NR 547 CEA Exam 2025| Chamberlain
University| Pre-Clinical Diagnostic Exam
Questions and Correct Answers
1. Your 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 powerlifter and works as a
trash collector. Which of the following diagnoses do you suspect the patient likely
has?
A. Hydrocele
B. Varicocele
C. Testicular torsion
D. Epididymitis
Correct Answer: B. Varicocele
Explanation: A varicocele is characterized by enlarged scrotal veins, often described
as feeling like a "bag of worms," and can be exacerbated by activities like heavy lifting
(e.g., powerlifting) or prolonged standing (e.g., trash collection).
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. Right 4th intercostal space midclavicular line
B. Left 5th intercostal space midclavicular line
C. Left 3rd intercostal space parasternal line
D. Right 5th intercostal space midclavicular line
Correct Answer: B. Left 5th intercostal space midclavicular line
Explanation: The PMI, corresponding to the apex of the heart, is typically palpable at
the left 5th intercostal space in the midclavicular line in healthy adults.
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 the highest on your differential diagnosis of this
physical examination finding?
A. Hypothyroidism
B. Hyperthyroidism
C. Orbital cellulitis
D. Myasthenia gravis
, Correct Answer: B. Hyperthyroidism
Explanation: Exophthalmos is a hallmark sign of hyperthyroidism, particularly
Graves’ disease, due to retro-orbital inflammation and tissue deposition.
4. Your patient with a suspected diagnosis of COPD has been seen by pulmonology
and has undergone a pulmonary function test (PFT) with spirometry. You explain
to the patient 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. Tidal volume
B. Forced vital capacity
C. Residual volume
D. Inspiratory reserve volume
Correct Answer: B. Forced vital capacity
Explanation: Forced vital capacity (FVC) measures the maximum volume of air
exhaled after a maximal inhalation, assessed during spirometry.
5. Your patient has a diagnosis of Addison’s disease. Which of the following might you
expect to find during an examination?
A. Hyperthermia
B. Low body temperature
C. Hypertension
D. Weight gain
Correct Answer: B. Low body temperature
Explanation: Addison’s disease (primary adrenal insufficiency) can cause
hypothermia due to reduced cortisol and aldosterone, affecting metabolism and
thermoregulation.
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
Explanation: Type 2 diabetes can cause end-organ damage, requiring renal function
panel (kidney damage), urinalysis (proteinuria, glycosuria), and eye exams (retinopathy).
7. During your visit with a 19-year-old patient for a college health physical, your
health history includes a diagnosis of angioedema. Which of the following parts of
the body was likely involved?
, A. Hands and feet
B. Face and lips
C. Abdomen
D. Lower legs
Correct Answer: B. Face and lips
Explanation: Angioedema commonly affects the face, lips, tongue, and throat, causing
swelling due to allergic or hereditary causes.
8. Which of the following dermatologic lesions is precancerous and likely due to
prolonged exposure to UV-B?
A. Seborrheic keratosis
B. Actinic keratosis
C. Basal cell carcinoma
D. Melanoma
Correct Answer: B. Actinic keratosis
Explanation: Actinic keratosis is a precancerous lesion caused by chronic UV-B
exposure, often progressing to squamous cell carcinoma if untreated.
9. Based on your evaluation of ABCDE for melanoma, which of the following
represents a suspicious finding?
A. Symmetrical shape
B. Irregular borders
C. Uniform color
D. Diameter less than 6 mm
Correct Answer: B. Irregular borders
Explanation: The ABCDE criteria for melanoma include Border irregularity,
indicating a suspicious lesion that may require biopsy.
10. Your patient is complaining of hypersomnia, lack of motivation, weight gain, and
anhedonia. Suspecting a diagnosis of clinical depression, you anticipate the patient
will benefit from treating their underlying deficit of which of the following
neurotransmitters?
A. Dopamine
B. Serotonin
C. Acetylcholine
D. GABA
Correct Answer: B. Serotonin
Explanation: Clinical depression is associated with serotonin deficiency, and
treatments like SSRIs aim to increase serotonin levels.
