NR603 CEA Final Exam : Actual Practice Questions with Detailed Rationales | Chamberlain University | Advanced Clinical Diagnosis | Instant Pdf Download

NR603 CEA Final Exam 2026-2027: Actual Practice Questions with
Detailed Rationales | Chamberlain University | Advanced Clinical
Diagnosis | Instant Pdf Download

Table of Contents
 Section 1: Endocrine & Metabolic Disorders (Q1-12)
 Section 2: Cardiovascular Disorders (Q13-22)
 Section 3: Respiratory & Pulmonary (Q23-30)
 Section 4: Neurologic Disorders (Q31-40)
 Section 5: Infectious Disease & Immunology (Q41-52)
 Section 6: Hematologic Disorders (Q53-62)
 Section 7: Renal & Genitourinary (Q63-72)
 Section 8: Musculoskeletal & Rheumatologic (Q73-82)
 Section 9: Dermatologic & General Assessment (Q83-90)


Section 1: Endocrine & Metabolic Disorders
1. A 22-year-old trans female patient is actively undergoing gender-affirming therapy
but abruptly stopped their medication regimen for the last two weeks due to
insurance issues. They present with hypotension, pallor, and hypothermia. Assuming
they are taking all of the following medications, which is most likely the culprit for
these symptoms after abrupt withdrawal?
 A) Spironolactone (Aldactone)
 B) Progestin (Heather)
 C) Abarelix (Plenaxis)
 D) Prednisone (Deltasone)
Answer: D – Prednisone (Deltasone)

,Rationale: Abrupt discontinuation of chronic corticosteroids (prednisone) can lead
to adrenal insufficiency. The body's natural cortisol production is suppressed during
prolonged use and cannot ramp up quickly enough after stopping. Symptoms include
hypotension, pallor, and hypothermia .
2. Gladys is a 72-year-old patient with a history of anemia of chronic disease from
kidney failure, diabetes mellitus, and hypothyroidism. Her most recent labs show
TSH 5.9 (normal 0.5-5 uU/mL) and Free T4 0.3 ng/dL (normal 0.8-2.8 ng/dL). Which
clinical sign/symptom would you expect with these findings?
 A) Cold intolerance
 B) Weight loss
 C) Heat intolerance
 D) Tachycardia
Answer: A – Cold intolerance
Rationale: TSH of 5.9 is mildly elevated and Free T4 is low, indicating hypothyroidism.
Symptoms include cold intolerance, fatigue, weight gain, bradycardia, and constipation. The
low Free T4 explains the hypothyroid state despite only mild TSH elevation .
3. A patient with a diagnosis of Addison's disease would most likely present with
which finding on examination?
 A) Low body temperature
 B) Abdominal striae
 C) Dowager's hump
 D) Moon facies
Answer: A – Low body temperature
Rationale: Addison's disease (primary adrenal insufficiency) leads to deficiency of cortisol
and aldosterone, resulting in hypothermia, hypotension, hyperpigmentation, and electrolyte
abnormalities. Abdominal striae, dowager's hump, and moon facies are characteristic
of Cushing's syndrome (cortisol excess), not Addison's .
4. Your schizophrenic patient is agitated during your exam. The most appropriate
initial management is:
 A) Administer haloperidol IM immediately

,  B) Verbally de-escalate and ensure a safe environment
 C) Restrain the patient for safety
 D) Call security and leave the room
Answer: B – Verbally de-escalate and ensure a safe environment
Rationale: The first-line approach for agitation is verbal de-escalation while maintaining a
calm, safe environment. Pharmacologic or physical restraints are used only if de-escalation
fails and there is imminent danger to the patient or staff.
5. The nurse practitioner assessing a patient with a rapid cardiac rhythm may assess
for a pulse deficit. Where would the S1 heart sound correlate with the ECG wave?
 A) At the end of the T wave
 B) Peak of the R wave
 C) At the start of the P wave
 D) At the start of the T wave
Answer: B – Peak of the R wave
Rationale: The S1 heart sound ("lub") is caused by closure of the AV valves (mitral and
tricuspid) at the beginning of ventricular systole. This occurs just after ventricular
depolarization, which is represented by the R wave on the ECG .
6. The point of maximum impulse (PMI) in a healthy adult is most commonly palpated
at which location?
 A) Left 2nd intercostal space, midaxillary line
 B) Right 4th intercostal space, midaxillary line
 C) Left 5th intercostal space, midclavicular line
 D) Right 2nd intercostal space, midclavicular line
Answer: C – Left 5th intercostal space, midclavicular line
Rationale: The PMI is typically felt at the left 5th intercostal space in the midclavicular
line due to the position of the heart in the thoracic cavity, where the left ventricle is closest
to the chest wall .

, 7. A patient with autoimmune hepatitis is being seen for routine follow-up. What is
the normal span when percussing the liver of a healthy adult?
 A) 6-12 cm in the midsternal line
 B) 4-8 cm in the right midclavicular line
 C) 6-12 cm in the right midclavicular line
 D) 4-8 cm in the left midclavicular line
Answer: C – 6-12 cm in the right midclavicular line
Rationale: The normal liver span by percussion is 6-12 cm in the right midclavicular line.
This measurement reflects the vertical span of liver dullness .
8. A 31-year-old woman presents with purpuric rash covering her arms, legs, and
abdomen, plus fever, chills, nausea, abdominal tenderness, tachycardia, and
myalgias. Labs show Gram-negative diplococci in blood, thrombocytopenia, and
elevated PMNs. She is diagnosed with meningococcemia. What major therapy should
she receive?
 A) Steroids
 B) Supportive care only
 C) Antibiotics
 D) Transfusion
Answer: C – Antibiotics
Rationale: Antibiotics are the treatment of choice for meningococcemia. The preferred
initial agent is penicillin G (or ceftriaxone/cefotaxime). Immediate antibiotic therapy is critical
for survival .
9. A 54-year-old HIV-positive man presents after a generalized seizure. He has been
unable to afford antiretroviral therapy for 2 years. MRI reveals several cortical ring-
enhancing lesions. What is the most likely diagnosis?
 A) AIDS dementia complex
 B) Cryptococcal meningitis
 C) Cytomegalovirus encephalitis
 D) Toxoplasma encephalitis