NR 603 CEA Midterm Exam - Advanced Clinical Diagnosis 2026
Chamberlain College
1. Which physical examination maneuver is specifically used to assess for acute
cholecystitis?
A. McBurney’s sign
B. Psoas sign
C. Rovsing’s sign
D. Murphy’s sign
Answer: D
Rationale: Murphy’s sign is performed by palpating the right upper quadrant while the
patient inspires; a positive test is characterized by the patient catching their breath due to
pain when the gallbladder descends against the examiner’s hand.
2. A patient presents with a suspected ACL tear. Which test is considered the
most sensitive for this diagnosis?
A. McMurray test
B. Anterior drawer test
C. Lachman test
D. Valgus stress test
Answer: C
Rationale: The Lachman test is widely considered the most sensitive clinical test for
diagnosing an ACL injury compared to the anterior drawer test.
,3. Which side effect is most commonly associated with Amlodipine (Norvasc)?
A. Dry cough
B. Hyperkalemia
C. Tachycardia
D. Peripheral edema
Answer: D
Rationale: Calcium channel blockers, especially dihydropyridines like amlodipine, often
cause peripheral edema due to precapillary vasodilation.
4. What is the gold standard diagnostic tool for confirming a diagnosis of COPD?
A. Spirometry
B. CT Scan
C. Pulse oximetry
D. Chest X-ray
Answer: A
Rationale: Spirometry is the gold standard for diagnosis, requiring a post-bronchodilator
FEV1/FVC ratio of less than 0.70 to confirm airflow limitation.
5. In a patient with primary hypothyroidism, what laboratory results would be
expected?
A. Low TSH, High Free T4
B. High TSH, Low Free T4
C. Normal TSH, Low Free T4
D. High TSH, High Free T4
Answer: B
Rationale: Primary hypothyroidism is characterized by an elevated TSH (as the pituitary
attempts to stimulate the gland) and a low free T4 (as the thyroid fails to produce sufficient
hormone).
, 6. Which type of anemia is characterized by a low Mean Corpuscular Volume
(MCV) and low ferritin?
A. B12 deficiency anemia
B. Folate deficiency anemia
C. Anemia of chronic disease
D. Iron deficiency anemia
Answer: D
Rationale: Iron deficiency anemia is a microcytic anemia (low MCV) typically associated
with low iron stores, evidenced by low ferritin levels.
7. A common side effect of ACE inhibitors that often necessitates switching to
an ARB is:
A. Hypokalemia
B. Hypertension
C. Dry, non-productive cough
D. Lower extremity edema
Answer: C
Rationale: The accumulation of bradykinin in the lungs while taking an ACE inhibitor can
cause a persistent dry cough in about 10-20% of patients.
8. Which of the following is a criterion for Metabolic Syndrome?
A. BMI < 25
B. HDL cholesterol > 60 mg/dL
C. Blood pressure < 120/80 mmHg
D. Triglycerides > 150 mg/dL
Answer: D
Rationale: Metabolic syndrome criteria include fasting triglycerides of 150 mg/dL or
higher, among other factors like waist circumference and elevated blood pressure.
Chamberlain College
1. Which physical examination maneuver is specifically used to assess for acute
cholecystitis?
A. McBurney’s sign
B. Psoas sign
C. Rovsing’s sign
D. Murphy’s sign
Answer: D
Rationale: Murphy’s sign is performed by palpating the right upper quadrant while the
patient inspires; a positive test is characterized by the patient catching their breath due to
pain when the gallbladder descends against the examiner’s hand.
2. A patient presents with a suspected ACL tear. Which test is considered the
most sensitive for this diagnosis?
A. McMurray test
B. Anterior drawer test
C. Lachman test
D. Valgus stress test
Answer: C
Rationale: The Lachman test is widely considered the most sensitive clinical test for
diagnosing an ACL injury compared to the anterior drawer test.
,3. Which side effect is most commonly associated with Amlodipine (Norvasc)?
A. Dry cough
B. Hyperkalemia
C. Tachycardia
D. Peripheral edema
Answer: D
Rationale: Calcium channel blockers, especially dihydropyridines like amlodipine, often
cause peripheral edema due to precapillary vasodilation.
4. What is the gold standard diagnostic tool for confirming a diagnosis of COPD?
A. Spirometry
B. CT Scan
C. Pulse oximetry
D. Chest X-ray
Answer: A
Rationale: Spirometry is the gold standard for diagnosis, requiring a post-bronchodilator
FEV1/FVC ratio of less than 0.70 to confirm airflow limitation.
5. In a patient with primary hypothyroidism, what laboratory results would be
expected?
A. Low TSH, High Free T4
B. High TSH, Low Free T4
C. Normal TSH, Low Free T4
D. High TSH, High Free T4
Answer: B
Rationale: Primary hypothyroidism is characterized by an elevated TSH (as the pituitary
attempts to stimulate the gland) and a low free T4 (as the thyroid fails to produce sufficient
hormone).
, 6. Which type of anemia is characterized by a low Mean Corpuscular Volume
(MCV) and low ferritin?
A. B12 deficiency anemia
B. Folate deficiency anemia
C. Anemia of chronic disease
D. Iron deficiency anemia
Answer: D
Rationale: Iron deficiency anemia is a microcytic anemia (low MCV) typically associated
with low iron stores, evidenced by low ferritin levels.
7. A common side effect of ACE inhibitors that often necessitates switching to
an ARB is:
A. Hypokalemia
B. Hypertension
C. Dry, non-productive cough
D. Lower extremity edema
Answer: C
Rationale: The accumulation of bradykinin in the lungs while taking an ACE inhibitor can
cause a persistent dry cough in about 10-20% of patients.
8. Which of the following is a criterion for Metabolic Syndrome?
A. BMI < 25
B. HDL cholesterol > 60 mg/dL
C. Blood pressure < 120/80 mmHg
D. Triglycerides > 150 mg/dL
Answer: D
Rationale: Metabolic syndrome criteria include fasting triglycerides of 150 mg/dL or
higher, among other factors like waist circumference and elevated blood pressure.
