NR 667 Comprehensive Exit Examination
CEA ACTUAL EXAM 2025 | Complete
Prep Guide | 324 Correctly Answered
Questions | Chamberlain University |
Guaranteed Pass Score | Verified Q&A - A+
Graded
DOMAIN 1: ASSESSMENT AND DIAGNOSIS (80 Questions)
Q1. A 45-year-old female presents with fatigue, weight gain, cold intolerance, constipation, and dry
skin. Physical examination reveals bradycardia, delayed deep tendon reflexes, and a palpable
goiter. What is the most appropriate initial diagnostic test?
A. Free T4 and TSH [CORRECT]
B. Thyroid ultrasound
C. Thyroid antibody panel
D. Thyroid scan
,Correct Answer: A
Rationale: TSH and free T4 are the initial tests for suspected thyroid dysfunction. TSH is the most
sensitive marker for hypothyroidism (elevated). Free T4 confirms the diagnosis and distinguishes
subclinical from overt hypothyroidism. Ultrasound (B) is indicated for nodule evaluation. Antibodies
(C) confirm autoimmune etiology (Hashimoto's) but are not initial diagnostic tests. Thyroid scan (D)
is used for hyperthyroidism or functional nodule evaluation.
Q2. A 68-year-old male with a 50-pack-year smoking history presents with chronic cough,
hemoptysis, and unintentional weight loss. Which initial imaging study is most appropriate?
A. Chest X-ray [CORRECT]
B. CT chest with contrast
C. PET-CT
D. MRI chest
Correct Answer: A
Rationale: Chest X-ray is the initial imaging study for suspected lung cancer. If abnormal, CT chest
without contrast is indicated for further characterization and staging workup. PET-CT (C) is used for
staging after tissue diagnosis. MRI (D) is reserved for evaluating superior sulcus tumors or brain
metastases.
,Q3. A 28-year-old female presents with episodic headaches, palpitations, sweating, and anxiety.
Blood pressure is 180/110 mmHg during episodes and normal between episodes. What is the most
appropriate initial test?
A. 24-hour urine catecholamines and metanephrines [CORRECT]
B. Renal artery Doppler ultrasound
C. Aldosterone-to-renin ratio
D. Serum cortisol
Correct Answer: A
Rationale: The episodic hypertension with classic triad of headache, palpitations, and sweating
suggests pheochromocytoma. Twenty-four-hour urine catecholamines and fractionated
metanephrines are the initial screening tests. Plasma-free metanephrines are also used. Renal
artery stenosis (B) causes refractory hypertension but not episodic symptoms. Primary
aldosteronism (C) causes resistant hypertension with hypokalemia.
Q4. A 52-year-old male presents with acute chest pain radiating to the back and a blood pressure
difference of 20 mmHg between arms. What is the diagnostic test of choice?
A. CT angiography of chest/abdomen/pelvis [CORRECT]
B. Transthoracic echocardiogram
C. Cardiac catheterization
, D. MRI angiography
Correct Answer: A
Rationale: This presentation is classic for aortic dissection. CT angiography is the diagnostic test of
choice—rapid, widely available, and highly sensitive/specific. TTE (B) may miss ascending aortic
dissections. Cardiac cath (C) is contraindicated due to risk of perforation.
Q5. A 34-year-old female with SLE presents with dyspnea, chest pain, and tachypnea. D-dimer is
elevated. What is the next step in management?
A. CT pulmonary angiography [CORRECT]
B. Ventilation-perfusion scan
C. D-dimer recheck in 48 hours
D. Lower extremity ultrasound
Correct Answer: A
Rationale: In patients with high clinical probability for PE (Wells criteria) or intermediate probability
with elevated D-dimer, CT pulmonary angiography (CTPA) is the diagnostic test of choice. V/Q
scan (B) is used when CTPA is contraindicated (pregnancy, renal failure). D-dimer (C) is not
followed serially. LE ultrasound (D) identifies DVT but does not diagnose PE directly.
