NR 547 CEA
3 FULL SET EXAMS
(CONSISTS OF 400+ QUESTIONS)
Verified Questions & Answers With Rationales
(Primary Care of the Childbearing and Childrearing Family)
Chamberlain
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,Table of Contents
NR 547 CEA SET 1 .................................................................. 2
NR 547 CEA SET 2 ................................................................ 67
NR 547 CEA SET 3 .............................................................. 132
NR 547 CEA SET 1
1. During a post-hospital discharge visit, you notice your 71 year old female
patient has been diagnosed with a "new murmur" found by the hospitalist during
their recent hospitalization for CHF exacerbation. In evaluating the patient, during
which phase of the cardiac cycle would you anticipate auscultation of a S3 or S4
heart sound?
Options:
A. Diastole
B. 53 in systole while S4 in diastole
C. Systole
D. S4 in diastole while S3 in systole
Correct Answer:
A. Diastole.
Expert Rationale:
S3 and S4 are extra heart sounds heard during diastole. S3 occurs in early diastole
with rapid ventricular filling, while S4 occurs in late diastole with atrial contraction into
a stiff ventricle.
2. The point of maximum impulse (PMI) is MOST often palpable in healthy adults
when positioned in the supine or left lateral decubitus position. Which one of the
following locations is most commonly described as the PMI in a healthy adult?
Options:
A. Left 2nd intercostal space, midaxillary line.
B. Left 5th intercostal space, midclavicular line.
C. Right 4th intercostal space, midaxillary line.
, D. Right 2nd intercostal space, midclavicular line.
Correct Answer:
B. Left 5th intercostal space, midclavicular line.
Expert Rationale:
The PMI is normally located at the left fifth intercostal space near the midclavicular
line. Displacement can suggest ventricular enlargement or other cardiopulmonary
pathology.
3. The nurse practitioner assessing the patient with a rapid cardiac rhythm may
assess for a pulse deficit by auscultating the patient's heart while watching the
EKG rhythm. Where would the S1 heart sounds correlate with the
electrocardiographic waves?
Options:
A. At the end of the T wave.
B. At the start of the T wave.
C. Peak of the R wave.
D. At the start of the P wave.
Correct Answer:
C. Peak of the R wave.
Expert Rationale:
S1 occurs with closure of the mitral and tricuspid valves at the onset of ventricular
systole. It corresponds closely with ventricular depolarization, represented by the
QRS complex/peak R wave on ECG.
4. Michael, a 72 year old male patient who previously presented with stable
cardiac-type chest pain has underwent a stress test. He presents today to review
the stress test results, which show EKG findings of ST segment depression
during the exam in leads V3 and V4 as well as some concurrent chest discomfort.
Based on these findings, which of the following are NOT priority medical
decisions?
Options:
A. Prescribe metoprolol (Lopressor) 12.5mg PO BID
B. Prescribe aspirin 81mg PO daily
C. Refer to cardiology for angiography
D. Check for thyroid dysfunction
Correct Answer:
D. Check for thyroid dysfunction.
, Expert Rationale:
Positive stress-test ischemia with ST depression and chest discomfort requires
antianginal therapy, antiplatelet therapy, and cardiology referral. Thyroid testing may
be useful in some rhythm complaints but is not the priority decision here.
5. While examining a 53 year old female patient, you auscultate abnormal breath
sounds over all fields, and now assess transmission of voice sounds by having
the patient say "ee" while auscultating the chest with the diaphragm of your
stethoscope. Normally, you should auscultate a muffled "e" sound, however, you
hear hear a nasally "a" sound. Which one of the following will you document is
present?
Options:
A. Positive stereognosis.
B. Positive for egophony.
C. Negative for bronchophony.
D. Negative for egophony
Correct Answer:
B. Positive for egophony.
Expert Rationale:
Egophony is present when the spoken “ee” sound is heard as a nasal “ay/a” sound
over consolidated lung tissue. It suggests increased transmission through fluid-filled
or consolidated lung.
6. While assessing the 19 year old patient for a new onset cough, the nurse
practitioner may inspect, auscultate, palpate, and/or percuss. How does
performing percussion of the thorax assist the provider during the physical
examination?
