NR 603 CEA PRACTICE EXAM
WITH 150 QUESTIONS AND
EXPERT-VERIFIED CORRECT
ANSWERS | WITH DETAILED
RATIONALES | MCQS | ALREADY
GRADED A+ | NR 603 CEA ACTUAL
EXAM 2026 [BRAND NEW]
Your patient with a history of two coronary stents and a LDL of 190 has been
started on lipid-lowering statin therapy on three separate attempts with
considerable side effects such as leg pain and in one event, hospitalization for
rhabdomyolysis. Which is the best option moving forward to manage their
lipids?
Initiate PCSK9 Inhibitor therapy
Use ezetimibe as monotherapy
Reattempt statin therapy
Aspiring 81mg daily - ANSWER-Initiate PCSK9 Inhibitor therapy
Rationale: Aspirin is not considered a lipid lowering agent. History of statin-
induced rhabdomyolysis is a contraindication for further statin attempts.
Ezetimibe as monotherapy does not provide any appreciable decrease in LDL to
goal of <100 for proven CAD (patient has stents in place). PCSK9 Inhibitors are
the best available drug class for this patient.
Wrong answerQuestion pts
,Which of the following medications does not cause beta 1 stimulation?
dobutamine
phenylephrine
epinephrine
dopamine - ANSWER-Phenylepherine
Rationale: Phenylephrine only stimulates alpha 1 receptors. The remaining three
all have beta receptor activity.
The suggested International Normalized Ratio (INR) range in a patient being
treated for atrial fibrillation is:
1.0-2.0
3.0-4.0
2.0-3.0
4.0-5.0 - ANSWER-2.0-3.0
Rationale: Remember that for international normalized ratio, the patient is their
own normalization with an INR of 1.0 as the standard of untreated blood, so
with an INR of 2.0, think of the patient as twice as thin for their blood as their
normal. Protime can also be used to evaluate bleeding time for warfarin
patients, but has in general been replaced many years ago by the INR as the
standard measurement, where PTT (partial thromboplastin time) or Anti-Xa are
more useful for evaluating bleeding times related to Heparin therapy.
A 35-year-old woman with a history of hypothyroidism presents with fatigue,
weight gain, constipation, and cold intolerance. Her TSH level is elevated, and
her free T4 is low. What is the most appropriate next step in management?
Increase levothyroxine dosage
Order an antithyroperoxidase antibody test
Refer to an endocrinologist
Start methimazole - ANSWER-Increase levothyroxine dosage
,Rationale: Her clinical findings suggest she has not found a stable state
(euthyroid) of her thyroid supplementation and an increased dose should be
given to reduce her cinical findings of hypothyroidism. This is supported by her
TSH being elevated and the T4 being low, both which support the patient not
having enough thryoid to bring the TSH down to normal and the T3/T4 up to
normal.
An adult male who has managed type 2 diabetes mellitus well for many years
presents for a 6-month follow up. His Hgb A1c has risen from 7% to 9% over
the interval. All other laboratory values are normal and his BMI is still 25. His
psychiatrist recently added olanzapine (Zypreza) to the medical regimen. The
nurse practitioner will most likely:
Encourage the patient to start walking for 30 min every other day
Begin to increase the patient's diabetes medications incrementally
Encourage the patient to cut back on dietary intake
Discontinue the olanzapine until the patient's psychiatrist has been consulted -
ANSWER-Begin to increase the patient's diabetes medications incrementally
Rationale: A common side effect of initiation of onanzapine (Zyprexa) is
increased appetite and it is evidenced by this by the patient having their A1c
increase from 7 to 9%. The patient should have their diabetic mediation dose
increased to help counteract this phemonemon, however a long-term strategy
may include consult the psychiatrist about decreasing the dose or altering the
medication as this represents a considerable health risk to the patient. As that
specifically was not an option, the best option would be to augment the anti-
diabetic medication regimen. Stopping the olanzapine without discussing it with
the psychiatrist would potentially cause the patient to experience
discontinuation syndrome.
A patient is evaluated in the urgent care for complications of Type 2 diabetes
due to an episode of recent life stressors. All the following are consistent with
HHS except:
BS= 850 mg/dL
, Arterial pH 7.6
Markedly positive serum ketones
Urine osmolality 380 mOsm/mL - ANSWER-Markedly positive serum ketones
Rationale: HHS presents with severe hyperglycemia with BS >600 and pts are
more dehydrated. Ketosis is more common in DKA. Hyperosmolality is the
hallmark of HHS, and the urine osmolality is typically 350-380 mOsm/mL and
in DKA typically have elevated plasma osmolality. Arterial pH is suppressed in
DKA <7.3 and is >7.3 in HHS
Which of the following is produced in the pancreas and counteracts
hypoglycemia?
Insulin
Pancrease
Glucagon
Growth hormone - ANSWER-Glucagon
Rationale: Glucagon is made in the pancreas and stimulates glycogen release
from the liver's glycogen stores which increases blood sugar in contrast to
insulin which lowers blood sugar by increasing permeability of the cell
membrane to glucose thereby increasing intracellular levels of glucose.
Your patient has been diagnosed with a 4.5cm ascending aortic aneurysm.
Which medical imaging is considered standard of care for serial surveillance?
