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NR 667 CEA EXAM 2025 TEST BANK WITH QUESTIONS AND CORRECT
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- Your 18-year-old patient has recently been diagnosed with streptococcal infection and has been successfully treated with an appropriate antimicrobial agent. They have no other noteworthy health history, chronic illness or medications on record. They are complaining today of hematuria, RBC cast on urinalysis with microscopy have been identified during this visit. Based on this finding you can make the diagnosis of which of the following? - CORRECT ANSWER- glomerulonephritis
- As a prudent nurse practitioner, the diabetic, hypertensive patients you are seeing should be evaluated for early evidence of renal damage from both diabetes and hypertension. Which of the following assessment tools should the nurse practitioner order first for evaluation of early renal dysfunction secondary to diabetes or hypertension? - CORRECT ANSWER- urinalysis with micro and micro albumin
- Your patient presents with a new onset rapid heart rate that is irregularly irregular, heart rate 100, BP 120/74, respiration 16 non-labored and an SpO2 is 99%. They state this has been going on for a week or so intermittently, but for the past four days straight it hasn't stopped. Your first priority intervention for this patient is to do which of the following? - CORRECT ANSWER- maintain rate control and anticoagulation prior to rhythm conversion
- As a prudent nurse practitioner, you know that a 28-year-old male patient with HIV would be considered well managed when they have which of the following in addition to having undetectable or very low viral copies? - CORRECT ANSWER- CD count of 500
- Your patient has expressed concern about a skin lesion which you identify as a darkened, round, and raised lesion. This benign lesion that appears like "stuck on" to the skin. Which of the following lesions best fits this description? - CORRECT ANSWER- Seborrheic keratosis
- You are treating a patient who has stopped taking their diuretic regimen against medical advice while they were on vacation since it made them urinate too frequently for their plans. Now they are 21 pounds heavier than their baseline weight, have respiratory crackles in bilateral bases, and have severe generalized lower extremity and truncal edema extending to the sacrum and abdomen. On your documentation, this is referred to as which of the following conditions? - CORRECT ANSWER- Anasarca
- While evaluating a patient in your clinic for a routine health visit, you auscultate crackles in the posterior left lower lobe, have the patient cough, with follow-up auscultation revealing clear breath sounds. Which one of the following would you suspect? - CORRECT ANSWER- Atelectasis
- Gladys is a 72-year-old patient with a history of anemia of chronic disease from kidney failure, diabetes mellitus, and hypothyroidism, presents today with concerns her thyroid medication is not working well enough. Her most recent labs reflect her TSH is 5.9 (normal range 0.5-5 uU/mL) and Free T4 is 0.3 ng/dL (normal
the pharmacology agents she is prescribed is most likely the common cause of the side effects? - CORRECT ANSWER- Norvasc
Sarah, a 28-year-old female patient presented to your clinic with wheezing and despite being treated with nebulized medication is not having any relief. You believe she is experiencing status asthmaticus. As a prudent nurse practitioner, you recall that she may benefit from IM injection of which of the following agents? - CORRECT ANSWER- Terbutaline
Your 72-year-old female patient with a pertinent medical history of coronary artery bypass graft and aortic valve replacement seven years ago with a porcine bioprosthetic valve has been previously stable on their medical regimen. Today she complains of near syncope when standing, which she states has been getting worse over the past six months but failed to tell anyone as she felt it was just part of natural aging and taking medications. Your workup should include evaluation of which of the following potential cardiac complications? - CORRECT ANSWER- Bioprosthetic aortic valve stenosis
During a post hospital discharge visit you notice a 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 sound? - CORRECT ANSWER- S3 in systole while S4 is diastole
