CLINICAL EDUCATION ASSOCIATES (CEA)Pre-
Clinical Diagnostic Exam Question and Answers
Latest Updates 2026 Top Rated A+
The CEA (Clinical Education Associates) Pre-Clinical Diagnostic Exam,
often used in Nurse Practitioner programs, tests foundational
knowledge in diagnostic reasoning, pathophysiology, pharmacology,
assessment, and clinical management. Below are sample practice
questions compiled from publicly available study resources (such as
Quizlet sets and prep materials). These are representative of common
topics like cardiovascular, respiratory, endocrine, and geriatrics.
Rationales are included where available.
1. Question: A patient presents with a productive cough and low-grade
fever. Chest X-ray (PA view) shows consolidation in the left lower chest
area adjacent to the left heart border, approximately 2 rib spaces above
the costophrenic angle. What is the most likely location of the
pneumonia?
Answer: Left upper lobe (lingula)
Rationale: Lingular consolidation appears in this location on PA view,
adjacent to the heart border.
2. Question: A 65-year-old female smoker with controlled hypertension
presents for follow-up. Family history: Mother died at age 40 from heart
attack. Fasting lipids: Total cholesterol 240 mg/dL, HDL 30 mg/dL, LDL
,200 mg/dL. In addition to therapeutic lifestyle changes, what should the
NP start?
Answer: Statin therapy
Rationale: High-risk profile (age, smoking, family history, elevated LDL)
warrants statin initiation per guidelines.
3. Question: A 50-year-old woman with hypertension presents with
dyspnea on exertion and orthopnea. Exam: Jugular venous distention
and bilateral lung crackles. What is the most likely diagnosis?
Answer: Congestive heart failure
Rationale: Symptoms and signs indicate fluid overload with left- and
right-sided heart failure.
4. Question: An otherwise healthy African American male with
hypertension has tried salt restriction, DASH diet, and exercise, but BP
remains elevated. What is the preferred initial pharmacologic therapy?
Answer: Calcium channel blocker (e.g., amlodipine)
Rationale: Guidelines (e.g., JNC8) recommend CCBs as first-line in
African American patients due to better efficacy.
5. Question: A patient has low TSH with thyroid tenderness and neck
pain. What lab tests should be ordered next?
Answer: Triiodothyronine (T3) and free thyroxine (FT4)
, Rationale: Low TSH with symptoms suggests hyperthyroidism;
elevated T3/T4 confirms it (e.g., subacute thyroiditis).
6. Question: An elderly patient presents with confusion. Vital signs: BP
110/76, HR 86, RR 12, Temp 97°F. What is the next step?
Answer: Assess for infection
Rationale: Elderly patients often have atypical presentations of
infection (e.g., no fever); high suspicion is needed.
7. Question: A frail elderly patient presents with constipation. What
screening tool is appropriate for mobility and fall risk?
Answer: Timed Up and Go (Get Up and Go) test
Rationale: This directly assesses mobility; other tools (e.g., PHQ-2,
clock drawing) do not.
8. Question: A 78-year-old man leans to the right ear during
conversation and asks for repetition. His daughter worries about
dementia. What should the PMHNP do first?
Answer: Examine the patient's ear canals
Rationale: Hearing loss (e.g., cerumen impaction) can mimic cognitive
issues; rule out reversible causes first.
9. Question: What physical exam maneuver is Murphy's sign?
, Answer: Palpate right upper quadrant below costal margin during
deep inspiration; positive if pain on inhalation.
Rationale: Classic for cholecystitis.
10. Question: A patient with allergic rhinitis has tried OTC
antihistamines with limited relief. Next step?
Answer: Intranasal corticosteroids
Rationale: First-line for moderate-persistent symptoms per guidelines.
11. Question: An adult female returns for a recheck. The only
remarkable lab is TSH at 0 microunits/mL (normal 0.4-4.0). She reports
neck pain; exam shows thyroid tenderness. Which labs should the NP
order next?
Answer: Triiodothyronine (T3) and free thyroxine (FT4)
Rationale: Low TSH with tenderness suggests hyperthyroidism (e.g.,
subacute thyroiditis); elevated T3/FT4 confirms diagnosis.
12. Question: An adult with type 2 diabetes follows carb-counting diet
and walks 30 min 5x/week. Fasting glucose 116 mg/dL, A1c 6%. Per ADA
guidelines, next follow-up?