Options:
A. To assist with the confirmation of cardiac origin of angina.
B. To assess for deep-seated lesion and tumors.
C. To assess for any pain or discomfort prior to palpitation of the chest wall.
D. To identify if underlying tissue are air-filled, fluid-filled or consolidated
Correct Answer:
D. To identify if underlying tissue are air-filled, fluid-filled or consolidated.
Expert Rationale:
Percussion helps determine whether underlying thoracic tissue is air-filled, fluid-filled,
, NR 547 CEA SET 2
1. A nurse is performing a physical examination on a 58-year-old male patient.
While percussing the right upper quadrant over the liver area, the nurse notes a
change in percussion sound. What percussion change is observed while
percussing over the liver?
A. Percussion changes from resonant to hyperresonant
B. Percussion changes from dull to tympany
C. Percussion changes from flat to dull
D. Percussion changes from tympany to resonant
Correct Answer:
B. Percussion changes from dull to tympany
Rationale:
The liver is a solid organ that normally produces a dull percussion sound. As percussion
moves from the liver toward the gastric air bubble or intestines, the sound changes to
tympany. This transition point helps estimate liver size and identify organ boundaries.
Option A describes changes associated with pneumothorax. Option C describes normal
lung-to-liver transition. Option D is the reverse of the correct progression.
2. A 45-year-old construction worker presents to the clinic complaining of
shoulder pain that worsens when he lifts his arm above his head. During the
physical examination, the nurse practitioner notes pain and weakness with
shoulder abduction and external rotation. What injury is suggested by these
findings?
A. Rotator cuff injury
B. Adhesive capsulitis
C. Glenohumeral joint dislocation
D. Acromioclavicular joint sprain
Correct Answer:
A. Rotator cuff injury
,Rationale:
The rotator cuff muscles (supraspinatus, infraspinatus, teres minor, and subscapularis)
are primarily responsible for shoulder abduction and external rotation. Pain and
weakness with these specific movements are hallmark signs of rotator cuff pathology,
particularly supraspinatus involvement. Adhesive capsulitis (B) presents with global
restriction of passive and active range of motion. Glenohumeral dislocation (C) presents
with a deformed shoulder and inability to move the arm. AC joint sprain (D) causes pain
at the top of the shoulder, particularly with cross-body adduction.
3. During a school physical examination of a 14-year-old adolescent, the nurse
observes that the patient's shoulders are not level and there is a visible lateral
curvature of the spine when the patient bends forward. What condition is
indicated by unequal shoulder height and a lateral spinal curve?
A. Kyphosis
B. Lordosis
C. Scoliosis
D. Spondylolisthesis
Correct Answer:
C. Scoliosis
Rationale:
Scoliosis is defined as a lateral (side-to-side) curvature of the spine, often accompanied
by vertebral rotation, rib hump, and unequal shoulder heights. The Adams forward bend
test is the standard screening tool. Kyphosis (A) is an exaggerated posterior curvature
(hunchback). Lordosis (B) is an exaggerated anterior curvature (swayback).
Spondylolisthesis (D) involves forward slippage of one vertebra over another and does
not typically present with lateral curvature.
4. A 62-year-old patient receiving chemotherapy complains of a terrible taste in
their mouth that makes eating difficult. What is the term for an awful taste
sensation?
A. Olfactory
B. Gustatory
C. Auditory
D. Tactile
Correct Answer:
B. Gustatory
, NR 547 CEA SET 3
1. The patient is exhibiting a productive cough and a low-grade fever. Chest X-ray on
PA view shows a left lower chest area of consolidation adjacent to the left border of
the heart approximately 2 rib spaces above the costophrenic angle. The lateral x-ray
view shows this lesion absent of the window posterior to the cardiac silhouette.
Which is the most likely location of this area of focal consolidation?
A. Left upper lobe apex
B. Right middle lobe
C. Left upper lobe lingula
D. Left lower lobe
Correct Answer:
Left upper lobe lingula
Rationale:
Lingular consolidation is described in this question precisely. If the cardiac
margin/silhouette is obliterated by the mass, the lesion is either right middle lobe or left
upper lobe lingula.
2. The inability to fully relax the myocardium during relaxation is a trademark of
which of the following diagnoses?