, 11. As a prudent nurse practitioner, the diabetic, hypertensive patient you are seeing
should be evaluated for early evidence of renal damage from both diabetes and
hypertension. Which of the following assessment tools should the nurse practitioner
order first for the evaluation of early renal dysfunction secondary to diabetes or
hypertension?
A. Serum creatinine
B. Urinalysis with micro/macro albumin
C. Renal ultrasound
D. 24-hour urine collection
Correct Answer: B. Urinalysis with micro/macro albumin
Explanation: Microalbuminuria is an early marker of renal damage in diabetes and
hypertension, detectable via urinalysis.
12. While evaluating a patient in your clinic for a routine health visit, you auscultate
crackles in the posterolateral left lower lobe and have the patient cough. Follow-up
auscultation reveals clear breath sounds. Which one of the following would you
suspect?
A. Pneumonia
B. Atelectasis
C. Pulmonary edema
D. Pleural effusion
Correct Answer: B. Atelectasis
Explanation: Crackles that clear after coughing suggest atelectasis, where collapsed
alveoli reopen with coughing.
13. Your 39-year-old patient, who has recently been hospitalized for an appendectomy,
is being seen in your clinic for post-operative follow-up with primary care. On
assessment, the patient complains of some incisional pain, and otherwise
examination is standard, with the exception of dull percussion sounds noted on the
thorax over lung tissue. Which of the following diagnoses would be explained by this
finding in a post-operative patient?
A. Pneumothorax
B. Atelectasis
C. Pulmonary embolism
D. Pneumonia
Correct Answer: B. Atelectasis
Explanation: Dull percussion sounds in a post-operative patient suggest atelectasis,
common due to reduced lung expansion after surgery.
14. You are evaluating a 41-year-old female patient in your clinic with symptoms of
right upper quadrant pain that worsens with deep breathing. The patient exhibits a
positive Murphy sign. These findings are most consistent with which one of the
University| Pre-Clinical Diagnostic Exam
Questions and Correct Answers
1. Your 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 powerlifter and works as a
trash collector. Which of the following diagnoses do you suspect the patient likely
has?
A. Hydrocele
B. Varicocele
C. Testicular torsion
D. Epididymitis
Correct Answer: B. Varicocele
Explanation: A varicocele is characterized by enlarged scrotal veins, often described
as feeling like a "bag of worms," and can be exacerbated by activities like heavy lifting
(e.g., powerlifting) or prolonged standing (e.g., trash collection).
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. Right 4th intercostal space midclavicular line
B. Left 5th intercostal space midclavicular line
C. Left 3rd intercostal space parasternal line
D. Right 5th intercostal space midclavicular line
Correct Answer: B. Left 5th intercostal space midclavicular line
Explanation: The PMI, corresponding to the apex of the heart, is typically palpable at
the left 5th intercostal space in the midclavicular line in healthy adults.
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 the highest on your differential diagnosis of this
physical examination finding?
A. Hypothyroidism
B. Hyperthyroidism
C. Orbital cellulitis
D. Myasthenia gravis
, Correct Answer: B. Hyperthyroidism
Explanation: Exophthalmos is a hallmark sign of hyperthyroidism, particularly
Graves’ disease, due to retro-orbital inflammation and tissue deposition.
4. Your patient with a suspected diagnosis of COPD has been seen by pulmonology
and has undergone a pulmonary function test (PFT) with spirometry. You explain
to the patient 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. Tidal volume
B. Forced vital capacity
C. Residual volume
D. Inspiratory reserve volume
Correct Answer: B. Forced vital capacity
Explanation: Forced vital capacity (FVC) measures the maximum volume of air
exhaled after a maximal inhalation, assessed during spirometry.
5. Your patient has a diagnosis of Addison’s disease. Which of the following might you
expect to find during an examination?
