NR 603 CEA Midterm Exam - Advanced Clinical Diagnosis 2026
Chamberlain
1. A 55-year-old male with a history of hypertension and diabetes presents with
a blood pressure of 152/94. According to JNC 8 guidelines, which class of
medication is the most appropriate initial choice?
A. ACE Inhibitor or ARB
B. Loop diuretic
C. Beta-blocker
D. Alpha-1 antagonist
Answer: A
Rationale: For patients with diabetes and hypertension, ACE inhibitors or ARBs are
recommended first-line because they provide renal protection in addition to blood
pressure control.
2. In the management of Chronic Obstructive Pulmonary Disease (COPD), which
of the following is the primary indicator for starting long-term oxygen therapy?
A. PaO2 of 55 mmHg or less or SaO2 of 88% or less
B. FEV1 less than 50% predicted
C. Patient complaint of shortness of breath at rest
D. Frequent exacerbations requiring hospitalization
Answer: A
Rationale: Long-term oxygen therapy is indicated in COPD patients with severe resting
hypoxemia (PaO2 ≤ 55 mmHg or SaO2 ≤ 88%).
,3. A patient presents with a ‘curtain-like’ loss of vision in the right eye. This
symptom is most characteristic of which condition?
A. Acute angle-closure glaucoma
B. Retinal detachment
C. Macular degeneration
D. Cataracts
Answer: B
Rationale: Retinal detachment often presents as a sudden, painless loss of vision described
as a curtain or shadow being pulled across the field of vision.
4. Which of the following laboratory findings is most indicative of iron
deficiency anemia?
A. Low MCV, low Ferritin, and high TIBC
B. Low MCV and high Ferritin
C. High MCV and low Ferritin
D. Normal MCV and high Serum Iron
Answer: A
Rationale: Iron deficiency anemia is characterized by microcytic (low MCV) cells, low iron
stores (low ferritin), and a high Total Iron Binding Capacity (TIBC) as the body attempts to
bind more iron.
5. When diagnosing Acute Rhinosinusitis, which symptom duration is the
threshold for considering bacterial etiology over viral?
A. 3 days
B. 5 days
C. 10 days
D. 14 days
Answer: C
, Rationale: Bacterial sinusitis is suspected when symptoms persist for 10 days or more
without improvement, or worsen after initial improvement (double sickening).
6. A 65-year-old female reports a sudden onset of ‘the worst headache of my
life.’ What is the most likely diagnosis?
A. Migraine with aura
B. Subarachnoid hemorrhage
C. Cluster headache
D. Temporal arteritis
Answer: B
Rationale: A ‘thunderclap’ headache or ‘worst headache of life’ is a classic presentation of a
subarachnoid hemorrhage.
7. According to the American Diabetes Association (ADA), what is the diagnostic
threshold for HbA1c to confirm Diabetes Mellitus?
A. 5.7% or higher
B. 6.0% or higher
C. 6.5% or higher
D. 7.0% or higher
Answer: C
Rationale: An HbA1c level of 6.5% or greater is diagnostic for Diabetes Mellitus when
confirmed by a repeat test or other diagnostic criteria.
8. Which heart sound is frequently associated with heart failure and fluid
volume overload in adults?
A. Ejection click
B. S4 gallop
C. S3 gallop
D. Mid-systolic click
Answer: C
Chamberlain
1. A 55-year-old male with a history of hypertension and diabetes presents with
a blood pressure of 152/94. According to JNC 8 guidelines, which class of
medication is the most appropriate initial choice?
A. ACE Inhibitor or ARB
B. Loop diuretic
C. Beta-blocker
D. Alpha-1 antagonist
Answer: A
Rationale: For patients with diabetes and hypertension, ACE inhibitors or ARBs are
recommended first-line because they provide renal protection in addition to blood
pressure control.
2. In the management of Chronic Obstructive Pulmonary Disease (COPD), which
of the following is the primary indicator for starting long-term oxygen therapy?
A. PaO2 of 55 mmHg or less or SaO2 of 88% or less
B. FEV1 less than 50% predicted
C. Patient complaint of shortness of breath at rest
D. Frequent exacerbations requiring hospitalization
Answer: A
Rationale: Long-term oxygen therapy is indicated in COPD patients with severe resting
hypoxemia (PaO2 ≤ 55 mmHg or SaO2 ≤ 88%).
,3. A patient presents with a ‘curtain-like’ loss of vision in the right eye. This
symptom is most characteristic of which condition?
A. Acute angle-closure glaucoma
B. Retinal detachment
C. Macular degeneration
D. Cataracts
Answer: B
Rationale: Retinal detachment often presents as a sudden, painless loss of vision described
as a curtain or shadow being pulled across the field of vision.
4. Which of the following laboratory findings is most indicative of iron
deficiency anemia?
A. Low MCV, low Ferritin, and high TIBC
B. Low MCV and high Ferritin
C. High MCV and low Ferritin
D. Normal MCV and high Serum Iron
Answer: A
Rationale: Iron deficiency anemia is characterized by microcytic (low MCV) cells, low iron
stores (low ferritin), and a high Total Iron Binding Capacity (TIBC) as the body attempts to
bind more iron.
5. When diagnosing Acute Rhinosinusitis, which symptom duration is the
threshold for considering bacterial etiology over viral?
A. 3 days
B. 5 days
C. 10 days
D. 14 days
Answer: C
, Rationale: Bacterial sinusitis is suspected when symptoms persist for 10 days or more
without improvement, or worsen after initial improvement (double sickening).
6. A 65-year-old female reports a sudden onset of ‘the worst headache of my
life.’ What is the most likely diagnosis?
A. Migraine with aura
B. Subarachnoid hemorrhage
C. Cluster headache
D. Temporal arteritis
Answer: B
Rationale: A ‘thunderclap’ headache or ‘worst headache of life’ is a classic presentation of a
subarachnoid hemorrhage.
7. According to the American Diabetes Association (ADA), what is the diagnostic
threshold for HbA1c to confirm Diabetes Mellitus?
A. 5.7% or higher
B. 6.0% or higher
C. 6.5% or higher
D. 7.0% or higher
Answer: C
Rationale: An HbA1c level of 6.5% or greater is diagnostic for Diabetes Mellitus when
confirmed by a repeat test or other diagnostic criteria.
8. Which heart sound is frequently associated with heart failure and fluid
volume overload in adults?
A. Ejection click
B. S4 gallop
C. S3 gallop
D. Mid-systolic click
Answer: C
