NR 603 CEA Midterm Exam - Advanced Clinical Diagnosis 2026/2027
Chamberlain
1. According to the JNC 8 guidelines, what is the blood pressure goal for a 65-
year-old patient with no other comorbidities?
A. < 130/80 mmHg
B. < 140/90 mmHg
C. < 150/90 mmHg
D. < 120/70 mmHg
Answer: C
Rationale: For patients aged 65 and older without diabetes or chronic kidney disease, JNC
8 recommends a blood pressure goal of less than 150/90 mmHg.
2. Which of the following is the gold standard diagnostic test for confirming
Chronic Obstructive Pulmonary Disease (COPD)?
A. Chest X-ray
B. Arterial Blood Gas (ABG)
C. Spirometry showing FEV1/FVC < 0.70
D. Pulse Oximetry
Answer: C
Rationale: Spirometry is required for diagnosis; a post-bronchodilator FEV1/FVC ratio of
less than 0.70 confirms persistent airflow limitation.
,3. A 52-year-old patient presents with an A1c of 7.2%. Which medication is
generally considered first-line therapy for Type 2 Diabetes?
A. Pioglitazone
B. Glipizide
C. Sitagliptin
D. Metformin
Answer: D
Rationale: Metformin is the first-line pharmacological treatment for type 2 diabetes due to
its efficacy, safety, and low cost.
4. A patient presents with a ‘pearl-like’ papule with telangiectasia on the nose.
What is the most likely diagnosis?
A. Squamous Cell Carcinoma
B. Melanoma
C. Basal Cell Carcinoma
D. Actinic Keratosis
Answer: C
Rationale: Basal cell carcinoma typically presents as a pearly or waxy papule with
prominent telangiectatic vessels.
5. Which heart sound is most commonly associated with Heart Failure with
Reduced Ejection Fraction (HFrEF)?
A. S3
B. S2
C. S1
D. S4
Answer: A
Rationale: The S3 gallop is a classic sign of fluid overload and ventricular dysfunction,
common in HFrEF.
, 6. In the treatment of Acute Bacterial Rhinosinusitis, what is the recommended
first-line antibiotic therapy for an adult?
A. Azithromycin
B. Ciprofloxacin
C. Amoxicillin-Clavulanate
D. Doxycycline
Answer: C
Rationale: Amoxicillin-clavulanate is the first-line choice for bacterial sinusitis to cover
both Streptococcus pneumoniae and Haemophilus influenzae.
7. Which laboratory finding is most indicative of primary hypothyroidism?
A. High TSH, High T4
B. Low TSH, Low T4
C. High TSH, Low T4
D. Low TSH, High T4
Answer: C
Rationale: Primary hypothyroidism is characterized by an elevated TSH as the pituitary
attempts to stimulate a failing thyroid gland, resulting in low T4 levels.
8. A 24-year-old female presents with frequent urination and dysuria. A urine
culture shows >100,000 CFU/mL of E. coli. What is the most common first-line
treatment for uncomplicated Cystitis?
A. Ceftriaxone
B. Nitrofurantoin
C. Doxycycline
D. Metronidazole
Answer: B
Rationale: Nitrofurantoin (Macrobid) is a first-line treatment for uncomplicated UTI in
women.
Chamberlain
1. According to the JNC 8 guidelines, what is the blood pressure goal for a 65-
year-old patient with no other comorbidities?
A. < 130/80 mmHg
B. < 140/90 mmHg
C. < 150/90 mmHg
D. < 120/70 mmHg
Answer: C
Rationale: For patients aged 65 and older without diabetes or chronic kidney disease, JNC
8 recommends a blood pressure goal of less than 150/90 mmHg.
2. Which of the following is the gold standard diagnostic test for confirming
Chronic Obstructive Pulmonary Disease (COPD)?
A. Chest X-ray
B. Arterial Blood Gas (ABG)
C. Spirometry showing FEV1/FVC < 0.70
D. Pulse Oximetry
Answer: C
Rationale: Spirometry is required for diagnosis; a post-bronchodilator FEV1/FVC ratio of
less than 0.70 confirms persistent airflow limitation.
,3. A 52-year-old patient presents with an A1c of 7.2%. Which medication is
generally considered first-line therapy for Type 2 Diabetes?
A. Pioglitazone
B. Glipizide
C. Sitagliptin
D. Metformin
Answer: D
Rationale: Metformin is the first-line pharmacological treatment for type 2 diabetes due to
its efficacy, safety, and low cost.
4. A patient presents with a ‘pearl-like’ papule with telangiectasia on the nose.
What is the most likely diagnosis?
A. Squamous Cell Carcinoma
B. Melanoma
C. Basal Cell Carcinoma
D. Actinic Keratosis
Answer: C
Rationale: Basal cell carcinoma typically presents as a pearly or waxy papule with
prominent telangiectatic vessels.
5. Which heart sound is most commonly associated with Heart Failure with
Reduced Ejection Fraction (HFrEF)?
A. S3
B. S2
C. S1
D. S4
Answer: A
Rationale: The S3 gallop is a classic sign of fluid overload and ventricular dysfunction,
common in HFrEF.
, 6. In the treatment of Acute Bacterial Rhinosinusitis, what is the recommended
first-line antibiotic therapy for an adult?
A. Azithromycin
B. Ciprofloxacin
C. Amoxicillin-Clavulanate
D. Doxycycline
Answer: C
Rationale: Amoxicillin-clavulanate is the first-line choice for bacterial sinusitis to cover
both Streptococcus pneumoniae and Haemophilus influenzae.
7. Which laboratory finding is most indicative of primary hypothyroidism?
A. High TSH, High T4
B. Low TSH, Low T4
C. High TSH, Low T4
D. Low TSH, High T4
Answer: C
Rationale: Primary hypothyroidism is characterized by an elevated TSH as the pituitary
attempts to stimulate a failing thyroid gland, resulting in low T4 levels.
8. A 24-year-old female presents with frequent urination and dysuria. A urine
culture shows >100,000 CFU/mL of E. coli. What is the most common first-line
treatment for uncomplicated Cystitis?
A. Ceftriaxone
B. Nitrofurantoin
C. Doxycycline
D. Metronidazole
Answer: B
Rationale: Nitrofurantoin (Macrobid) is a first-line treatment for uncomplicated UTI in
women.
