Download CEA PREP FULL PRACTICE EXAM WITH CORRECT ANSWERS 2025 and more Exams Nursing in PDF only on Docsity!
CEA PREP FULL PRACTICE EXAM
WITH CORRECT ANSWERS 2025
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? *Left upper lobe apex *Right middle lobe *Left upper lobe lingula *Left lower lobe correct answers >> Left upper lobe lingula Ratonale: 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.
The inability to fully relax the myocardium during relaxation is a trademark of which of the following diagnoses? correct answers >> 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. 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 answers >> 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. Your patient has been diagnosed with a 4.5cm ascending aortic aneurysm. Which medical imaging is considered standard of care for serial surveillance? correct answers >> CT angiography of the chest
acute myocardial infarction that precipitated this, however, a patient has not described that, rather is only describing dyspnea on exertion and orthopnea, which both speak to a state of fluid overload. The only appropriate response of these available is congestive heart failure. Your patient with a history of HFrEF (heart failure with reduced ejection fraction) with an ejection fraction of 40% who is also not on optimal medical therapy has been diagnosed with a myocardial infarction this admission and received emergent placement of a drug-eluting stent to the left anterior descending artery. As the medical home who will manage this patient after discharge, which medication strategy would you expect to be a priority in the patient's care? correct answers >> Ordering a transthoracic echocardiogram and order a Lifevest if EF is less than 35% Rationale: The patient should have a protective mechanism such as an implantable automated cardioverter defibrillator (AICD) or a Lifevest if the EF is less than 35% due to the increased risk of sudden cardiac death with low EF states. Since most patients are not eligible for 90 days for an AICD in this state, optimizing their medication regimen and repeating an echo in 2-3 months to re-evaluate for improvement in their EF is required by most insurance companies. A baseline echo is needed at discharge to provide a baseline for improvement vs their repeat echo in 2-3 months.
Dual anti-platelet therapy is required for 12 months minimum post-MI. A Holter monitor does not provide any conceivable benefit for this patient as presented. Which of the following people groups represent the least risk of cardiac disease? correct answers >> Caucasians Rationale: Statistically African Americans, Native Hawaiians, and American Indians are at at increased risk of cardiac disease due to higher rates of hypertension, diabetes, and obesity than Caucasians. A 65-year-old woman presents for a follow-up examination. She is a smoker, and her hypertension is now adequately controlled with medication. Her mother died at age 40 from a heart attack. The fasting lipid profile shows cholesterol = 240 mg/dL, HDL = 30, and LDL = 200. In addition to starting therapeutic lifestyle changes, the nurse practitioner should start the patient on: correct answers >> a statin drug. Rationale: Bile acid sequestrants and cholesterol absorption inhibitors may be useful in reducing ASVD risk, but for a patient who is an active smoker with premature coronary disease history (less than age 65 for women), has hypertension and is far from an LDL goal, this patient is most
elevated serum testosterone and LH ratio > 2:1. What is the most appropriate initial treatment? correct answers >> Oral contraceptives Rationale: These are classic symptoms of polycystic ovarian syndrome and the patient should be treated with oral contraceptives to help stabilize their estrogen and progesterone. Additionally, they may be managed on metformin and/or spironolactone for their PCOS. Oral contraceptive pills (OCPs) are often the first pharmacological treatment for polycystic ovary syndrome (PCOS) because they help manage in several ways: Menstrual irregularities: OCPs can help regulate menstrual cycles, making periods lighter and more regular. This is important because irregular ovulation can lead to endometrial hyperplasia, which is a buildup of uterine tissue that can increase the risk of uterine cancer. Androgen excess: OCPs can reduce androgen production and increase sex hormone-binding globulin (SHBG), which binds androgens. This can help reduce symptoms like acne, hirsutism (unwanted body and facial hair), and androgenic alopecia (male pattern baldness). Endometrium protection: OCPs can protect the endometrium by ensuring regular ovulation
