from the ovary.
Interference with Fertilization: It may also interfere with fertilization by affecting the movement
of sperm or egg.
Alteration of the Uterine Lining: Levonorgestrel can alter the lining of the uterus, making it less
suitable for implantation if fertilization has already occurred.
Major complications of pelvic inflammatory disease (PID) include:
- polycystic ovaries and bleeding corpus luteum.
- infertility and ectopic pregnancy.
- diverticulitis and endometriosis.
- pelvic organ prolapse.
infertility and ectopic pregnancy.
Explanation: Pelvic inflammatory disease (PID) can lead to severe and long-term complications
if not adequately treated. These complications include chronic pelvic pain, infertility, ectopic
pregnancy, tubo-ovarian abscess, Fitz-Hugh-Curtis syndrome, adhesions, recurrent PID, and
increased risk of miscarriage and preterm birth. Early diagnosis, prompt treatment of STIs, and
regular medical follow-ups are essential to prevent these complications and protect reproductive
health.
An adult female Pap smear results reveals high-grade squamous intraepithelial lesion. What
should the nurse practitioner do next?
- Perform human papillomavirus testing
- Repeat the Pap smear in 1 month
- Repeat the Pap smear in 4 to 6 months
- Refer for colposcopy
Refer for colposcopy
Explanation:
When a Pap smear reveals a high-grade squamous intraepithelial lesion (HSIL), it indicates a
significant abnormality that has a higher potential to progress to cervical cancer if left untreated.
The recommended next step is further evaluation through colposcopy and possibly biopsy.
A 16-year-old female in the first month of taking Ortho-Novum 7/7/7 complains of midcycle
spotting. She has not missed any doses and uses no other medication. Which of the following is
QUESTIONS AND CORRECT ANSWERS WITH
EXPLANATIONS FOR GUARANTEED PASS
Your anxious 73-year-old male patient who presents to urgent care after a panic attack notices he
has a rapid cyclical rate tremor and is concerned he has undiagnosed Parkinson's disease since
his family history includes this diagnosis in his father. Which of the following clinical findings
noted above suggest this is an unlikely diagnosis?
- Rapid rate of tremor
- Age
- Gender
Rapid rate of tremor
Explanation: Parkinson's disease is most frequently associated with male patients (1.5-2x more
likely than women) of advanced age with a family history of Parkinson's disease. Tremors
traditionally associated with Parkinsonism are slower rate. Rapid cyclical rate tremors are
typically either situational from stress or medications, or benign essential tremors.
Family history of Parkinson's disease
Medication overuse (analgesia rebound) headaches occur:
- in approximately half of all patients with chronic daily headaches.
- infrequently in patients who use analgesics regularly.
- in the majority of patients using analgesics.
- occasionally during switching from one type of analgesic to another.
in approximately half of all patients with chronic daily headaches.
Explanation: Analgesic rebound, also known as medication-overuse headache (MOH), is a
phenomenon where frequent use of pain-relieving medications, such as analgesics or migraine
medications, leads to worsening headaches. The frequency of analgesic rebound headaches can
vary depending on several factors, including the type of medication used, dosage, and individual
susceptibility. In occurs in approximately half of all patients with chronic daily headaches.
1st line treatment for generalized anxiety disorder:
- buspar
- zoloft
,- wellbutrin
- remeron
zoloft
Explanation: SSRIs increase serotonin levels in the brain, which helps improve mood and reduce
anxiety. Serotonin is a neurotransmitter associated with mood regulation and anxiety reduction.
By blocking the reabsorption (reuptake) of serotonin into neurons, Zoloft allows more serotonin
to be available in the brain, which can help improve mood and reduce anxiety.
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).
- refer to physical therapy.
- start methocarbamol (Robaxin).
discontinue amitriptyline (Elavil) and begin gabapentin (Neurontin)
Explanation: 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
An adult male presents with general malaise and concerns about delayed ejaculation. His
medication regimen consists of quinapril (Accupril) 20 mg daily; paroxetine (Paxil) 20 mg daily;
loratadine (Claritin) 10 mg daily; hydrochlorothiazide (HCTZ) 25 mg daily. The delayed
ejaculation is most likely caused by the:
- quinapril (Accupril).