Answer: 6 months
Clinical Diagnostic Exam Question and Answers
Latest Updates 2026 Top Rated A+
The CEA (Clinical Education Associates) Pre-Clinical Diagnostic Exam,
often used in Nurse Practitioner programs, tests foundational
knowledge in diagnostic reasoning, pathophysiology, pharmacology,
assessment, and clinical management. Below are sample practice
questions compiled from publicly available study resources (such as
Quizlet sets and prep materials). These are representative of common
topics like cardiovascular, respiratory, endocrine, and geriatrics.
Rationales are included where available.
1. Question: A patient presents with a productive cough and low-grade
fever. Chest X-ray (PA view) shows consolidation in the left lower chest
area adjacent to the left heart border, approximately 2 rib spaces above
the costophrenic angle. What is the most likely location of the
pneumonia?
Answer: Left upper lobe (lingula)
Rationale: Lingular consolidation appears in this location on PA view,
adjacent to the heart border.
2. Question: A 65-year-old female smoker with controlled hypertension
presents for follow-up. Family history: Mother died at age 40 from heart
attack. Fasting lipids: Total cholesterol 240 mg/dL, HDL 30 mg/dL, LDL
,200 mg/dL. In addition to therapeutic lifestyle changes, what should the
NP start?
Answer: Statin therapy
Rationale: High-risk profile (age, smoking, family history, elevated LDL)
warrants statin initiation per guidelines.
3. Question: A 50-year-old woman with hypertension presents with
dyspnea on exertion and orthopnea. Exam: Jugular venous distention
and bilateral lung crackles. What is the most likely diagnosis?
Answer: Congestive heart failure
Rationale: Symptoms and signs indicate fluid overload with left- and
right-sided heart failure.
4. Question: An otherwise healthy African American male with
hypertension has tried salt restriction, DASH diet, and exercise, but BP
remains elevated. What is the preferred initial pharmacologic therapy?
Answer: Calcium channel blocker (e.g., amlodipine)
Rationale: Guidelines (e.g., JNC8) recommend CCBs as first-line in
African American patients due to better efficacy.
5. Question: A patient has low TSH with thyroid tenderness and neck
pain. What lab tests should be ordered next?
Answer: Triiodothyronine (T3) and free thyroxine (FT4)
, Rationale: Low TSH with symptoms suggests hyperthyroidism;
elevated T3/T4 confirms it (e.g., subacute thyroiditis).
6. Question: An elderly patient presents with confusion. Vital signs: BP
110/76, HR 86, RR 12, Temp 97°F. What is the next step?
Answer: Assess for infection
Rationale: Elderly patients often have atypical presentations of
infection (e.g., no fever); high suspicion is needed.
7. Question: A frail elderly patient presents with constipation. What
screening tool is appropriate for mobility and fall risk?
Answer: Timed Up and Go (Get Up and Go) test
Rationale: This directly assesses mobility; other tools (e.g., PHQ-2,
clock drawing) do not.
8. Question: A 78-year-old man leans to the right ear during
conversation and asks for repetition. His daughter worries about
dementia. What should the PMHNP do first?
Answer: Examine the patient's ear canals
Rationale: Hearing loss (e.g., cerumen impaction) can mimic cognitive
issues; rule out reversible causes first.
9. Question: What physical exam maneuver is Murphy's sign?
, Answer: Palpate right upper quadrant below costal margin during
deep inspiration; positive if pain on inhalation.
Rationale: Classic for cholecystitis.
10. Question: A patient with allergic rhinitis has tried OTC
antihistamines with limited relief. Next step?
Answer: Intranasal corticosteroids
Rationale: First-line for moderate-persistent symptoms per guidelines.
11. Question: An adult female returns for a recheck. The only
remarkable lab is TSH at 0 microunits/mL (normal 0.4-4.0). She reports
neck pain; exam shows thyroid tenderness. Which labs should the NP
order next?
Answer: Triiodothyronine (T3) and free thyroxine (FT4)
Rationale: Low TSH with tenderness suggests hyperthyroidism (e.g.,
subacute thyroiditis); elevated T3/FT4 confirms diagnosis.
12. Question: An adult with type 2 diabetes follows carb-counting diet
and walks 30 min 5x/week. Fasting glucose 116 mg/dL, A1c 6%. Per ADA
guidelines, next follow-up?
Answer: 6 months