Correct Answer:
Diastolic dysfunction
Rationale:
The inability for the heart to relax is a trademark of the diagnosis of diastolic dysfunction
and is common in patients with thickened hypertrophic myocardium.
3. An otherwise healthy African American adult male has been diagnosed with
hypertension. He has been restricting his salt intake, eating a DASH (Dietary
Approaches to Stop Hypertension) diet, and exercising more, but his blood pressure
is still elevated. Which is the BEST medication to prescribe him?
, Correct Answer:
Calcium channel blocker
Rationale:
African American patients per JNC8 Hypertension Guidelines should be managed with a
dihydropyridine calcium channel blocker such as amlodipine (Norvasc) as first line
management therapy for hypertension not at goal with DASH and lifestyle modifications.
4. Your patient has been diagnosed with a 4.5cm ascending aortic aneurysm. Which
medical imaging is considered standard of care for serial surveillance?-
Correct Answer:
CT angiography of the chest
Rationale:
CT angiography is considered the standard of care for measuring vascular luminal
dimensions with contrast. CT PE protocol is not timed properly for the aorta (it's timed
for the pulmonary artery). Although a plain film is able to catch large aneurysms at times,
they are not able to provide multi-axis reconstruction needed to accurately measure the
size. Transesophageal echo is not needed to accurately measure the aorta and requires
the patient to undergo sedation which is unnecessary.
5. Which of the following medications does not cause beta 1 stimulation?
Correct Answer:
phenylephrine
Rationale:
Phenylephrine only stimulates alpha 1 receptors. The remaining three all have beta
receptor activity.
6. A 50-year-old woman with a history of hypertension presents with dyspnea on
exertion and orthopnea. On examination, she has jugular venous distention and
bilateral crackles on lung auscultation. What is the most likely diagnosis?
Correct Answer:
Congestive heart failure
Rationale:
Of the available options, the most accurate response is congestive heart failure as it is
, NR 547 CEA
3 FULL SET EXAMS
(CONSISTS OF 400+ QUESTIONS)
Verified Questions & Answers With Rationales
(Primary Care of the Childbearing and Childrearing Family)
Chamberlain
3 FULL SET EXAMS
(CONSISTS OF 400+ QUESTIONS)
Verified Questions & Answers With Rationales
(Primary Care of the Childbearing and Childrearing Family)
Chamberlain
, PREVIEW
P
Preview Pages Below
Get the Complete PDF After
Purchase
If you require further clarification or in need of any study
resources, feel free to Message me.
PREVIEW QUESTIONS FOLLOW
,Table of Contents
NR 547 CEA SET 1 .................................................................. 2
NR 547 CEA SET 2 ................................................................ 67
NR 547 CEA SET 3 .............................................................. 132
NR 547 CEA SET 1
1. During a post-hospital discharge visit, you notice your 71 year old female
patient has been diagnosed with a "new murmur" found by the hospitalist during
their recent hospitalization for CHF exacerbation. In evaluating the patient, during
which phase of the cardiac cycle would you anticipate auscultation of a S3 or S4
heart sound?
Options:
A. Diastole
B. 53 in systole while S4 in diastole
C. Systole
D. S4 in diastole while S3 in systole
Correct Answer:
A. Diastole.
Expert Rationale:
S3 and S4 are extra heart sounds heard during diastole. S3 occurs in early diastole
with rapid ventricular filling, while S4 occurs in late diastole with atrial contraction into
a stiff ventricle.
2. The point of maximum impulse (PMI) is MOST often palpable in healthy adults
when positioned in the supine or left lateral decubitus position. Which one of the
following locations is most commonly described as the PMI in a healthy adult?
Options:
A. Left 2nd intercostal space, midaxillary line.
B. Left 5th intercostal space, midclavicular line.
C. Right 4th intercostal space, midaxillary line.
, D. Right 2nd intercostal space, midclavicular line.
Correct Answer:
B. Left 5th intercostal space, midclavicular line.
Expert Rationale:
The PMI is normally located at the left fifth intercostal space near the midclavicular
line. Displacement can suggest ventricular enlargement or other cardiopulmonary
pathology.
3. The nurse practitioner assessing the patient with a rapid cardiac rhythm may
assess for a pulse deficit by auscultating the patient's heart while watching the
EKG rhythm. Where would the S1 heart sounds correlate with the
electrocardiographic waves?
