CEA Exam Questions and Answers
During a post-hospital discharge visit, you notice your 71 year old female patient has been diagnosed
with a "new murmur" found by the hospitalist during their recent hospitalization for CHF exacerbation.
In evaluating the patient, during which phase of the cardiac cycle would you anticipate auscultation of a
S3 or S4 heart sound?
*Diastole
*53 in systole while S4 in diastole
*Systole
*S4 in diastole while S3 in systole - Answer-Diastole
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?
*Left 2nd intercostal space, midaxillary line.
*Left 5th intercostal space, midclavicular line.
*Right 4th intercostal space, midaxillary line.
*Right 2nd intercostal space, midclavicular line. - Answer-Left 5th intercostal space, midclavicular line
,The nurse practitioner assessing the patient with a rapid cardiac rhythm may assess for a pulse deficit by
auscultating the patient's heart while watching the EKG rhythm. Where would the S1 heart sounds
correlate with the electrocardiographic waves?
*At the end of the T wave.
*At the start of the T wave.
*Peak of the R wave.
*At the start of the P wave. - Answer-Peak of the R wave.
Michael, a 72 year old male patient who previously presented with stable cardiac-type chest pain has
underwent a stress test. He presents today to review the stress test results, which show EKG findings of
ST segment depression during the exam in leads V3 and V4 as well as some concurrent chest discomfort.
Based on these findings, which of the following are NOT priority medical decisions?
*Prescribe metoprolol (Lopressor) 12.5mg PO BID
*Prescribe aspirin 81mg PO daily
*Refer to cardiology for angiography
• Check for thyroid dysfunction - Answer-Check for thyroid dysfunction
While examining a 53 year old female patient, you auscultate abnormal breath sounds over all fields,
and now assess transmission of voice sounds by having the patient say "ee" while auscultating the chest
with the diaphragm of your stethoscope. Normally, you should auscultate a muffled "e" sound, however,
you hear hear a nasally "a" sound. Which one of the following will you document is present?
*Positive stereognosis.
*Positive for egophony.
*Negative for bronchophony.
*Negative for egophony - Answer-Positive for egophony
While assessing the 19 year old patient for a new onset cough, the nurse practitioner may inspect,
auscultate, palpate, and/or percuss.
How does performing percussion of the thorax assist the provider during the physical examination?
,*To assist with the confirmation of cardiac origin of angina.
*To assess for deep-seated lesion and tumors.
*To assess for any pain or discomfort prior to palpitation of the chest wall.
*To identify if underlying tissue are air-filled, fluid-filled or consolidated - Answer-To identify if
underlying tissue are air-filled, fluid-filled or consolidated
Your 42 year old male patient has been referred to your clinic for establishing care and on his intake
survey, you note he has documented diagnosis of interstitial lung disease. You have decided to perform
a diaphragmatic excursion test on the patient. Which one of the following results would you expect to
see in this patient?
*Approximately equal level of change in the descent of the diaphragm bilaterally during maximal
inspiration and expiration. with a decreased overall inspiratory capacity.
*Ascension of 8-12 inches of the diaphragm noted bilaterally on expiration, though often much less on
the right side due to the location of the heart and great vessels.
*Much greater descent of the diaphragm on the right side due to the liver present (two-three times
larger).
*Absent or no change in movement of the diaphragm noted between full inspiration and full expiration
measurement. - Answer-Approximately equal level of change in the descent of the diaphragm
bilaterally during maximal inspiration and expiration. with a decreased overall inspiratory capacity
Your 50 year old Caucasian male patient has not seen a primary care giver in 20+ years and is here for a
history and physical examination. While examining the head and face, you see your patient has
nonpitting periorbital edema, particularly underneath their eyes and very dry, thinned hair, including the
lateral third of eyebrows (as pictured below: Sparse hairline, thin lateral eyebrows, Periobital edema).
Which one of the folowing would you expect to cause this finding?
*Severe hypothyroidism
*Addison's disease
*Grave's disease
*Alzhemiers. - Answer-Severe hypothyroidism
, A40 year old, female, African American patient presents for history and physical. Upon your initial
assessment, you notice she has severe exophthalmos as pictured below. Which one of the following
diagnoses below would be the highest on your differential diagnose of this physical examination finding?
(eyes bulging out of her head)
*Bilateral conjunctivitis.
*Hyperthyroidism.
*hypothyroidism
*myexedma - Answer-Hyperthyroidism.
Your patient with a suspected diagnosis of COPD has been seen by pulmonology and has underwent a
pulmonary function test (PFT) with spirometry. As the patient's primary healthcare provider, you have
been asked to explain the findings of the PFT to the patient in a
follow-up visit at which time the patient asks what the study was evaluating. To describe the PFT to the
patient in more useful terms, 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?
*Forced Expiratory Volume over 1 second (FEV1).
*Functional Reserve Capacity.
*Inspiratory Reserve
*Forced Vital Capacity. - Answer-Forced Vital Capacity.
Your newly established patient states in the past year, they have progressively developed a noticeable
bump on their neck and when asked about symptoms, they report feeling very anxious, have developed
a tremor, and are commonly feeling palpitations in their chest.
On examination, you identify an enlarged thyroid gland suspicious for a goiter. Of the following
diagnoses, which is most likely for the patient to develop based on these findings above?
*Thyrotoxicosis.
*lodine Excess.
*Myxedema Coma.
