NR 603 CEA Midterm Exam (2026) - Advanced Clinical Diagnosis
Chamberlain College
1. A 65-year-old male presents with a new onset of a ‘blowing’ holosystolic
murmur heard best at the apex, radiating to the axilla. What is the most likely
diagnosis?
A. Aortic Stenosis
B. Mitral Regurgitation
C. Mitral Stenosis
D. Tricuspid Regurgitation
Answer: B
Rationale: Mitral Regurgitation is characterized by a holosystolic murmur at the apex that
radiates to the axilla.
2. Which of the following findings is most diagnostic of Iron Deficiency Anemia
(IDA)?
A. Increased Ferritin
B. Decreased Total Iron Binding Capacity (TIBC)
C. Low Serum Ferritin
D. High Mean Corpuscular Volume (MCV)
Answer: C
Rationale: Serum ferritin is the most sensitive and specific test for iron deficiency anemia;
it reflects total body iron stores.
,3. A patient with COPD presents with increased dyspnea and productive cough.
Which GOLD category involves a FEV1 between 50% and 80% of predicted?
A. GOLD 1 (Mild)
B. GOLD 4 (Very Severe)
C. GOLD 3 (Severe)
D. GOLD 2 (Moderate)
Answer: D
Rationale: GOLD 2 (Moderate) is defined as an FEV1 between 50% and 79% predicted.
4. According to the JNC 8 guidelines, what is the blood pressure goal for a 62-
year-old patient with Diabetes Mellitus?
A. < 150/90 mmHg
B. < 130/80 mmHg
C. < 140/90 mmHg
D. < 120/70 mmHg
Answer: C
Rationale: JNC 8 recommends a target BP of less than 140/90 mmHg for all adults with
diabetes or chronic kidney disease regardless of age.
5. Which physical exam maneuver is used to confirm a diagnosis of Benign
Paroxysmal Positional Vertigo (BPPV)?
A. Dix-Hallpike Test
B. Epley Maneuver
C. Lachman’s Test
D. Phalen’s Maneuver
Answer: A
Rationale: The Dix-Hallpike test is the gold standard for diagnosing BPPV, while the Epley
maneuver is used for treatment.
, 6. A patient presents with a ‘herald patch’ followed by a Christmas tree
distribution of smaller lesions. What is the diagnosis?
A. Tinea Corporis
B. Pityriasis Rosea
C. Psoriasis
D. Secondary Syphilis
Answer: B
Rationale: Pityriasis Rosea typically begins with a herald patch followed by a generalized
eruption in a Christmas tree pattern.
7. What is the primary diagnostic test for detecting H. pylori infection in a
primary care setting for a symptomatic patient?
A. Barium Swallow
B. Serum Antibody Test
C. Gastric Biopsy
D. Urea Breath Test
Answer: D
Rationale: The Urea Breath Test or Stool Antigen Test are the preferred non-invasive
methods for diagnosing active H. pylori infection.
8. Which of the following is considered a ‘red flag’ in a patient presenting with
acute low back pain?
A. Pain that improves with rest
B. Pain for 2 days
C. Muscle stiffness in the morning
D. Unintentional weight loss
Answer: D
Rationale: Unintentional weight loss, night pain, and saddle anesthesia are red flags
suggesting malignancy or cauda equina syndrome.
Chamberlain College
1. A 65-year-old male presents with a new onset of a ‘blowing’ holosystolic
murmur heard best at the apex, radiating to the axilla. What is the most likely
diagnosis?
A. Aortic Stenosis
B. Mitral Regurgitation
C. Mitral Stenosis
D. Tricuspid Regurgitation
Answer: B
Rationale: Mitral Regurgitation is characterized by a holosystolic murmur at the apex that
radiates to the axilla.
2. Which of the following findings is most diagnostic of Iron Deficiency Anemia
(IDA)?
A. Increased Ferritin
B. Decreased Total Iron Binding Capacity (TIBC)
C. Low Serum Ferritin
D. High Mean Corpuscular Volume (MCV)
Answer: C
Rationale: Serum ferritin is the most sensitive and specific test for iron deficiency anemia;
it reflects total body iron stores.
,3. A patient with COPD presents with increased dyspnea and productive cough.
Which GOLD category involves a FEV1 between 50% and 80% of predicted?
A. GOLD 1 (Mild)
B. GOLD 4 (Very Severe)
C. GOLD 3 (Severe)
D. GOLD 2 (Moderate)
Answer: D
Rationale: GOLD 2 (Moderate) is defined as an FEV1 between 50% and 79% predicted.
4. According to the JNC 8 guidelines, what is the blood pressure goal for a 62-
year-old patient with Diabetes Mellitus?
A. < 150/90 mmHg
B. < 130/80 mmHg
C. < 140/90 mmHg
D. < 120/70 mmHg
Answer: C
Rationale: JNC 8 recommends a target BP of less than 140/90 mmHg for all adults with
diabetes or chronic kidney disease regardless of age.
5. Which physical exam maneuver is used to confirm a diagnosis of Benign
Paroxysmal Positional Vertigo (BPPV)?
A. Dix-Hallpike Test
B. Epley Maneuver
C. Lachman’s Test
D. Phalen’s Maneuver
Answer: A
Rationale: The Dix-Hallpike test is the gold standard for diagnosing BPPV, while the Epley
maneuver is used for treatment.
, 6. A patient presents with a ‘herald patch’ followed by a Christmas tree
distribution of smaller lesions. What is the diagnosis?
A. Tinea Corporis
B. Pityriasis Rosea
C. Psoriasis
D. Secondary Syphilis
Answer: B
Rationale: Pityriasis Rosea typically begins with a herald patch followed by a generalized
eruption in a Christmas tree pattern.
7. What is the primary diagnostic test for detecting H. pylori infection in a
primary care setting for a symptomatic patient?
A. Barium Swallow
B. Serum Antibody Test
C. Gastric Biopsy
D. Urea Breath Test
Answer: D
Rationale: The Urea Breath Test or Stool Antigen Test are the preferred non-invasive
methods for diagnosing active H. pylori infection.
8. Which of the following is considered a ‘red flag’ in a patient presenting with
acute low back pain?
A. Pain that improves with rest
B. Pain for 2 days
C. Muscle stiffness in the morning
D. Unintentional weight loss
Answer: D
Rationale: Unintentional weight loss, night pain, and saddle anesthesia are red flags
suggesting malignancy or cauda equina syndrome.