- loratadine (Claritin).
- hydrochlorothiazide (HCTZ).
- paroxetine (Paxil).
paroxetine (Paxil).
A 22-year-old has ASCAS on Pap smear and negative for HPV. The next step is:
- No follow up is needed.
- Repeat HPV in 3 months
- Colposcopy
- Repeat Pap in 6 months
,Repeat Pap in 6 months
Explanation: For a 22-year-old with ASC-US on Pap smear and a negative HPV test, the next
appropriate step is to repeat the cytology in six months. This approach minimizes unnecessary
interventions while ensuring ongoing monitoring for any potential progression of cervical cell
abnormalities.
A pap smear report for a 24-year-old indicates atypical squamous cells of undetermined
significance (ASCUS). The patient's previous Pap smears were normal. The nurse practitioner
should next:
- Refer for colposcopy
- Repeat the Pap smear in 1 month
- Have the patient return for a Pap smear in 1 year
- Request HPV testing
Request HPV testing
Explanation: Managing an abnormal Pap smear involves a combination of further diagnostic
evaluations, patient communication, and appropriate follow-up actions. For cases of other
uncertain results, HPV testing can help determine the need for further investigation.
Which of the following tests is the most effective in differentiating between solid and cystic
breast lesions?
- Ultrasonography
- Xeromammographic
- Screening mammography
- Fine needle aspiration
Ultrasonography
Explanation: Ultrasound is the most effective and widely used imaging technique for
distinguishing between solid and cystic breast lesions.
A female patient was sexually assaulted within the past 120 hours and is concerned about
unwanted pregnancy. The correct prescription would be:
- misprostol
- medroxprogesterone, 5mg every 6 hours times 4
- norgestrel
- levonorgestrel 1.5 mg as a single dose
levonorgestrel 1.5 mg as a single dose
Explanation:
, Levonorgestrel is a type of emergency contraception, commonly known as the morning-after pill.
Levonorgestrel works in the following ways:
Prevention of Ovulation: Levonorgestrel primarily works by preventing ovulation, meaning it
stops the release of an egg from the ovary.
Interference with Fertilization: It may also interfere with fertilization by affecting the movement
of sperm or egg.
Alteration of the Uterine Lining: Levonorgestrel can alter the lining of the uterus, making it less
suitable for implantation if fertilization has already occurred.
Major complications of pelvic inflammatory disease (PID) include:
- polycystic ovaries and bleeding corpus luteum.
- infertility and ectopic pregnancy.
- diverticulitis and endometriosis.
- pelvic organ prolapse.
infertility and ectopic pregnancy.
Explanation: Pelvic inflammatory disease (PID) can lead to severe and long-term complications
if not adequately treated. These complications include chronic pelvic pain, infertility, ectopic
pregnancy, tubo-ovarian abscess, Fitz-Hugh-Curtis syndrome, adhesions, recurrent PID, and
increased risk of miscarriage and preterm birth. Early diagnosis, prompt treatment of STIs, and
regular medical follow-ups are essential to prevent these complications and protect reproductive
health.
An adult female Pap smear results reveals high-grade squamous intraepithelial lesion. What
should the nurse practitioner do next?
- Perform human papillomavirus testing
- Repeat the Pap smear in 1 month
- Repeat the Pap smear in 4 to 6 months
- Refer for colposcopy
Refer for colposcopy
Explanation:
When a Pap smear reveals a high-grade squamous intraepithelial lesion (HSIL), it indicates a
significant abnormality that has a higher potential to progress to cervical cancer if left untreated.
The recommended next step is further evaluation through colposcopy and possibly biopsy.
A 16-year-old female in the first month of taking Ortho-Novum 7/7/7 complains of midcycle
spotting. She has not missed any doses and uses no other medication. Which of the following is
