,NR 603 CEA Midterm Exam – Adv Clinical Diagnosis – (2026) Actual Questions &
Answers (Chamberlain) 100% Guarantee Pass
1. Rule of Palms - Burn Assessment
Scenario: A 19-year-old male has a first-degree burn over his entire torso. You use
the Rule of Palms to document burned surface area. What percentage of total
BSA does the patient's palm represent?
A. 0.5%
B. 1%
C. 2.5%
D. 5%
Answer: B. 1%
Rationale: The Rule of Palms states the patient's palm, including fingers,
represents approximately 1% of their total BSA. This is a critical assessment tool
for calculating burn extent and fluid resuscitation needs.
2. DVT Treatment Understanding
Scenario: A 22-year-old male has unilateral leg swelling after prolonged
immobility. DVT is suspected. Which statement indicates understanding of
warfarin therapy?
A. "I will need to take aspirin daily for six months."
B. "Warfarin alone is sufficient for immediate anticoagulation."
C. "NOACs require bridging with heparin for the first week."
D. "If they find a clot, I will need Lovenox with warfarin until my INR is 3."
Answer: D
Rationale: Warfarin requires bridging with low molecular weight heparin
(Lovenox) because it takes 4-5 days to reach therapeutic INR. The target INR for
DVT is 2.0-3.0.
3. Adrenal Crisis from Steroid Withdrawal
Scenario: A 22-year-old trans female on gender-affirming therapy stopped
medications two weeks ago. She presents with hypotension, pallor, and
hypothermia. Which medication is most likely the culprit?
A. Estrogen
B. Spironolactone
C. Prednisone (Deltasone)
,D. Progesterone
Answer: C. Prednisone (Deltasone)
Rationale: Abrupt discontinuation of chronic corticosteroids can precipitate
adrenal crisis, characterized by hypotension and hypothermia due to HPA axis
suppression and cortisol deficiency.
4. Tumor Lysis Syndrome Prophylaxis
Scenario: A 55-year-old female has acute myeloid leukemia. Which agent assists
in managing anticipated side effects of chemotherapy?
A. Allopurinol
B. Filgrastim
C. Ondansetron
D. Epoetin alfa
Answer: A. Allopurinol
Rationale: Allopurinol prevents tumor lysis syndrome by inhibiting xanthine
oxidase, reducing uric acid formation during chemotherapy for hematologic
malignancies.
5. First-Line for PTSD & MDD
Question: Which class is first-line management for both PTSD and Major
Depressive Disorder?
A. Benzodiazepines
B. Selective Serotonin Reuptake Inhibitors (SSRIs)
C. Beta-blockers
D. Antipsychotics
Answer: B. SSRIs
Rationale: SSRIs are FDA-approved first-line pharmacotherapy for both PTSD and
MDD. Sertraline and paroxetine are specifically indicated for PTSD.
6. Narrow Therapeutic Index
Question: Which concept refers to small differences in dose leading to life-
threatening adverse reactions?
A. Therapeutic range
B. Narrow therapeutic index
C. Bioavailability
D. First-pass metabolism
, Answer: B. Narrow therapeutic index
Rationale: NTI drugs (warfarin, digoxin, lithium) require precise monitoring
because the effective dose approaches the toxic dose, necessitating frequent lab
surveillance.
7. Pressure Diuresis
Scenario: A student asks about types of diuretics. The use of TED stockings for
lower extremity edema is an example of which type of diuresis?
A. Pressure diuresis
B. Osmotic diuresis
C. Chemical diuresis
D. Hormonal diuresis
Answer: A. Pressure diuresis
Rationale: Compression stockings promote venous return and reduce capillary
hydrostatic pressure, mechanically facilitating fluid movement from interstitial
spaces back into circulation.
8. S1 Heart Sound on ECG
Question: Where does the S1 heart sound correlate with the ECG wave?
A. Peak of the R wave
B. Beginning of the P wave
C. End of the T wave
D. ST segment depression
Answer: A. Peak of the R wave
Rationale: S1 (closure of mitral and tricuspid valves) correlates with the peak of
the R wave, marking the beginning of ventricular systole.
9. Point of Maximum Impulse (PMI)
Question: Where is the PMI most commonly palpable in a healthy adult?
A. 5th intercostal space, mid-clavicular line, left side
B. 4th intercostal space, sternal border
C. 3rd intercostal space, mid-axillary line
D. Xiphoid process
Answer: A
Rationale: The normal PMI is at the 5th intercostal space, left mid-clavicular line
(apex of the heart). Displacement suggests cardiomegaly.