A 50-year-old woman with hypertension and diabetes comes in for a routine check-up. What screening test should be regularly performed to monitor for early signs of diabetic nephropathy? correct answers >> Urine dipstick for protein Rationale: The most sensitive indicator of diabetic nephropathy would be the evidence of small proteins in the urine (proteinuria) as found on urinalysis. The other options might describe macro-organ function (such as BUN/Creat from a BMP, a renal biopsy which is not indicated for routine diabetic nephropathy testing, and a Abd CT, which is more akin to evaluation of less subtle findings), but at the functional level of the nephron, namely the glomerulus, evidence of glucose-related damage is easily identified with proteinuria from a UA. Which of the following is at highest risk for DMII? correct answers >> An adult woman with a BMI of 27 who just delivered a baby weighing 9 1/2 lbs Rationale: Of these options, an adult woman with a BMI of 27 who just delivered a baby weighing 9 1/2 lbs is the most likely due to their increased BMI and the large size of the baby. giving birth to a large baby, also known as a large-for- gestational-age (LGA) baby, can increase the risk of developing type 2 diabetes later in life. Women who give birth to a LGA baby are 10% more likely to develop DMII 10-
T3/T4 and clinical symptoms of a goiter, tremulousness, anxiety, palpitations, weight loss, insomnia, diarrhea, etc. This patient is describing a sore neck as well, which is suggestive of Graves disease (hyperthyroid state). All the following are symptoms of hypocalcemia except: correct answers >> Visual field deficits Rationale: Visual field deficits is a potential symptom of pituitary adenoma. All other are symptoms related to hypocalcemia. An adult patient diagnosed with type 2 diabetes mellitus presents for a recheck. The patient follows a carbohydrate counting diet and walks 30 minutes 5 times weekly. Current fasting blood glucose = 116 mg/dL [normal = less than 99 mg/dL] and A1c = 6.3% [normal = less than 7.0%]. In accordance with the American Diabetes Association, the nurse practitioner would recommend that the next follow-up appointment be scheduled for: correct answers >> 6 months. Rationale: Based off of the ADA recommendation, this patient should be evaluated in six months. They are actually showing good control and excellent compliance with diet and exercise management strategies. If there compliance was worse or
they were not controlled with their A1c, this would likely be a three month follow up. Your patient has a diagnosis of Hashimoto's and is on Levothyroxine 75 mcg daily. Her recent TSH was elevated at 15 uU/mL. Your next best action is to: correct answers >> Increase Levothyroxine to 100 mcg daily Rationale: When the TSH is elevated the patient needs more thyroid hormone. Once diagnosed with Hashimoto's there is no clinical need/benefit to repeating anti bodies. A patient has a 3 cm pituitary mass noted on CT. What is your next step in evaluating the patient? correct answers >> Screen for hormone deficiencies Rationale: Initial work up includes hormone testing. Cabergoline is the treatment for prolactinoma. Surgery consult is indicated when there are VF deficits and/or abutment/compression on optic nerves or chiasm or if adenoma is hyperfunctioning. Adenomas >1 cm with no VF deficit or abutment/compression of optic nerves or chiasm require a follow up MRI at 6 months. An adult female presents with a chief complaint of fatigue and weight gain. She states that she doesn't feel like herself. A
weight loss and abdominal pain may be present with adenocarcinoma it is unlikely to present with jaundice, and you're unlikely to have abdominal pain or jaundice with any esophageal malignancy. A 63-year-old male presents with a suspected lower GI bleed. He reports passing frank small amounts of blood several times today. He denies any use of NSAID's or blood thinners. What must be taken into consideration before performing a colonoscopy on this patient? correct answers >> All are reasonable options Rationale: This patient has had blood loss and should first be hemodynamically stable, and fluid/blood product resuscitated. In all cases of GI bleed risk factors for an upper GI bleed must be taken into consideration first, we must always discuss with the patient all risks and benefits associated with the procedure to provide an informed consent. A 39-year-old female is being seen by your service for diarrhea. Patient reports 3-4 loose stools a day. She also reports mild cramping. Which labs would be helpful in further workup of a diagnosis? correct answers >> ESR, fecal occult, Stool culture
Rationale: ESR, Fecal occult, and stool culture would be the biggest benefit to determine the potential cause of her symptoms. An adult female presents with a 1-week history of left lower quadrant abdominal pain. T=101.2 degrees F. (38.4 degrees C) and an elevated WBC count. This is the patient's first episode of severe abdominal pain. The nurse practitioner suspects diverticulitis. Which of the following diagnostic tests would confirm the diagnosis? correct answers >> CT scan of the abdomen Rationale: For patients with acute diverticulitis, CT of the abdomen will provide evidence of the pathophysiology. Evidence of diverticula will be present on a flat plate KUB x- ray, but there is not enough specificity to show that it is inflamed as with a CT scan. A 70-year-old patient presents to the clinic with dyspnea, palpitations, and fatigue. The patient reports a 2-week history of blackened stools, which the patient attributes to drinking berry juice. Assessment reveals vital signs of BP = 110/60, P = 100, R = 24; Hgb = 4.5 g/dL; Hct = 16%. What is the most appropriate immediate intervention? correct answers >> Send to the emergency room.
