NR511 WEEK 2 CEA EXAM: DIFFERENTIAL
DIAGNOSIS AND PRIMARY CARE
PRACTICUM
SECTION A: DIAGNOSTIC REASONING AND CLINICAL DECISION-MAKING
Questions 1-25
1. A 71-year-old female patient is seen during a post-hospital discharge visit following a
CHF exacerbation. The hospitalist documented a "new murmur." During which phase of the
cardiac cycle would the nurse practitioner anticipate auscultation of an S3 or S4 heart
sound in this patient?
A. Systole
B. Diastole
C. Early systole
D. Mid-systole
Answer: B
2. A 62-year-old otherwise healthy male with an active lifestyle presents with a chief
complaint of gnawing abdominal pain and a history of orthopedic overuse injuries. Which
question is most useful in probing this further to rule out more serious conditions?
,A. What time of day are you taking your acetaminophen?
B. Have you been taking any non-steroidal anti-inflammatory medications lately?
C. When was the last time you took topical corticosteroids for pain?
D. Have you noticed any particular food has made this worse?
Answer: B
3. A 19-year-old otherwise healthy male has been monitoring peak flow at home after a
recent asthma diagnosis. Which medication is most likely to be the first prescription?
A. Fluticasone/salmeterol (Advair Diskus) 250/50 BID PRN
B. Salmeterol (Serevent) 50 mcg inhaled daily
C. Albuterol (Xopenex) MDI PRN for wheezing
D. Montelukast (Singulair) 10 mg PO daily
Answer: C
4. A 52-year-old male with heart failure with reduced ejection fraction (HFrEF) at 30%
following a recent MI has been started on optimal medical therapy. Assuming he tolerates
all medicines without side effects, which agent should be avoided for optimal medical
therapy specifically aimed at optimizing his HFrEF?
A. Amlodipine (Norvasc)
B. Entresto (Sacubitril/Valsartan)
C. Furosemide (Lasix)
D. Carvedilol (Coreg)
,Answer: A
5. The nurse practitioner is caring for a patient with elevated WBC, fever, chills, and
malaise. Which of the following is NOT a potential cause of the elevated WBC?
A. Sepsis
B. Diabetes Mellitus Type 2
C. Leukemia
D. Recent oral corticosteroid therapy
Answer: B
6. A 21-year-old sexually active female reports "weird bumps" on her vulva during a routine
health exam. Condyloma are caused by exposure to which of the following?
A. Chlamydia
B. Herpes zoster
C. Human papillomavirus type 6 and 11
D. Parvovirus B19
Answer: C
7. A patient at a rehabilitation center following a major medical procedure appears
despondent and has difficulty staying wakeful during therapy sessions. Vital signs are
stable, temperature is normal, and urine output is adequate. This may represent which
condition?
, A. Cushing syndrome
B. Situational depression
C. Addison's disease
D. Untreated anxiety
Answer: B
8. An 18-year-old female patient exhibits fear of abandonment, intense interpersonal
relationships, affective instability, and recurrent self-harm. Which diagnosis does this
describe?
A. Borderline personality disorder
B. Seasonal affective disorder
C. Reactive attachment disorder
D. Bipolar disorder
Answer: A
9. A patient who stopped their diuretic regimen while on vacation is now 21 pounds heavier
than baseline, has respiratory crackles in bilateral bases, and severe generalized lower
extremity and truncal edema extending to the sacrum and abdomen. This condition is
referred to as:
A. Nephrotic syndrome
B. Syndrome of inappropriate antidiuretic hormone (SIADH)
C. Ascites
D. Anasarca
DIAGNOSIS AND PRIMARY CARE
PRACTICUM
SECTION A: DIAGNOSTIC REASONING AND CLINICAL DECISION-MAKING
Questions 1-25
1. A 71-year-old female patient is seen during a post-hospital discharge visit following a
CHF exacerbation. The hospitalist documented a "new murmur." During which phase of the
cardiac cycle would the nurse practitioner anticipate auscultation of an S3 or S4 heart
sound in this patient?
A. Systole
B. Diastole
C. Early systole
D. Mid-systole
Answer: B
2. A 62-year-old otherwise healthy male with an active lifestyle presents with a chief
complaint of gnawing abdominal pain and a history of orthopedic overuse injuries. Which
question is most useful in probing this further to rule out more serious conditions?
,A. What time of day are you taking your acetaminophen?
B. Have you been taking any non-steroidal anti-inflammatory medications lately?
C. When was the last time you took topical corticosteroids for pain?
D. Have you noticed any particular food has made this worse?
Answer: B
3. A 19-year-old otherwise healthy male has been monitoring peak flow at home after a
recent asthma diagnosis. Which medication is most likely to be the first prescription?
A. Fluticasone/salmeterol (Advair Diskus) 250/50 BID PRN
B. Salmeterol (Serevent) 50 mcg inhaled daily
C. Albuterol (Xopenex) MDI PRN for wheezing
D. Montelukast (Singulair) 10 mg PO daily
Answer: C
4. A 52-year-old male with heart failure with reduced ejection fraction (HFrEF) at 30%
following a recent MI has been started on optimal medical therapy. Assuming he tolerates
all medicines without side effects, which agent should be avoided for optimal medical
therapy specifically aimed at optimizing his HFrEF?
A. Amlodipine (Norvasc)
B. Entresto (Sacubitril/Valsartan)
C. Furosemide (Lasix)
D. Carvedilol (Coreg)
,Answer: A
5. The nurse practitioner is caring for a patient with elevated WBC, fever, chills, and
malaise. Which of the following is NOT a potential cause of the elevated WBC?
A. Sepsis
B. Diabetes Mellitus Type 2
C. Leukemia
D. Recent oral corticosteroid therapy
Answer: B
6. A 21-year-old sexually active female reports "weird bumps" on her vulva during a routine
health exam. Condyloma are caused by exposure to which of the following?
A. Chlamydia
B. Herpes zoster
C. Human papillomavirus type 6 and 11
D. Parvovirus B19
Answer: C
7. A patient at a rehabilitation center following a major medical procedure appears
despondent and has difficulty staying wakeful during therapy sessions. Vital signs are
stable, temperature is normal, and urine output is adequate. This may represent which
condition?
, A. Cushing syndrome
B. Situational depression
C. Addison's disease
D. Untreated anxiety
Answer: B
8. An 18-year-old female patient exhibits fear of abandonment, intense interpersonal
relationships, affective instability, and recurrent self-harm. Which diagnosis does this
describe?
A. Borderline personality disorder
B. Seasonal affective disorder
C. Reactive attachment disorder
D. Bipolar disorder
Answer: A
9. A patient who stopped their diuretic regimen while on vacation is now 21 pounds heavier
than baseline, has respiratory crackles in bilateral bases, and severe generalized lower
extremity and truncal edema extending to the sacrum and abdomen. This condition is
referred to as:
A. Nephrotic syndrome
B. Syndrome of inappropriate antidiuretic hormone (SIADH)
C. Ascites
D. Anasarca