Options:
A. At the end of the T wave.
B. At the start of the T wave.
C. Peak of the R wave.
D. At the start of the P wave.
Correct Answer:
C. Peak of the R wave.
Expert Rationale:
S1 occurs with closure of the mitral and tricuspid valves at the onset of ventricular
systole. It corresponds closely with ventricular depolarization, represented by the
QRS complex/peak R wave on ECG.
4. Michael, a 72 year old male patient who previously presented with stable
cardiac-type chest pain has underwent a stress test. He presents today to review
the stress test results, which show EKG findings of ST segment depression
during the exam in leads V3 and V4 as well as some concurrent chest discomfort.
Based on these findings, which of the following are NOT priority medical
decisions?
Options:
A. Prescribe metoprolol (Lopressor) 12.5mg PO BID
B. Prescribe aspirin 81mg PO daily
C. Refer to cardiology for angiography
D. Check for thyroid dysfunction
Correct Answer:
D. Check for thyroid dysfunction.
, Expert Rationale:
Positive stress-test ischemia with ST depression and chest discomfort requires
antianginal therapy, antiplatelet therapy, and cardiology referral. Thyroid testing may
be useful in some rhythm complaints but is not the priority decision here.
5. While examining a 53 year old female patient, you auscultate abnormal breath
sounds over all fields, and now assess transmission of voice sounds by having
the patient say "ee" while auscultating the chest with the diaphragm of your
stethoscope. Normally, you should auscultate a muffled "e" sound, however, you
hear hear a nasally "a" sound. Which one of the following will you document is
present?
Options:
A. Positive stereognosis.
B. Positive for egophony.
C. Negative for bronchophony.
D. Negative for egophony
Correct Answer:
B. Positive for egophony.
Expert Rationale:
Egophony is present when the spoken “ee” sound is heard as a nasal “ay/a” sound
over consolidated lung tissue. It suggests increased transmission through fluid-filled
or consolidated lung.
6. While assessing the 19 year old patient for a new onset cough, the nurse
practitioner may inspect, auscultate, palpate, and/or percuss. How does
performing percussion of the thorax assist the provider during the physical
examination?
Options:
A. To assist with the confirmation of cardiac origin of angina.
B. To assess for deep-seated lesion and tumors.
C. To assess for any pain or discomfort prior to palpitation of the chest wall.
D. To identify if underlying tissue are air-filled, fluid-filled or consolidated
Correct Answer:
D. To identify if underlying tissue are air-filled, fluid-filled or consolidated.
Expert Rationale:
Percussion helps determine whether underlying thoracic tissue is air-filled, fluid-filled,
, NR 547 CEA SET 2
1. A nurse is performing a physical examination on a 58-year-old male patient.
While percussing the right upper quadrant over the liver area, the nurse notes a
change in percussion sound. What percussion change is observed while
percussing over the liver?
A. Percussion changes from resonant to hyperresonant
B. Percussion changes from dull to tympany
C. Percussion changes from flat to dull
D. Percussion changes from tympany to resonant
Correct Answer:
B. Percussion changes from dull to tympany
Rationale:
The liver is a solid organ that normally produces a dull percussion sound. As percussion
moves from the liver toward the gastric air bubble or intestines, the sound changes to
tympany. This transition point helps estimate liver size and identify organ boundaries.
Option A describes changes associated with pneumothorax. Option C describes normal
lung-to-liver transition. Option D is the reverse of the correct progression.
2. A 45-year-old construction worker presents to the clinic complaining of
shoulder pain that worsens when he lifts his arm above his head. During the
physical examination, the nurse practitioner notes pain and weakness with
shoulder abduction and external rotation. What injury is suggested by these
findings?
A. Rotator cuff injury
B. Adhesive capsulitis
C. Glenohumeral joint dislocation
D. Acromioclavicular joint sprain
Correct Answer:
A. Rotator cuff injury
,Rationale:
The rotator cuff muscles (supraspinatus, infraspinatus, teres minor, and subscapularis)
are primarily responsible for shoulder abduction and external rotation. Pain and
weakness with these specific movements are hallmark signs of rotator cuff pathology,
particularly supraspinatus involvement. Adhesive capsulitis (B) presents with global
restriction of passive and active range of motion. Glenohumeral dislocation (C) presents
with a deformed shoulder and inability to move the arm. AC joint sprain (D) causes pain
at the top of the shoulder, particularly with cross-body adduction.