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 thoracic assist the provider in doing the physical
examination? - CORRECT ANSWER- To identify if underlying tissue are air filled, fluid filled or consolidated
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 hear a muffled "E" sound, however you heard a nasally "A" sound. What will you document is present? - CORRECT ANSWER- Positive egophony
Your patient with a suspected diagnosis of COPD has been seen by pulmonology and has undergone a pulmonary function test with spirometry. As the patient's primary health care provider you have been asked to explain the findings of the PFT to the patient in a follow-up visit. The patient asks what the study was evaluating. Please describe the pulmonary function test to the patient and more useful terms. You state that the large inspiration of air to the furthest extent they could reasonably accomplish followed by a full exhalation is referred to as which of the following measurements during the PFT? - CORRECT ANSWER- Forced vital capacity
Your newly established patient states in the past year they have progressively developed a noticeable bump on their neck and when asked about symptoms they report feeling very anxious, have developed a tremor and are commonly feeling palpitations in their chest. On examination you identify an enlarged thyroid gland suspicious of which of the following diagnosis most likely for the patient to develop based on these findings above? - CORRECT ANSWER- Graves disease
A patient of Mediterranean descent who presents with microcytic anemia with normal red cell distribution width should be evaluated using gel electrophoresis to confirm which of the following types of anemia? - CORRECT ANSWER- Thalassemia
You're a 22-year-old male patient states during his review of systems that his scrotum is very enlarged and feels like it is full of worms. He is a power lifter and works as a trash collector. You suspect that patient likely has which of the following diagnosis? - CORRECT ANSWER- Varicocele
Your patient had a history of hepatitis A approximately 1 year ago. Which of the following immunoglobulins is most likely to be elevated at this time? - CORRECT ANSWER- IgG
Your patient has just been diagnosed with hepatitis A. Which of the following immunoglobulins are first to be elevated in the serum? - CORRECT ANSWER- IgM
Your 32-year-old patient presents with a suspected diagnosis of systemic lupus erythematosus. Which of the following are useful labs in making the diagnosis of SLE? - CORRECT ANSWER- Anti-nuclear antibody (ANA)
Which of the following dermatologic lesions is precancerous and likely due to prolonged exposure to UVB? - CORRECT ANSWER- Actinic keratosis
- Your 64-year-old female patient presents with a complaint of severe pain in her left big toe that began acutely this morning. It is red, warm, and very tender to touch. She reports drinking wine with dinner last night. Based on these
findings, which of the following is the most likely diagnosis? - CORRECT ANSWER- Gout
- A 40-year-old patient with hyperpigmented, velvety patches in the axilla and neck should be evaluated for which of the following underlying disorders? - CORRECT ANSWER- Diabetes mellitus
- Which of the following dermatologic lesions can be described as a small (< cm), circumscribed, elevated, fluid-filled lesion? - CORRECT ANSWER- Vesicle
- A patient presents with a bulls-eye lesion after a camping trip in the Northeast United States. What is the most likely diagnosis? - CORRECT ANSWER- Lyme disease
- A patient presents with a widespread, itchy, red rash with silvery scales over the extensor surfaces of the elbows and knees. What is the most likely diagnosis? - CORRECT ANSWER- Psoriasis
- A patient with a suspected diagnosis of basal cell carcinoma would most likely present with which of the following skin lesions? - CORRECT ANSWER- Pearly papule with rolled borders
- Your 68-year-old male patient presents with difficulty starting urination and a weak urinary stream. He also reports nocturia and urgency. What is the most likely diagnosis? - CORRECT ANSWER- Benign prostatic hyperplasia
- Which of the following signs is most suggestive of cholecystitis? - CORRECT ANSWER- Positive Murphy's sign
- A patient presents with severe, sharp left lower quadrant abdominal pain and fever. Which of the following diagnoses is most likely? - CORRECT ANSWER- Diverticulitis