A. Hyperthermia
B. Low body temperature
C. Hypertension
D. Weight gain
Correct Answer: B. Low body temperature
Explanation: Addison’s disease (primary adrenal insufficiency) can cause
hypothermia due to reduced cortisol and aldosterone, affecting metabolism and
thermoregulation.
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
Explanation: Type 2 diabetes can cause end-organ damage, requiring renal function
panel (kidney damage), urinalysis (proteinuria, glycosuria), and eye exams (retinopathy).
7. During your visit with a 19-year-old patient for a college health physical, your
health history includes a diagnosis of angioedema. Which of the following parts of
the body was likely involved?
, A. Hands and feet
B. Face and lips
C. Abdomen
D. Lower legs
Correct Answer: B. Face and lips
Explanation: Angioedema commonly affects the face, lips, tongue, and throat, causing
swelling due to allergic or hereditary causes.
8. Which of the following dermatologic lesions is precancerous and likely due to
prolonged exposure to UV-B?
A. Seborrheic keratosis
B. Actinic keratosis
C. Basal cell carcinoma
D. Melanoma
Correct Answer: B. Actinic keratosis
Explanation: Actinic keratosis is a precancerous lesion caused by chronic UV-B
exposure, often progressing to squamous cell carcinoma if untreated.
9. Based on your evaluation of ABCDE for melanoma, which of the following
represents a suspicious finding?
A. Symmetrical shape
B. Irregular borders
C. Uniform color
D. Diameter less than 6 mm
Correct Answer: B. Irregular borders
Explanation: The ABCDE criteria for melanoma include Border irregularity,
indicating a suspicious lesion that may require biopsy.
10. Your patient is complaining of hypersomnia, lack of motivation, weight gain, and
anhedonia. Suspecting a diagnosis of clinical depression, you anticipate the patient
will benefit from treating their underlying deficit of which of the following
neurotransmitters?
A. Dopamine
B. Serotonin
C. Acetylcholine
D. GABA
Correct Answer: B. Serotonin
Explanation: Clinical depression is associated with serotonin deficiency, and
treatments like SSRIs aim to increase serotonin levels.
, 11. As a prudent nurse practitioner, the diabetic, hypertensive patient you are seeing
should be evaluated for early evidence of renal damage from both diabetes and
hypertension. Which of the following assessment tools should the nurse practitioner
order first for the evaluation of early renal dysfunction secondary to diabetes or
hypertension?
A. Serum creatinine
B. Urinalysis with micro/macro albumin
C. Renal ultrasound
D. 24-hour urine collection
Correct Answer: B. Urinalysis with micro/macro albumin
Explanation: Microalbuminuria is an early marker of renal damage in diabetes and
hypertension, detectable via urinalysis.
12. While evaluating a patient in your clinic for a routine health visit, you auscultate
crackles in the posterolateral left lower lobe and have the patient cough. Follow-up
auscultation reveals clear breath sounds. Which one of the following would you
suspect?
A. Pneumonia
B. Atelectasis
C. Pulmonary edema
D. Pleural effusion
Correct Answer: B. Atelectasis
Explanation: Crackles that clear after coughing suggest atelectasis, where collapsed
alveoli reopen with coughing.
13. Your 39-year-old patient, who has recently been hospitalized for an appendectomy,
is being seen in your clinic for post-operative follow-up with primary care. On
assessment, the patient complains of some incisional pain, and otherwise
examination is standard, with the exception of dull percussion sounds noted on the
thorax over lung tissue. Which of the following diagnoses would be explained by this
finding in a post-operative patient?
A. Pneumothorax
B. Atelectasis
C. Pulmonary embolism
D. Pneumonia
Correct Answer: B. Atelectasis
Explanation: Dull percussion sounds in a post-operative patient suggest atelectasis,
common due to reduced lung expansion after surgery.
14. You are evaluating a 41-year-old female patient in your clinic with symptoms of
right upper quadrant pain that worsens with deep breathing. The patient exhibits a
positive Murphy sign. These findings are most consistent with which one of the