CEA ACTUAL EXAM 2025 | Complete
Prep Guide | 324 Correctly Answered
Questions | Chamberlain University |
Guaranteed Pass Score | Verified Q&A - A+
Graded
DOMAIN 1: ASSESSMENT AND DIAGNOSIS (80 Questions)
Q1. A 45-year-old female presents with fatigue, weight gain, cold intolerance, constipation, and dry
skin. Physical examination reveals bradycardia, delayed deep tendon reflexes, and a palpable
goiter. What is the most appropriate initial diagnostic test?
A. Free T4 and TSH [CORRECT]
B. Thyroid ultrasound
C. Thyroid antibody panel
D. Thyroid scan
,Correct Answer: A
Rationale: TSH and free T4 are the initial tests for suspected thyroid dysfunction. TSH is the most
sensitive marker for hypothyroidism (elevated). Free T4 confirms the diagnosis and distinguishes
subclinical from overt hypothyroidism. Ultrasound (B) is indicated for nodule evaluation. Antibodies
(C) confirm autoimmune etiology (Hashimoto's) but are not initial diagnostic tests. Thyroid scan (D)
is used for hyperthyroidism or functional nodule evaluation.
Q2. A 68-year-old male with a 50-pack-year smoking history presents with chronic cough,
hemoptysis, and unintentional weight loss. Which initial imaging study is most appropriate?
A. Chest X-ray [CORRECT]
B. CT chest with contrast
C. PET-CT
D. MRI chest
Correct Answer: A
Rationale: Chest X-ray is the initial imaging study for suspected lung cancer. If abnormal, CT chest
without contrast is indicated for further characterization and staging workup. PET-CT (C) is used for
staging after tissue diagnosis. MRI (D) is reserved for evaluating superior sulcus tumors or brain
metastases.
,Q3. A 28-year-old female presents with episodic headaches, palpitations, sweating, and anxiety.
Blood pressure is 180/110 mmHg during episodes and normal between episodes. What is the most
appropriate initial test?
A. 24-hour urine catecholamines and metanephrines [CORRECT]
B. Renal artery Doppler ultrasound
C. Aldosterone-to-renin ratio
D. Serum cortisol
Correct Answer: A
Rationale: The episodic hypertension with classic triad of headache, palpitations, and sweating
suggests pheochromocytoma. Twenty-four-hour urine catecholamines and fractionated
metanephrines are the initial screening tests. Plasma-free metanephrines are also used. Renal
artery stenosis (B) causes refractory hypertension but not episodic symptoms. Primary
aldosteronism (C) causes resistant hypertension with hypokalemia.
Q4. A 52-year-old male presents with acute chest pain radiating to the back and a blood pressure
difference of 20 mmHg between arms. What is the diagnostic test of choice?
A. CT angiography of chest/abdomen/pelvis [CORRECT]
B. Transthoracic echocardiogram
C. Cardiac catheterization
, D. MRI angiography
Correct Answer: A
Rationale: This presentation is classic for aortic dissection. CT angiography is the diagnostic test of
choice—rapid, widely available, and highly sensitive/specific. TTE (B) may miss ascending aortic
dissections. Cardiac cath (C) is contraindicated due to risk of perforation.
Q5. A 34-year-old female with SLE presents with dyspnea, chest pain, and tachypnea. D-dimer is
elevated. What is the next step in management?
A. CT pulmonary angiography [CORRECT]
B. Ventilation-perfusion scan
C. D-dimer recheck in 48 hours
D. Lower extremity ultrasound
Correct Answer: A
Rationale: In patients with high clinical probability for PE (Wells criteria) or intermediate probability
with elevated D-dimer, CT pulmonary angiography (CTPA) is the diagnostic test of choice. V/Q
scan (B) is used when CTPA is contraindicated (pregnancy, renal failure). D-dimer (C) is not
followed serially. LE ultrasound (D) identifies DVT but does not diagnose PE directly.
