CHAMBERLAIN NR 667
CEA WEEK 8 EXIT EXAMINATION
Primary Care Practicum I
────────────────────────────
2026/2027 Edition
50 Questions | Verified Answers | 100% Correct | Graded A+
Chamberlain University College of Nursing
FNP / AGPCNP Program
Aligned with USPSTF, CDC, AAFP, ACC/AHA, ADA, NCQA Standards
Testing Time: 90–120 Minutes | Proctored, Computer-Based
Passing Score: 75–80% | Clinical Competency Benchmarks Apply
, Chamberlain NR 667 CEA Week 8 Exit Exam 2026/2027
Table of Contents
Table of Contents .......................................................................................................................................... 2
Introduction .................................................................................................................................................. 3
Exam Structure ............................................................................................................................................. 3
Content Domain Distribution ...................................................................................................................... 3
Domain 1: Clinical Reasoning & Differential Diagnosis ..............................................................................5
Domain 2: Patient Assessment & Documentation Standards..................................................................... 7
Domain 3: Evidence-Based Guideline Integration ..................................................................................... 9
Domain 4: Pharmacologic Decision-Making & Prescribing Safety .......................................................... 11
Domain 5: Interprofessional Collaboration & Referral Protocols ............................................................ 13
Domain 6: Patient Education & Health Promotion ................................................................................... 15
Domain 7: Legal/Ethical Responsibilities & APRN Scope of Practice ..................................................... 17
Domain 8: Quality Improvement & Clinical Outcome Measurement ...................................................... 19
Domain 9: Cultural Humility & Patient-Centered Care ............................................................................ 21
Domain 10: Scenario-Based Clinical Judgment (NGN) ........................................................................... 23
Page 2 of 29
, Chamberlain NR 667 CEA Week 8 Exit Exam 2026/2027
Introduction
This Chamberlain NR 667 CEA Week 8 Exit Exam format for 2026/2027 reflects the standardized
competency assessment used to evaluate clinical practicum proficiency for Family Nurse Practitioner
(FNP), Adult-Gerontology Primary Care NP (AGPCNP), or other advanced practice nursing students
at Chamberlain University. NR 667 represents Primary Care Practicum I; CEA denotes Clinical
Evaluation Assessment. The Week 8 Exit Exam serves as a mid-point or term-end clinical competency
evaluation measuring knowledge of clinical reasoning, patient assessment and documentation,
evidence-based guideline application, pharmacologic decision-making, interprofessional
collaboration, patient education, legal and ethical practice, quality improvement, cultural humility,
and scenario-based clinical judgment essential for safe, effective primary care practicum performance.
Exam Structure
Component Details
Total Questions 50 multiple-choice items
Single-best-answer and scenario-based clinical
Question Types
judgment items
Testing Time 90–120 minutes (computer-based, proctored)
Passing Score 75–80% per Chamberlain University policy
USPSTF, CDC, AAFP, ACC/AHA, ADA, NCQA,
Guidelines
NCSBN, WPATH
Table 1: NR 667 CEA Week 8 Exit Exam Structure
Content Domain Distribution
Q# Content Domain Items
Clinical Reasoning &
1–4 4
Differential Diagnosis
Patient Assessment &
5–9 5
Documentation Standards
Evidence-Based Guideline
10–13 4
Integration
Pharmacologic Decision-
14–17 4
Making & Prescribing Safety
Interprofessional
18–21 Collaboration & Referral 4
Protocols
Patient Education & Health
22–25 4
Promotion
Legal/Ethical Responsibilities
26–29 4
& APRN Scope of Practice
Page 3 of 29
, Chamberlain NR 667 CEA Week 8 Exit Exam 2026/2027
Q# Content Domain Items
Quality Improvement &
30–33 Clinical Outcome 4
Measurement
Cultural Humility & Patient-
34–36 3
Centered Care
Scenario-Based Clinical
37–50 14
Judgment (NGN)
Table 2: Question Distribution by Domain
Page 4 of 29
, Chamberlain NR 667 CEA Week 8 Exit Exam 2026/2027
Domain 1: Clinical Reasoning & Differential Diagnosis
Questions 1–4 | 4 Items
1. A 58-year-old male presents with acute onset substernal chest pressure radiating to
the left arm, diaphoresis, and shortness of breath that began 45 minutes ago while
shoveling snow. He has a history of hypertension and type 2 diabetes. His blood
pressure is 168/96 mmHg, heart rate is 102 bpm, and he appears anxious. What is the
most appropriate immediate action for the nurse practitioner in the primary care
setting?
