CEA Prep: Full Practice Exam Questions & Answers.
Left upper lobe lingula
1. The patient is exhibiting a pro-
Ratonale: Lingular consolidation is described in this question
ductive cough and a low-grade
precisely. If the cardiac margin/silhouette is obliterated by
fever. Chest X-ray on PA view
the mass, the lesion is either right middle lobe or left upper
shows a left lower chest area
of consolidation adjacent to the lobe lingula.
left border of the heart approx-
imately 2 rib spaces above the
costophrenic angle. The lateral
x-ray view shows this lesion ab-
sent of the window posterior to
the cardiac silhouette. Which is
the most likely location of this
area of focal consolidation?
*Left upper lobe apex
*Right middle lobe
*Left upper lobe lingula
*Left lower lobe
2. The inability to fully relax the Diastolic dysfunction
myocardium during relaxation Rationale: The inability for the heart to relax is a trademark
is a trademark of which of the of the diagnosis of diastolic dysfunction and is common in
following diagnoses? patients with thickened hypertrophic myocardium.
3. An otherwise healthy African Calcium channel blocker
American adult male has been Rationale: African American patients per JNC8 Hypertension
diagnosed with hypertension. Guidelines should be managed with a dihydropyridine cal-
He has been restricting his salt cium channel blocker such as amlodipine (Norvasc) as first
intake, eating a DASH (Dietary line management therapy for hypertension not at goal with
Approaches to Stop Hyperten- DASH and lifestyle modifications.
sion) diet, and exercising more,
but his blood pressure is still el-
, CEA Prep: Full Practice Exam Questions & Answers.
evated. Which is the BEST med-
ication to prescribe him?
4. Your patient has been diag- CT angiography of the chest
nosed with a 4.5cm ascending Rationale: CT angiography is considered the standard of care
aortic aneurysm. Which med- for measuring vascular luminal dimensions with contrast. CT
ical imaging is considered stan- PE protocol is not timed properly for the aorta (it's timed for
dard of care for serial surveil- the pulmonary artery). Although a plain film is able to catch
lance? large aneurysms at times, they are not able to provide mul-
ti-axis reconstruction needed to accurately measure the size.
Transesophageal echo is not needed to accurately measure
the aorta and requires the patient to undergo sedation which
is unnecessary.
5. Which of the following med- phenylephrine
ications does not cause beta 1 Rationale: Phenylephrine only stimulates alpha 1 receptors.
stimulation? The remaining three all have beta receptor activity.
6. A 50-year-old woman with a Congestive heart failure
history of hypertension pre- Rationale: Of the available options, the most accurate re-
sents with dyspnea on exer- sponse is congestive heart failure as it is signifying both
tion and orthopnea. On exam- a right ventricular back up with jugular venous extension
ination, she has jugular venous and crackles on lung assault, which are suggestive of left
distention and bilateral crack- ventricular back up. it is possible the patient may have an
les on lung auscultation. What acute myocardial infarction that precipitated this, however,
is the most likely diagnosis? a patient has not described that, rather is only describing
dyspnea on exertion and orthopnea, which both speak to
a state of fluid overload. The only appropriate response of
these available is congestive heart failure.
7. Your patient with a history of Ordering a transthoracic echocardiogram and order a
HFrEF (heart failure with re- Lifevest if EF is less than 35%
, CEA Prep: Full Practice Exam Questions & Answers.
duced ejection fraction) with an Rationale: The patient should have a protective mechanism
, CEA Prep: Full Practice Exam Questions & Answers.
ejection fraction of 40% who such as an implantable automated cardioverter defibrillator
is also not on optimal med- (AICD) or a Lifevest if the EF is less than 35% due to the in-
ical therapy has been diag- creased risk of sudden cardiac death with low EF states. Since
nosed with a myocardial in- most patients are not eligible for 90 days for an AICD in this
farction this admission and re- state, optimizing their medication regimen and repeating an
ceived emergent placement of echo in 2-3 months to re-evaluate for improvement in their
a drug-eluting stent to the EF is required by most insurance companies. A baseline echo
left anterior descending artery. is needed at discharge to provide a baseline for improve-
As the medical home who ment vs their repeat echo in 2-3 months.
will manage this patient af- Dual anti-platelet therapy is required for 12 months mini-
ter discharge, which medica- mum post-MI.
tion strategy would you expect A Holter monitor does not provide any conceivable benefit
to be a priority in the patient's for this patient as presented.
care?
8. A 65-year-old woman presents a statin drug.
for a follow-up examination. Rationale: Bile acid sequestrants and cholesterol absorption
She is a smoker, and her hy- inhibitors may be useful in reducing ASVD risk, but for a
pertension is now adequate- patient who is an active smoker with premature coronary dis-
ly controlled with medication. ease history (less than age 65 for women), has hypertension
Her mother died at age 40 and is far from an LDL goal, this patient is most certainly
from a heart attack. The fasting a candidate for statin therapy, which represents the most
lipid profile shows cholesterol = aggressive therapy option of these four listed.