A 28-year-old woman presents with abdominal pain, diarrhea, and weight loss. She also reports occasional bloody stools. Colonoscopy reveals continuous inflammation from the rectum extending proximally. What is the most likely diagnosis? correct answers >> Ulcerative colitis Rationale: The presence of inflammatory bowel disease which is present in the patient with bloody stool suggests ulcerative colitis. This patient should be acutely managed with steroids and chronically with auto-immune therapy such as biologics and/or DMARDs. A 63-year-old male presents with a suspected lower GI bleed. He reports passing frank small amounts of blood several times today. He denies use of NSAID's or blood thinners. What questions would be important to ask to further differentiate your diagnosis? correct answers >> All these questions would help determine if this bleed was associated with a potential diverticular bleed (typically painless), painful bowel movement associated with IBD (UC/Crohn's), and changes in bowel habit/colonoscopy risk for malignancy. Which is best performed to assess the risk for fall in an 88- year old adult? correct answers >> Get up and go test Rationale: This question is asking you if you understand the different screening to available for Mobility and fall risk. The
global screening assessment, PHQ-2 questionnaire, and clock drawing test have no clinical significance to mobility. The "get up and go" test is the only option that is a mobility test of these four. A frail elderly patient presents with constipation. Which of the following normal physiologic changes seen with aging is the most likely cause? correct answers >> Decreased bowel muscle tone Rationale: The frail, elderly patient will typically have their GI track decrease bile secretion and decrease absorption of calcium. A decrease in pancreas secretions is not related to presence of constipation, however, decreased bowel muscle tone certainly does reduce the GI motility and increase the transit time, thereby increasing the drying of stool in the large intestine which leads to constipation An elderly patient diagnosed with end-stage lung cancer has been refusing meals, opting instead for ice cream only. The family is concerned about the patient not getting enough nutrition. The NP: correct answers >> explains loss of appetite is common at the end of life Rationale: Death is an uncomfortable topic, and must be handled tactfully. Factual re-orientation to the terminal state of a patient's condition may be appropriate when unrealistic
The management of COPD in the elderly is best guided by: correct answers >> symptomatology. Rationale: Symptomatology is what guides COPD management since the severity and frequency of symptoms will warrant changes and additions to medications as exacerbations present. Although very useful tool for chronic management and baseline status, spirometry does not typically dictate therapy, rather diagnose the disease state itself. Our blood gases may be used for clinically correlate severity during an exacerbation, and radiologic imaging may showcase severity of stable chronic finding such as somatic, lung tissue or bullae. Which of the following is an example of implied consent? correct answers >> The patient collapses while having a myocardial infarction in the hospital cafeteria. Bystanders witnessed the patient clutch his chest, say "my chest", then collapse. They start CPR and initiate the emergency care system to transport the patient for care in the emergency department. Rationale: Surgical consent is by definition "informed" when the risks and benefits are discussed as with the patients undergoing surgery and a chest tube, and 2 person emergency consent is described with the patient with altered
mental status. The collapsed patient reflects a clear inability to care for oneself and care is being performed under the assumption of what is implied as what any reasonable person would want. Which of the following refers to the primary access point of medical care patients are encouraged to use to aid in providing continuity and reduction of cost per the Affordable Care Act? correct answers >> The Medical Home Rationale: The medical home reduces cost by providing continuity of care, reducing overtesting, duplicate testing, and aids with longitudinal management of the patient. The other options all increase these cost-burdening elements and should be avoided unless care through the medical home is not a reasonable or appropriate option. A patient states they do not want to have any further medical care and wishes to leave against medical advice. Unknown to you, the healthcare tech then held their arm down to get an IV catheter placed against their will. The healthcare tech is at risk of being charged with which of the following: correct answers >> Battery Rationale: Assault refers to the risk of a harm to others, whereas battery refers to the actual act of that harm.