A. Order a 12-lead ECG, administer aspirin 325 mg chewed, and activate EMS for
transfer to the nearest emergency department
B. Prescribe sublingual nitroglycerin and schedule a follow-up cardiology appointment within 1
week
C. Obtain a comprehensive metabolic panel and chest X-ray in the office before determining the
next steps
D. Reassure the patient that his symptoms are likely musculoskeletal and recommend rest with
ibuprofen
Answer: A. Order a 12-lead ECG, administer aspirin 325 mg chewed, and activate
EMS for transfer to the nearest emergency department
Rationale: This presentation is a classic acute coronary syndrome (ACS) with multiple red
flags: acute substernal chest pressure with radiation, diaphoresis, and risk factors (HTN,
T2DM). In the primary care setting, the NP must immediately obtain a 12-lead ECG, give
aspirin 325 mg (class I recommendation per ACC/AHA guidelines), and activate emergency
medical services. Time is myocardium, and delays in ACS management significantly increase
mortality. This reflects SOAP Assessment priority: recognizing life-threatening conditions
requiring emergent stabilization and transfer.
2. A 34-year-old female presents with a chief complaint of recurrent headaches for the
past 3 months. She describes them as bilateral, pressing, and worsening during
stressful periods at work. The headaches occur 3-4 times per week and last 4-6 hours.
Neurological examination is normal. Which of the following represents the correct
prioritized differential diagnosis list for this patient?
A. Brain tumor, subarachnoid hemorrhage, temporal arteritis, tension-type headache
B. Cluster headache, migraine with aura, intracranial hypertension, sinus headache
C. Trigeminal neuralgia, meningitis, stroke, pseudotumor cerebri
D. Tension-type headache, migraine without aura, medication overuse headache,
cervical headache
Answer: D. Tension-type headache, migraine without aura, medication overuse
headache, cervical headache
Rationale: Differential diagnosis prioritization follows the principle of ranking from most
common/likely to least common, with red-flag conditions addressed first through history and
exam. This patient's bilateral pressing quality, stress association, and normal neurological exam
make tension-type headache (most common primary headache) the leading diagnosis. Migraine
without aura is the second most common primary headache in women. Medication overuse
headache should be considered in any recurrent headache. Cluster headache (unilateral, severe,
periorbital) and conditions like brain tumor and SAH are unlikely given the chronic, stable
pattern and normal exam. AAFP headache guidelines emphasize this systematic approach.
3. A 72-year-old female presents with a 2-week history of progressive fatigue, decreased
appetite, and a 10-pound weight loss. She also reports dark stools and mild abdominal
discomfort. Her husband notes she has become increasingly confused over the past 3
Page 5 of 29
CEA WEEK 8 EXIT EXAMINATION
Primary Care Practicum I
────────────────────────────
2026/2027 Edition
50 Questions | Verified Answers | 100% Correct | Graded A+
Chamberlain University College of Nursing
FNP / AGPCNP Program
Aligned with USPSTF, CDC, AAFP, ACC/AHA, ADA, NCQA Standards
Testing Time: 90–120 Minutes | Proctored, Computer-Based
Passing Score: 75–80% | Clinical Competency Benchmarks Apply
, Chamberlain NR 667 CEA Week 8 Exit Exam 2026/2027
Table of Contents
Table of Contents .......................................................................................................................................... 2
Introduction .................................................................................................................................................. 3
Exam Structure ............................................................................................................................................. 3
Content Domain Distribution ...................................................................................................................... 3
Domain 1: Clinical Reasoning & Differential Diagnosis ..............................................................................5
Domain 2: Patient Assessment & Documentation Standards..................................................................... 7
Domain 3: Evidence-Based Guideline Integration ..................................................................................... 9
Domain 4: Pharmacologic Decision-Making & Prescribing Safety .......................................................... 11
Domain 5: Interprofessional Collaboration & Referral Protocols ............................................................ 13
Domain 6: Patient Education & Health Promotion ................................................................................... 15
Domain 7: Legal/Ethical Responsibilities & APRN Scope of Practice ..................................................... 17
Domain 8: Quality Improvement & Clinical Outcome Measurement ...................................................... 19
Domain 9: Cultural Humility & Patient-Centered Care ............................................................................ 21
Domain 10: Scenario-Based Clinical Judgment (NGN) ........................................................................... 23
Page 2 of 29
, Chamberlain NR 667 CEA Week 8 Exit Exam 2026/2027
Introduction
This Chamberlain NR 667 CEA Week 8 Exit Exam format for 2026/2027 reflects the standardized
competency assessment used to evaluate clinical practicum proficiency for Family Nurse Practitioner
(FNP), Adult-Gerontology Primary Care NP (AGPCNP), or other advanced practice nursing students
at Chamberlain University. NR 667 represents Primary Care Practicum I; CEA denotes Clinical
Evaluation Assessment. The Week 8 Exit Exam serves as a mid-point or term-end clinical competency
evaluation measuring knowledge of clinical reasoning, patient assessment and documentation,
evidence-based guideline application, pharmacologic decision-making, interprofessional
collaboration, patient education, legal and ethical practice, quality improvement, cultural humility,
and scenario-based clinical judgment essential for safe, effective primary care practicum performance.