Answers (Chamberlain) 100% Guarantee Pass
1. Rule of Palms - Burn Assessment
Scenario: A 19-year-old male has a first-degree burn over his entire torso. You use
the Rule of Palms to document burned surface area. What percentage of total
BSA does the patient's palm represent?
A. 0.5%
B. 1%
C. 2.5%
D. 5%
Answer: B. 1%
Rationale: The Rule of Palms states the patient's palm, including fingers,
represents approximately 1% of their total BSA. This is a critical assessment tool
for calculating burn extent and fluid resuscitation needs.
2. DVT Treatment Understanding
Scenario: A 22-year-old male has unilateral leg swelling after prolonged
immobility. DVT is suspected. Which statement indicates understanding of
warfarin therapy?
A. "I will need to take aspirin daily for six months."
B. "Warfarin alone is sufficient for immediate anticoagulation."
C. "NOACs require bridging with heparin for the first week."
D. "If they find a clot, I will need Lovenox with warfarin until my INR is 3."
Answer: D
Rationale: Warfarin requires bridging with low molecular weight heparin
(Lovenox) because it takes 4-5 days to reach therapeutic INR. The target INR for
DVT is 2.0-3.0.
3. Adrenal Crisis from Steroid Withdrawal
Scenario: A 22-year-old trans female on gender-affirming therapy stopped
medications two weeks ago. She presents with hypotension, pallor, and
hypothermia. Which medication is most likely the culprit?
A. Estrogen
B. Spironolactone
C. Prednisone (Deltasone)
,D. Progesterone
Answer: C. Prednisone (Deltasone)
Rationale: Abrupt discontinuation of chronic corticosteroids can precipitate
adrenal crisis, characterized by hypotension and hypothermia due to HPA axis
suppression and cortisol deficiency.
4. Tumor Lysis Syndrome Prophylaxis
Scenario: A 55-year-old female has acute myeloid leukemia. Which agent assists
in managing anticipated side effects of chemotherapy?
A. Allopurinol
B. Filgrastim
C. Ondansetron
D. Epoetin alfa
Answer: A. Allopurinol
Rationale: Allopurinol prevents tumor lysis syndrome by inhibiting xanthine
oxidase, reducing uric acid formation during chemotherapy for hematologic
malignancies.
5. First-Line for PTSD & MDD
Question: Which class is first-line management for both PTSD and Major
Depressive Disorder?
A. Benzodiazepines
B. Selective Serotonin Reuptake Inhibitors (SSRIs)
C. Beta-blockers
D. Antipsychotics
Answer: B. SSRIs
Rationale: SSRIs are FDA-approved first-line pharmacotherapy for both PTSD and
MDD. Sertraline and paroxetine are specifically indicated for PTSD.
6. Narrow Therapeutic Index
Question: Which concept refers to small differences in dose leading to life-
threatening adverse reactions?
A. Therapeutic range
B. Narrow therapeutic index
C. Bioavailability
D. First-pass metabolism
, Answer: B. Narrow therapeutic index
Rationale: NTI drugs (warfarin, digoxin, lithium) require precise monitoring
because the effective dose approaches the toxic dose, necessitating frequent lab
surveillance.
7. Pressure Diuresis
Scenario: A student asks about types of diuretics. The use of TED stockings for
lower extremity edema is an example of which type of diuresis?
A. Pressure diuresis
B. Osmotic diuresis
C. Chemical diuresis
D. Hormonal diuresis
Answer: A. Pressure diuresis
Rationale: Compression stockings promote venous return and reduce capillary
hydrostatic pressure, mechanically facilitating fluid movement from interstitial
spaces back into circulation.
8. S1 Heart Sound on ECG
Question: Where does the S1 heart sound correlate with the ECG wave?
A. Peak of the R wave
B. Beginning of the P wave
C. End of the T wave
D. ST segment depression
Answer: A. Peak of the R wave
Rationale: S1 (closure of mitral and tricuspid valves) correlates with the peak of
the R wave, marking the beginning of ventricular systole.
9. Point of Maximum Impulse (PMI)
Question: Where is the PMI most commonly palpable in a healthy adult?
A. 5th intercostal space, mid-clavicular line, left side
B. 4th intercostal space, sternal border
C. 3rd intercostal space, mid-axillary line
D. Xiphoid process
Answer: A
Rationale: The normal PMI is at the 5th intercostal space, left mid-clavicular line
(apex of the heart). Displacement suggests cardiomegaly.