- Which of the following dietary modifications should be recommended to a patient recovering from diverticulitis? - CORRECT ANSWER- Low-residue diet
- Which of the following is the most appropriate screening recommendation for a 21-year-old female with normal Pap history? - CORRECT ANSWER- Pap smear every 3 years
- A female patient complains of painful urination, increased urinary frequency, and urgency. Urinalysis shows positive nitrites and leukocyte esterase. What is the most likely diagnosis? - CORRECT ANSWER- Urinary tract infection
- Which of the following is the most appropriate antibiotic choice for uncomplicated cystitis in an otherwise healthy woman? - CORRECT ANSWER- Nitrofurantoin
- Your patient reports frothy, green vaginal discharge with a strong odor. What is the most likely diagnosis? - CORRECT ANSWER- Trichomoniasis
- Which of the following medications is the treatment of choice for trichomoniasis? - CORRECT ANSWER- Metronidazole
- A patient presents with genital vesicles on an erythematous base, fever, and dysuria. What is the most likely diagnosis? - CORRECT ANSWER- Herpes simplex virus
- A 29-year-old woman presents with a malodorous, thin, gray vaginal discharge. Wet mount reveals clue cells. What is the most likely diagnosis? - CORRECT ANSWER- Bacterial vaginosis
- Which of the following medications is the treatment of choice for bacterial vaginosis? - CORRECT ANSWER- Metronidazole
- A 26-year-old sexually active woman presents with lower abdominal pain, cervical motion tenderness, and purulent cervical discharge. What is the most likely diagnosis? - CORRECT ANSWER- Pelvic inflammatory disease
- Which of the following organisms is most commonly associated with pelvic inflammatory disease? - CORRECT ANSWER- Chlamydia trachomatis
- Your 30-year-old male patient presents with a painless ulcer on the penis and reports recent unprotected intercourse. What is the most likely diagnosis? - CORRECT ANSWER- Syphilis
- Your 26-year-old female patient presents with painful menses accompanied by cramping and lower abdominal pain. What is the most likely diagnosis? - CORRECT ANSWER- Dysmenorrhea
- A 33-year-old woman presents with complaints of infertility and hirsutism. On exam she is obese and has acne. Which of the following is the most likely diagnosis? - CORRECT ANSWER- Polycystic ovarian syndrome
- Which of the following lab findings is most consistent with polycystic ovarian syndrome? - CORRECT ANSWER- Elevated LH/FSH ratio
- A 29-year-old female with irregular menses is being evaluated for infertility. Her progesterone level during the luteal phase is low. What does this indicate? - CORRECT ANSWER- Anovulation
- Which of the following contraceptive methods is contraindicated in a woman with a history of DVT? - CORRECT ANSWER- Combined oral contraceptives
- Which of the following is a common side effect of depot medroxyprogesterone acetate (Depo-Provera)? - CORRECT ANSWER- Weight gain
- Your 18-year-old female patient complains of painful, heavy menstrual bleeding. Which of the following is the first-line treatment? - CORRECT ANSWER- Combined oral contraceptives
- Which of the following vaccines is recommended for all individuals beginning at age 11-12 years to prevent HPV-related diseases? - CORRECT ANSWER- HPV vaccine (Gardasil)
- A patient with a history of alcohol use disorder presents with confusion, ataxia, and ophthalmoplegia. What is the most likely diagnosis? - CORRECT ANSWER- Wernicke's encephalopathy
- Which vitamin deficiency is associated with Wernicke's encephalopathy? - CORRECT ANSWER- Thiamine (Vitamin B1)
- Which of the following medications is most appropriate for the acute treatment of panic disorder? - CORRECT ANSWER- Benzodiazepines
- A 25-year-old female presents with fatigue, cold intolerance, and constipation. Which of the following lab abnormalities would confirm hypothyroidism? - CORRECT ANSWER- Elevated TSH and low free T
- Which of the following is the most appropriate first-line treatment for hypothyroidism? - CORRECT ANSWER- Levothyroxine
- A 60-year-old man presents with weight loss, diarrhea, and hyperpigmentation. Lab results show low sodium and high potassium. What is the most likely diagnosis? - CORRECT ANSWER- Addison's disease