3. During a school physical examination of a 14-year-old adolescent, the nurse
observes that the patient's shoulders are not level and there is a visible lateral
curvature of the spine when the patient bends forward. What condition is
indicated by unequal shoulder height and a lateral spinal curve?
A. Kyphosis
B. Lordosis
C. Scoliosis
D. Spondylolisthesis
Correct Answer:
C. Scoliosis
Rationale:
Scoliosis is defined as a lateral (side-to-side) curvature of the spine, often accompanied
by vertebral rotation, rib hump, and unequal shoulder heights. The Adams forward bend
test is the standard screening tool. Kyphosis (A) is an exaggerated posterior curvature
(hunchback). Lordosis (B) is an exaggerated anterior curvature (swayback).
Spondylolisthesis (D) involves forward slippage of one vertebra over another and does
not typically present with lateral curvature.
4. A 62-year-old patient receiving chemotherapy complains of a terrible taste in
their mouth that makes eating difficult. What is the term for an awful taste
sensation?
A. Olfactory
B. Gustatory
C. Auditory
D. Tactile
Correct Answer:
B. Gustatory
, NR 547 CEA SET 3
1. The patient is exhibiting a productive cough and a low-grade fever. Chest X-ray on
PA view shows a left lower chest area of consolidation adjacent to the left border of
the heart approximately 2 rib spaces above the costophrenic angle. The lateral x-ray
view shows this lesion absent of the window posterior to the cardiac silhouette.
Which is the most likely location of this area of focal consolidation?
A. Left upper lobe apex
B. Right middle lobe
C. Left upper lobe lingula
D. Left lower lobe
Correct Answer:
Left upper lobe lingula
Rationale:
Lingular consolidation is described in this question precisely. If the cardiac
margin/silhouette is obliterated by the mass, the lesion is either right middle lobe or left
upper lobe lingula.
2. The inability to fully relax the myocardium during relaxation is a trademark of
which of the following diagnoses?
Correct Answer:
Diastolic dysfunction
Rationale:
The inability for the heart to relax is a trademark of the diagnosis of diastolic dysfunction
and is common in patients with thickened hypertrophic myocardium.
3. An otherwise healthy African American adult male has been diagnosed with
hypertension. He has been restricting his salt intake, eating a DASH (Dietary
Approaches to Stop Hypertension) diet, and exercising more, but his blood pressure
is still elevated. Which is the BEST medication to prescribe him?
, Correct Answer:
Calcium channel blocker
Rationale:
African American patients per JNC8 Hypertension Guidelines should be managed with a
dihydropyridine calcium channel blocker such as amlodipine (Norvasc) as first line
management therapy for hypertension not at goal with DASH and lifestyle modifications.
4. Your patient has been diagnosed with a 4.5cm ascending aortic aneurysm. Which
medical imaging is considered standard of care for serial surveillance?-
Correct Answer:
CT angiography of the chest
Rationale:
CT angiography is considered the standard of care for measuring vascular luminal
dimensions with contrast. CT PE protocol is not timed properly for the aorta (it's timed
for the pulmonary artery). Although a plain film is able to catch large aneurysms at times,
they are not able to provide multi-axis reconstruction needed to accurately measure the
size. Transesophageal echo is not needed to accurately measure the aorta and requires
the patient to undergo sedation which is unnecessary.
5. Which of the following medications does not cause beta 1 stimulation?
Correct Answer:
phenylephrine
Rationale:
Phenylephrine only stimulates alpha 1 receptors. The remaining three all have beta
receptor activity.
6. A 50-year-old woman with a history of hypertension presents with dyspnea on
exertion and orthopnea. On examination, she has jugular venous distention and
bilateral crackles on lung auscultation. What is the most likely diagnosis?
Correct Answer:
Congestive heart failure
Rationale:
Of the available options, the most accurate response is congestive heart failure as it is
, NR 547 CEA
3 FULL SET EXAMS
(CONSISTS OF 400+ QUESTIONS)
Verified Questions & Answers With Rationales
(Primary Care of the Childbearing and Childrearing Family)
Chamberlain