240 mg/dL, HDL = 30, and LDL
= 200. In addition to starting
therapeutic lifestyle changes,
the nurse practitioner should
start the patient on:
9. Which of the following end-or- Peripheral neuropathy
gan sequelae is not directly Ratioanle: Although patients with hypertension frequently
Left upper lobe lingula
1. The patient is exhibiting a pro-
Ratonale: Lingular consolidation is described in this question
ductive cough and a low-grade
precisely. If the cardiac margin/silhouette is obliterated by
fever. Chest X-ray on PA view
the mass, the lesion is either right middle lobe or left upper
shows a left lower chest area
of consolidation adjacent to the lobe lingula.
left border of the heart approx-
imately 2 rib spaces above the
costophrenic angle. The lateral
x-ray view shows this lesion ab-
sent of the window posterior to
the cardiac silhouette. Which is
the most likely location of this
area of focal consolidation?
*Left upper lobe apex
*Right middle lobe
*Left upper lobe lingula
*Left lower lobe
2. The inability to fully relax the Diastolic dysfunction
myocardium during relaxation Rationale: The inability for the heart to relax is a trademark
is a trademark of which of the of the diagnosis of diastolic dysfunction and is common in
following diagnoses? patients with thickened hypertrophic myocardium.
3. An otherwise healthy African Calcium channel blocker
American adult male has been Rationale: African American patients per JNC8 Hypertension
diagnosed with hypertension. Guidelines should be managed with a dihydropyridine cal-
He has been restricting his salt cium channel blocker such as amlodipine (Norvasc) as first
intake, eating a DASH (Dietary line management therapy for hypertension not at goal with
Approaches to Stop Hyperten- DASH and lifestyle modifications.
sion) diet, and exercising more,
but his blood pressure is still el-
, CEA Prep: Full Practice Exam Questions & Answers.
evated. Which is the BEST med-
ication to prescribe him?
4. Your patient has been diag- CT angiography of the chest
nosed with a 4.5cm ascending Rationale: CT angiography is considered the standard of care
aortic aneurysm. Which med- for measuring vascular luminal dimensions with contrast. CT
ical imaging is considered stan- PE protocol is not timed properly for the aorta (it's timed for
dard of care for serial surveil- the pulmonary artery). Although a plain film is able to catch
lance? large aneurysms at times, they are not able to provide mul-
ti-axis reconstruction needed to accurately measure the size.
Transesophageal echo is not needed to accurately measure
the aorta and requires the patient to undergo sedation which
is unnecessary.
5. Which of the following med- phenylephrine
ications does not cause beta 1 Rationale: Phenylephrine only stimulates alpha 1 receptors.
stimulation? The remaining three all have beta receptor activity.
6. A 50-year-old woman with a Congestive heart failure
history of hypertension pre- Rationale: Of the available options, the most accurate re-
sents with dyspnea on exer- sponse is congestive heart failure as it is signifying both
tion and orthopnea. On exam- a right ventricular back up with jugular venous extension
ination, she has jugular venous and crackles on lung assault, which are suggestive of left
distention and bilateral crack- ventricular back up. it is possible the patient may have an
les on lung auscultation. What acute myocardial infarction that precipitated this, however,
is the most likely diagnosis? a patient has not described that, rather is only describing
dyspnea on exertion and orthopnea, which both speak to
a state of fluid overload. The only appropriate response of
these available is congestive heart failure.
7. Your patient with a history of Ordering a transthoracic echocardiogram and order a
HFrEF (heart failure with re- Lifevest if EF is less than 35%
, CEA Prep: Full Practice Exam Questions & Answers.
duced ejection fraction) with an Rationale: The patient should have a protective mechanism
, CEA Prep: Full Practice Exam Questions & Answers.
ejection fraction of 40% who such as an implantable automated cardioverter defibrillator
is also not on optimal med- (AICD) or a Lifevest if the EF is less than 35% due to the in-
ical therapy has been diag- creased risk of sudden cardiac death with low EF states. Since
nosed with a myocardial in- most patients are not eligible for 90 days for an AICD in this
farction this admission and re- state, optimizing their medication regimen and repeating an
ceived emergent placement of echo in 2-3 months to re-evaluate for improvement in their
a drug-eluting stent to the EF is required by most insurance companies. A baseline echo
left anterior descending artery. is needed at discharge to provide a baseline for improve-
As the medical home who ment vs their repeat echo in 2-3 months.
will manage this patient af- Dual anti-platelet therapy is required for 12 months mini-
ter discharge, which medica- mum post-MI.
tion strategy would you expect A Holter monitor does not provide any conceivable benefit
to be a priority in the patient's for this patient as presented.
care?
8. A 65-year-old woman presents a statin drug.
for a follow-up examination. Rationale: Bile acid sequestrants and cholesterol absorption
She is a smoker, and her hy- inhibitors may be useful in reducing ASVD risk, but for a
pertension is now adequate- patient who is an active smoker with premature coronary dis-
ly controlled with medication. ease history (less than age 65 for women), has hypertension
Her mother died at age 40 and is far from an LDL goal, this patient is most certainly
from a heart attack. The fasting a candidate for statin therapy, which represents the most
lipid profile shows cholesterol = aggressive therapy option of these four listed.
240 mg/dL, HDL = 30, and LDL
= 200. In addition to starting
therapeutic lifestyle changes,
the nurse practitioner should
start the patient on:
9. Which of the following end-or- Peripheral neuropathy
gan sequelae is not directly Ratioanle: Although patients with hypertension frequently