- A patient taking metformin develops nausea, vomiting, and abdominal pain. Lab shows an elevated anion gap and lactic acidosis. What is the most likely diagnosis? - CORRECT ANSWER- Metformin-associated lactic acidosis
- Which of the following vaccines is recommended annually for patients with diabetes mellitus? - CORRECT ANSWER- Influenza vaccine
- A 55-year-old smoker presents with hematuria. Which of the following should be included in the initial workup? - CORRECT ANSWER- Urinalysis and cystoscopy
- Which of the following is the most appropriate initial imaging study for suspected aortic dissection? - CORRECT ANSWER- CT angiography
- A 63-year-old female presents with gradual loss of central vision. Fundoscopic exam reveals drusen bodies. What is the most likely diagnosis? - CORRECT ANSWER- Macular degeneration
- A 75-year-old male complains of sudden painless loss of vision in one eye. Fundoscopic exam shows a pale retina with a cherry-red spot. What is the most likely diagnosis? - CORRECT ANSWER- Central retinal artery occlusion
- A 65-year-old patient presents with new onset jaw pain while chewing and scalp tenderness. ESR is markedly elevated. What is the most likely diagnosis? - CORRECT ANSWER- Temporal arteritis
- A patient with hypertension presents for follow-up. Lifestyle modifications are discussed. Which of the following is most effective in lowering blood pressure? - CORRECT ANSWER- Weight loss
- A 60-year-old patient presents with a blood pressure of 165/95 mmHg on two separate visits. Which of the following is the most appropriate initial antihypertensive agent for this patient with no other comorbidities? - CORRECT ANSWER- Thiazide diuretic
- Which of the following medications is most appropriate for initial treatment of hypertension in a Black patient without chronic kidney disease? - CORRECT ANSWER- Calcium channel blocker
- A patient with a history of hypertension presents with a dry cough. Which class of medications is most likely responsible? - CORRECT ANSWER- ACE inhibitor
- A 52-year-old male with elevated LDL and no history of cardiovascular disease asks about statin therapy. According to ACC/AHA guidelines, what is the most appropriate recommendation? - CORRECT ANSWER- Initiate moderate- to high- intensity statin
- A patient taking a statin reports new onset of muscle pain. Which of the following labs should be ordered? - CORRECT ANSWER- Creatine kinase (CK)
- A 40-year-old patient presents with a blood pressure of 150/92 mmHg and fasting glucose of 130 mg/dL. He has a waist circumference of 42 inches and
A. Strep pharyngitis
B. Tonsillitis
C. Epstein Barr virus (EBV)
D. Pancreatitis
C
Which of the following best characterizes presbycusis in the older adult?
A. Bilateral low-frequency sensorineural hearing loss
B. Bilateral high-frequency sensorineural hearing loss
C. Unilateral high-frequency sensorineural hearing loss
D. Unilateral low-frequency sensorineural hearing loss
B
A 35-year-old woman presents with allergic rhinitis, experiencing significant nasal congestion, sneezing, and itchy eyes. She has tried over-the-counter antihistamines with limited relief. What is the most appropriate next step in management?
A. Oral decongestants
B. Nasal saline irrigation
C. Intranasal corticosteroids
D. Referral to an allergist for immunotherapy
C
A patient currently undergoing concurrent chemotherapy/radiation treatment for glottic squamous cell carcinoma is admitted to the rehab unit you oversee for management of intractable nausea, vomiting, and dehydration. Admission CBC showed WBC 1.3, Hgb 7.5, PLT 45, ANC 0.8. Which of the following conditions is this patient at risk for?
A. Iron deficiency anemia due to chronic blood loss
B. Microcytic anemia due to chronic kidney disease
C. Macrocytic anemia due to B12 deficiency
D. Aplastic anemia due to bone marrow suppression
D
A 78 y.o. M patient reports chronic infections, bruising, fatigue, SOB, and fevers. He has a history of rectal adenocarcinoma and completed concurrent chemotherapy/radiation earlier this year. His CBC shows Hgb 7.5, PLT 88, WBC 1.2, ANC 0.8, and peripheral smear shows dysplasia. What additional work-up would you anticipate for this patient?
A. Colonoscopy and fecal occult blood test
B. Bone marrow biopsy and flow cytometry
C. No additional work-up is required, these are expected sequela of his oncologic treatment
D. Repeat CBC/CMP/peripheral smear in eight weeks