Exam Structure
Component Details
Total Questions 50 multiple-choice items
Single-best-answer and scenario-based clinical
Question Types
judgment items
Testing Time 90–120 minutes (computer-based, proctored)
Passing Score 75–80% per Chamberlain University policy
USPSTF, CDC, AAFP, ACC/AHA, ADA, NCQA,
Guidelines
NCSBN, WPATH
Table 1: NR 667 CEA Week 8 Exit Exam Structure
Content Domain Distribution
Q# Content Domain Items
Clinical Reasoning &
1–4 4
Differential Diagnosis
Patient Assessment &
5–9 5
Documentation Standards
Evidence-Based Guideline
10–13 4
Integration
Pharmacologic Decision-
14–17 4
Making & Prescribing Safety
Interprofessional
18–21 Collaboration & Referral 4
Protocols
Patient Education & Health
22–25 4
Promotion
Legal/Ethical Responsibilities
26–29 4
& APRN Scope of Practice
Page 3 of 29
, Chamberlain NR 667 CEA Week 8 Exit Exam 2026/2027
Q# Content Domain Items
Quality Improvement &
30–33 Clinical Outcome 4
Measurement
Cultural Humility & Patient-
34–36 3
Centered Care
Scenario-Based Clinical
37–50 14
Judgment (NGN)
Table 2: Question Distribution by Domain
Page 4 of 29
, Chamberlain NR 667 CEA Week 8 Exit Exam 2026/2027
Domain 1: Clinical Reasoning & Differential Diagnosis
Questions 1–4 | 4 Items
1. A 58-year-old male presents with acute onset substernal chest pressure radiating to
the left arm, diaphoresis, and shortness of breath that began 45 minutes ago while
shoveling snow. He has a history of hypertension and type 2 diabetes. His blood
pressure is 168/96 mmHg, heart rate is 102 bpm, and he appears anxious. What is the
most appropriate immediate action for the nurse practitioner in the primary care
setting?
A. Order a 12-lead ECG, administer aspirin 325 mg chewed, and activate EMS for
transfer to the nearest emergency department
B. Prescribe sublingual nitroglycerin and schedule a follow-up cardiology appointment within 1
week
C. Obtain a comprehensive metabolic panel and chest X-ray in the office before determining the
next steps
D. Reassure the patient that his symptoms are likely musculoskeletal and recommend rest with
ibuprofen
Answer: A. Order a 12-lead ECG, administer aspirin 325 mg chewed, and activate
EMS for transfer to the nearest emergency department
Rationale: This presentation is a classic acute coronary syndrome (ACS) with multiple red
flags: acute substernal chest pressure with radiation, diaphoresis, and risk factors (HTN,
T2DM). In the primary care setting, the NP must immediately obtain a 12-lead ECG, give
aspirin 325 mg (class I recommendation per ACC/AHA guidelines), and activate emergency
medical services. Time is myocardium, and delays in ACS management significantly increase
mortality. This reflects SOAP Assessment priority: recognizing life-threatening conditions
requiring emergent stabilization and transfer.
2. A 34-year-old female presents with a chief complaint of recurrent headaches for the
past 3 months. She describes them as bilateral, pressing, and worsening during
stressful periods at work. The headaches occur 3-4 times per week and last 4-6 hours.
Neurological examination is normal. Which of the following represents the correct
prioritized differential diagnosis list for this patient?
A. Brain tumor, subarachnoid hemorrhage, temporal arteritis, tension-type headache
B. Cluster headache, migraine with aura, intracranial hypertension, sinus headache
C. Trigeminal neuralgia, meningitis, stroke, pseudotumor cerebri
D. Tension-type headache, migraine without aura, medication overuse headache,
cervical headache
Answer: D. Tension-type headache, migraine without aura, medication overuse
headache, cervical headache
Rationale: Differential diagnosis prioritization follows the principle of ranking from most
common/likely to least common, with red-flag conditions addressed first through history and
exam. This patient's bilateral pressing quality, stress association, and normal neurological exam
make tension-type headache (most common primary headache) the leading diagnosis. Migraine
without aura is the second most common primary headache in women. Medication overuse
headache should be considered in any recurrent headache. Cluster headache (unilateral, severe,
periorbital) and conditions like brain tumor and SAH are unlikely given the chronic, stable
pattern and normal exam. AAFP headache guidelines emphasize this systematic approach.
3. A 72-year-old female presents with a 2-week history of progressive fatigue, decreased
appetite, and a 10-pound weight loss. She also reports dark stools and mild abdominal
discomfort. Her husband notes she has become increasingly confused over the past 3
Page 5 of 29