CT PE rule-out protocol
Transesophageal Echocardiogram
Plain film chest X-ray (CXR)
CT angiography of the chest - ANSWER-CT angiography of the chest
WITH 150 QUESTIONS AND
EXPERT-VERIFIED CORRECT
ANSWERS | WITH DETAILED
RATIONALES | MCQS | ALREADY
GRADED A+ | NR 603 CEA ACTUAL
EXAM 2026 [BRAND NEW]
Your patient with a history of two coronary stents and a LDL of 190 has been
started on lipid-lowering statin therapy on three separate attempts with
considerable side effects such as leg pain and in one event, hospitalization for
rhabdomyolysis. Which is the best option moving forward to manage their
lipids?
Initiate PCSK9 Inhibitor therapy
Use ezetimibe as monotherapy
Reattempt statin therapy
Aspiring 81mg daily - ANSWER-Initiate PCSK9 Inhibitor therapy
Rationale: Aspirin is not considered a lipid lowering agent. History of statin-
induced rhabdomyolysis is a contraindication for further statin attempts.
Ezetimibe as monotherapy does not provide any appreciable decrease in LDL to
goal of <100 for proven CAD (patient has stents in place). PCSK9 Inhibitors are
the best available drug class for this patient.
Wrong answerQuestion pts
,Which of the following medications does not cause beta 1 stimulation?
dobutamine
phenylephrine
epinephrine
dopamine - ANSWER-Phenylepherine
Rationale: Phenylephrine only stimulates alpha 1 receptors. The remaining three
all have beta receptor activity.
The suggested International Normalized Ratio (INR) range in a patient being
treated for atrial fibrillation is:
1.0-2.0
3.0-4.0
2.0-3.0
4.0-5.0 - ANSWER-2.0-3.0
Rationale: Remember that for international normalized ratio, the patient is their
own normalization with an INR of 1.0 as the standard of untreated blood, so
with an INR of 2.0, think of the patient as twice as thin for their blood as their
normal. Protime can also be used to evaluate bleeding time for warfarin
patients, but has in general been replaced many years ago by the INR as the
standard measurement, where PTT (partial thromboplastin time) or Anti-Xa are
more useful for evaluating bleeding times related to Heparin therapy.
A 35-year-old woman with a history of hypothyroidism presents with fatigue,
weight gain, constipation, and cold intolerance. Her TSH level is elevated, and
her free T4 is low. What is the most appropriate next step in management?
Increase levothyroxine dosage
Order an antithyroperoxidase antibody test
Refer to an endocrinologist
Start methimazole - ANSWER-Increase levothyroxine dosage
,Rationale: Her clinical findings suggest she has not found a stable state
(euthyroid) of her thyroid supplementation and an increased dose should be
given to reduce her cinical findings of hypothyroidism. This is supported by her
TSH being elevated and the T4 being low, both which support the patient not
having enough thryoid to bring the TSH down to normal and the T3/T4 up to
normal.
An adult male who has managed type 2 diabetes mellitus well for many years
presents for a 6-month follow up. His Hgb A1c has risen from 7% to 9% over
the interval. All other laboratory values are normal and his BMI is still 25. His
psychiatrist recently added olanzapine (Zypreza) to the medical regimen. The
nurse practitioner will most likely:
Encourage the patient to start walking for 30 min every other day
Begin to increase the patient's diabetes medications incrementally
Encourage the patient to cut back on dietary intake
Discontinue the olanzapine until the patient's psychiatrist has been consulted -
ANSWER-Begin to increase the patient's diabetes medications incrementally
Rationale: A common side effect of initiation of onanzapine (Zyprexa) is
increased appetite and it is evidenced by this by the patient having their A1c
increase from 7 to 9%. The patient should have their diabetic mediation dose
increased to help counteract this phemonemon, however a long-term strategy
may include consult the psychiatrist about decreasing the dose or altering the
medication as this represents a considerable health risk to the patient. As that
specifically was not an option, the best option would be to augment the anti-
diabetic medication regimen. Stopping the olanzapine without discussing it with
the psychiatrist would potentially cause the patient to experience
discontinuation syndrome.
A patient is evaluated in the urgent care for complications of Type 2 diabetes
due to an episode of recent life stressors. All the following are consistent with
HHS except:
BS= 850 mg/dL
, Arterial pH 7.6
Markedly positive serum ketones
Urine osmolality 380 mOsm/mL - ANSWER-Markedly positive serum ketones
Rationale: HHS presents with severe hyperglycemia with BS >600 and pts are
more dehydrated. Ketosis is more common in DKA. Hyperosmolality is the
hallmark of HHS, and the urine osmolality is typically 350-380 mOsm/mL and
in DKA typically have elevated plasma osmolality. Arterial pH is suppressed in
DKA <7.3 and is >7.3 in HHS
Which of the following is produced in the pancreas and counteracts
hypoglycemia?
Insulin
Pancrease
Glucagon
Growth hormone - ANSWER-Glucagon
Rationale: Glucagon is made in the pancreas and stimulates glycogen release
from the liver's glycogen stores which increases blood sugar in contrast to
insulin which lowers blood sugar by increasing permeability of the cell
membrane to glucose thereby increasing intracellular levels of glucose.
Your patient has been diagnosed with a 4.5cm ascending aortic aneurysm.
Which medical imaging is considered standard of care for serial surveillance?
CT PE rule-out protocol
Transesophageal Echocardiogram
Plain film chest X-ray (CXR)
CT angiography of the chest - ANSWER-CT angiography of the chest
