NR 547 CEA (Clinical Evaluation Assessment) Actual Exam |
Complete Questions with Correct Answers and Explanations – Latest
Update 2026/2027 | Graded A+
Question 1
A 67-year-old man presents with progressively worsening shortness of breath
on exertion, orthopnea, and bilateral ankle edema. On examination, you hear
an S3 heart sound. Which diagnosis is MOST likely?
A. Stable angina
B. Heart failure with reduced ejection fraction (HFrEF)
C. Aortic stenosis
D. Pulmonary embolism
Correct Answer: B. Heart Failure with Reduced Ejection Fraction (HFrEF)
Explanation:
An S3 gallop is commonly associated with volume overload and reduced left
ventricular systolic function. Orthopnea, peripheral edema, and exertional
dyspnea are classic manifestations of heart failure.
Question 2
A healthy adult's point of maximal impulse (PMI) is normally palpated at
which location?
A. Right fifth intercostal space, midclavicular line
B. Left fifth intercostal space, midclavicular line
C. Left third intercostal space
D. Right second intercostal space
1|Page
,Correct Answer: B. Left Fifth Intercostal Space, Midclavicular Line
Explanation:
The PMI is normally found at the left fifth intercostal space along the
midclavicular line.
Question 3
A 42-year-old woman presents with weight loss, heat intolerance, tremor,
tachycardia, and bilateral exophthalmos. Which diagnosis is MOST likely?
A. Hypothyroidism
B. Graves disease
C. Cushing syndrome
D. Addison disease
Correct Answer: B. Graves Disease
Explanation:
Graves disease commonly presents with hyperthyroidism and
ophthalmopathy characterized by exophthalmos.
Question 4
A patient has chronic smoking history and spirometry demonstrates
persistent airflow obstruction that is not fully reversible. Which diagnosis is
most consistent?
A. Asthma
B. COPD
C. Pneumonia
D. Pulmonary fibrosis
2|Page
,Correct Answer: B. COPD
Explanation:
Persistent, largely irreversible airflow limitation is characteristic of chronic
obstructive pulmonary disease.
Question 5
Macrocytic anemia is most commonly associated with deficiency of:
A. Iron
B. Vitamin B12
C. Vitamin C
D. Calcium
Correct Answer: B. Vitamin B12
Explanation:
Vitamin B12 deficiency results in megaloblastic (macrocytic) anemia.
Question 6
A patient presents with a butterfly-shaped facial rash worsened by sun
exposure. Which disease should be highest on the differential diagnosis?
A. Psoriasis
B. Systemic lupus erythematosus
C. Cellulitis
D. Rosacea
Correct Answer: B. Systemic Lupus Erythematosus
3|Page
, Explanation:
The malar ("butterfly") rash is a classic finding in systemic lupus
erythematosus.
Question 7
The most appropriate initial laboratory tests when hyperthyroidism is
suspected include:
A. CBC and ESR
B. TSH and Free T4
C. Hemoglobin A1c
D. Troponin
Correct Answer: B. TSH and Free T4
Explanation:
TSH is typically suppressed, while Free T4 is elevated in primary
hyperthyroidism.
Question 8
A patient reports severe unilateral eye pain, halos around lights, headache,
nausea, and blurred vision. Which diagnosis requires immediate referral?
A. Cataract
B. Open-angle glaucoma
C. Acute angle-closure glaucoma
D. Conjunctivitis
Correct Answer: C. Acute Angle-Closure Glaucoma
4|Page
Complete Questions with Correct Answers and Explanations – Latest
Update 2026/2027 | Graded A+
Question 1
A 67-year-old man presents with progressively worsening shortness of breath
on exertion, orthopnea, and bilateral ankle edema. On examination, you hear
an S3 heart sound. Which diagnosis is MOST likely?
A. Stable angina
B. Heart failure with reduced ejection fraction (HFrEF)
C. Aortic stenosis
D. Pulmonary embolism
Correct Answer: B. Heart Failure with Reduced Ejection Fraction (HFrEF)
Explanation:
An S3 gallop is commonly associated with volume overload and reduced left
ventricular systolic function. Orthopnea, peripheral edema, and exertional
dyspnea are classic manifestations of heart failure.
Question 2
A healthy adult's point of maximal impulse (PMI) is normally palpated at
which location?
A. Right fifth intercostal space, midclavicular line
B. Left fifth intercostal space, midclavicular line
C. Left third intercostal space
D. Right second intercostal space
1|Page
,Correct Answer: B. Left Fifth Intercostal Space, Midclavicular Line
Explanation:
The PMI is normally found at the left fifth intercostal space along the
midclavicular line.
Question 3
A 42-year-old woman presents with weight loss, heat intolerance, tremor,
tachycardia, and bilateral exophthalmos. Which diagnosis is MOST likely?
A. Hypothyroidism
B. Graves disease
C. Cushing syndrome
D. Addison disease
Correct Answer: B. Graves Disease
Explanation:
Graves disease commonly presents with hyperthyroidism and
ophthalmopathy characterized by exophthalmos.
Question 4
A patient has chronic smoking history and spirometry demonstrates
persistent airflow obstruction that is not fully reversible. Which diagnosis is
most consistent?
A. Asthma
B. COPD
C. Pneumonia
D. Pulmonary fibrosis
2|Page
,Correct Answer: B. COPD
Explanation:
Persistent, largely irreversible airflow limitation is characteristic of chronic
obstructive pulmonary disease.
Question 5
Macrocytic anemia is most commonly associated with deficiency of:
A. Iron
B. Vitamin B12
C. Vitamin C
D. Calcium
Correct Answer: B. Vitamin B12
Explanation:
Vitamin B12 deficiency results in megaloblastic (macrocytic) anemia.
Question 6
A patient presents with a butterfly-shaped facial rash worsened by sun
exposure. Which disease should be highest on the differential diagnosis?
A. Psoriasis
B. Systemic lupus erythematosus
C. Cellulitis
D. Rosacea
Correct Answer: B. Systemic Lupus Erythematosus
3|Page
, Explanation:
The malar ("butterfly") rash is a classic finding in systemic lupus
erythematosus.
Question 7
The most appropriate initial laboratory tests when hyperthyroidism is
suspected include:
A. CBC and ESR
B. TSH and Free T4
C. Hemoglobin A1c
D. Troponin
Correct Answer: B. TSH and Free T4
Explanation:
TSH is typically suppressed, while Free T4 is elevated in primary
hyperthyroidism.
Question 8
A patient reports severe unilateral eye pain, halos around lights, headache,
nausea, and blurred vision. Which diagnosis requires immediate referral?
A. Cataract
B. Open-angle glaucoma
C. Acute angle-closure glaucoma
D. Conjunctivitis
Correct Answer: C. Acute Angle-Closure Glaucoma
4|Page