*Hashimotos Thyroiditis...not this one - Answer-Thyrotoxicosis
During a post-hospital discharge visit, you notice your 71 year old female patient has been diagnosed
with a "new murmur" found by the hospitalist during their recent hospitalization for CHF exacerbation.
In evaluating the patient, during which phase of the cardiac cycle would you anticipate auscultation of a
S3 or S4 heart sound?
*Diastole
*53 in systole while S4 in diastole
*Systole
*S4 in diastole while S3 in systole - Answer-Diastole
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?
*Left 2nd intercostal space, midaxillary line.
*Left 5th intercostal space, midclavicular line.
*Right 4th intercostal space, midaxillary line.
*Right 2nd intercostal space, midclavicular line. - Answer-Left 5th intercostal space, midclavicular line
,The nurse practitioner assessing the patient with a rapid cardiac rhythm may assess for a pulse deficit by
auscultating the patient's heart while watching the EKG rhythm. Where would the S1 heart sounds
correlate with the electrocardiographic waves?
*At the end of the T wave.
*At the start of the T wave.
*Peak of the R wave.
*At the start of the P wave. - Answer-Peak of the R wave.
Michael, a 72 year old male patient who previously presented with stable cardiac-type chest pain has
underwent a stress test. He presents today to review the stress test results, which show EKG findings of
ST segment depression during the exam in leads V3 and V4 as well as some concurrent chest discomfort.
Based on these findings, which of the following are NOT priority medical decisions?
*Prescribe metoprolol (Lopressor) 12.5mg PO BID
*Prescribe aspirin 81mg PO daily
*Refer to cardiology for angiography
• Check for thyroid dysfunction - Answer-Check for thyroid dysfunction
While examining a 53 year old female patient, you auscultate abnormal breath sounds over all fields,
and now assess transmission of voice sounds by having the patient say "ee" while auscultating the chest
with the diaphragm of your stethoscope. Normally, you should auscultate a muffled "e" sound, however,
you hear hear a nasally "a" sound. Which one of the following will you document is present?
*Positive stereognosis.
*Positive for egophony.
*Negative for bronchophony.
*Negative for egophony - Answer-Positive for egophony
While assessing the 19 year old patient for a new onset cough, the nurse practitioner may inspect,
auscultate, palpate, and/or percuss.
How does performing percussion of the thorax assist the provider during the physical examination?
,*To assist with the confirmation of cardiac origin of angina.
*To assess for deep-seated lesion and tumors.
*To assess for any pain or discomfort prior to palpitation of the chest wall.
*To identify if underlying tissue are air-filled, fluid-filled or consolidated - Answer-To identify if
underlying tissue are air-filled, fluid-filled or consolidated
Your 42 year old male patient has been referred to your clinic for establishing care and on his intake
survey, you note he has documented diagnosis of interstitial lung disease. You have decided to perform
a diaphragmatic excursion test on the patient. Which one of the following results would you expect to
see in this patient?
*Approximately equal level of change in the descent of the diaphragm bilaterally during maximal
inspiration and expiration. with a decreased overall inspiratory capacity.
*Ascension of 8-12 inches of the diaphragm noted bilaterally on expiration, though often much less on
the right side due to the location of the heart and great vessels.
*Much greater descent of the diaphragm on the right side due to the liver present (two-three times
larger).
*Absent or no change in movement of the diaphragm noted between full inspiration and full expiration
measurement. - Answer-Approximately equal level of change in the descent of the diaphragm
bilaterally during maximal inspiration and expiration. with a decreased overall inspiratory capacity
Your 50 year old Caucasian male patient has not seen a primary care giver in 20+ years and is here for a
history and physical examination. While examining the head and face, you see your patient has
nonpitting periorbital edema, particularly underneath their eyes and very dry, thinned hair, including the
lateral third of eyebrows (as pictured below: Sparse hairline, thin lateral eyebrows, Periobital edema).
Which one of the folowing would you expect to cause this finding?
*Severe hypothyroidism
*Addison's disease
*Grave's disease
*Alzhemiers. - Answer-Severe hypothyroidism
, A40 year old, female, African American patient presents for history and physical. Upon your initial
assessment, you notice she has severe exophthalmos as pictured below. Which one of the following
diagnoses below would be the highest on your differential diagnose of this physical examination finding?
(eyes bulging out of her head)
*Bilateral conjunctivitis.
*Hyperthyroidism.
*hypothyroidism
*myexedma - Answer-Hyperthyroidism.
Your patient with a suspected diagnosis of COPD has been seen by pulmonology and has underwent a
pulmonary function test (PFT) with spirometry. As the patient's primary healthcare provider, you have
been asked to explain the findings of the PFT to the patient in a
follow-up visit at which time the patient asks what the study was evaluating. To describe the PFT to the
patient in more useful terms, 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?
*Forced Expiratory Volume over 1 second (FEV1).
*Functional Reserve Capacity.
*Inspiratory Reserve
*Forced Vital Capacity. - Answer-Forced Vital Capacity.
Your newly established patient states in the past year, they have progressively developed a noticeable
bump on their neck and when asked about symptoms, they report feeling very anxious, have developed
a tremor, and are commonly feeling palpitations in their chest.
On examination, you identify an enlarged thyroid gland suspicious for a goiter. Of the following
diagnoses, which is most likely for the patient to develop based on these findings above?
*Thyrotoxicosis.
*lodine Excess.
*Myxedema Coma.
*Hashimotos Thyroiditis...not this one - Answer-Thyrotoxicosis
