NR667- CEA FNP ACTUAL EXAM REVIEW 100
QUESTIONS AND CORRECT ANSWERS 2026 LATEST
EDITION
OVERVIEW
The 2026 NR667 CEA FNP exam emphasizes clinical reasoning in primary care, focusing on
oncology complications, hematologic emergencies, infectious diseases, geriatric changes, and
allergy management. Patients receiving chemotherapy or radiation are at risk for pancytopenia,
aplastic anemia, and myelodysplastic syndrome, which may progress to AML. EBV presents with
fatigue, exudative pharyngitis, and splenomegaly, while presbycusis causes bilateral high-
frequency hearing loss in older adults. For allergic rhinitis unresponsive to OTC antihistamines,
intranasal corticosteroids are first-line. Overall, the exam tests risk recognition, lab interpretation,
and evidence-based interventions in acute, chronic, and preventive care.
1. 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. Macrocytic anemia due to B12 deficiency
B. Iron deficiency anemia due to chronic blood loss
C. Microcytic anemia due to chronic kidney disease
D. Aplastic anemia due to bone marrow suppression
Answer: D
Rationale: Concurrent chemotherapy and radiation suppress bone marrow, leading to pancytopenia and
increased risk for aplastic anemia.
2. Your patient presents to the urgent care clinic with a swollen exudative pharynx, profound fatigue,
and a very tender left upper quadrant abdomen. What is the most likely diagnosis?
A. Strep pharyngitis
B. Tonsillitis
C. Epstein Barr virus (EBV)
D. Pancreatitis
Answer: C
Rationale: EBV causes infectious mononucleosis, classically presenting with exudative pharyngitis,
fatigue, and splenomegaly causing LUQ tenderness.
3. 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
Answer: B
Rationale: Presbycusis is age-related, symmetric, bilateral high-frequency sensorineural hearing loss.
4. 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
Answer: C
Rationale: Intranasal corticosteroids are first-line therapy for moderate to severe allergic rhinitis when
antihistamines are insufficient.
5. 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
Answer: D
Rationale: Suppression of all blood cell lines after chemoradiation indicates bone marrow failure
consistent with aplastic anemia.
6. 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
, Answer: B
Rationale: Pancytopenia with dysplasia raises concern for myelodysplastic syndrome or leukemia and
requires bone marrow biopsy.
7. Progression to Acute Myelogenous Leukemia (AML) is a risk for untreated or poorly responsive:
A. Pancytopenia
B. Aplastic anemia
C. Macrocytic anemia
D. Myelodysplastic syndrome
Answer: D
Rationale: Myelodysplastic syndrome carries a significant risk of progression to AML.
8. Treatment for symptomatic aplastic anemia includes all the following except:
A. Bone marrow transplant
B. PRBC/Platelet/WBC transfusions
C. Prophylactic antibiotics
D. Removal of bone marrow stimulants
Answer: D
Rationale: Removing bone marrow stimulants would worsen aplastic anemia rather than treat it.
9. A patient diagnosed with iron deficiency anemia requires iron supplementation. Which of the
following treatments would likely be ineffective?
A. Ferrous sulfate 325 mg PO BID for a 43 y.o. F s/p gastric bypass 2 years ago
B. Iron sucrose 200 mg IV infusion weekly x 8 weeks in a 26 y.o. F at 34 weeks of pregnancy
C. Ferrous sulfate 325 mg PO TID for a 25 y.o. F with menorrhagia
D. Ferrous sulfate 325 mg PO BID for a 63 y.o. M with ulcerative colitis
Answer: A
Rationale: Post–gastric bypass patients have impaired iron absorption, making oral iron ineffective.
10. Which of the following is not a common mechanism of neutrophil expenditure and resultant
neutropenia?
A. Decreased neutrophil production in the bone marrow
B. Redistribution of neutrophils to the spleen or vascular endothelium
C. Loss of circulating neutrophils in acute blood loss
D. Immune destruction
QUESTIONS AND CORRECT ANSWERS 2026 LATEST
EDITION
OVERVIEW
The 2026 NR667 CEA FNP exam emphasizes clinical reasoning in primary care, focusing on
oncology complications, hematologic emergencies, infectious diseases, geriatric changes, and
allergy management. Patients receiving chemotherapy or radiation are at risk for pancytopenia,
aplastic anemia, and myelodysplastic syndrome, which may progress to AML. EBV presents with
fatigue, exudative pharyngitis, and splenomegaly, while presbycusis causes bilateral high-
frequency hearing loss in older adults. For allergic rhinitis unresponsive to OTC antihistamines,
intranasal corticosteroids are first-line. Overall, the exam tests risk recognition, lab interpretation,
and evidence-based interventions in acute, chronic, and preventive care.
1. 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. Macrocytic anemia due to B12 deficiency
B. Iron deficiency anemia due to chronic blood loss
C. Microcytic anemia due to chronic kidney disease
D. Aplastic anemia due to bone marrow suppression
Answer: D
Rationale: Concurrent chemotherapy and radiation suppress bone marrow, leading to pancytopenia and
increased risk for aplastic anemia.
2. Your patient presents to the urgent care clinic with a swollen exudative pharynx, profound fatigue,
and a very tender left upper quadrant abdomen. What is the most likely diagnosis?
A. Strep pharyngitis
B. Tonsillitis
C. Epstein Barr virus (EBV)
D. Pancreatitis
Answer: C
Rationale: EBV causes infectious mononucleosis, classically presenting with exudative pharyngitis,
fatigue, and splenomegaly causing LUQ tenderness.
3. 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
Answer: B
Rationale: Presbycusis is age-related, symmetric, bilateral high-frequency sensorineural hearing loss.
4. 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
Answer: C
Rationale: Intranasal corticosteroids are first-line therapy for moderate to severe allergic rhinitis when
antihistamines are insufficient.
5. 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
Answer: D
Rationale: Suppression of all blood cell lines after chemoradiation indicates bone marrow failure
consistent with aplastic anemia.
6. 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
, Answer: B
Rationale: Pancytopenia with dysplasia raises concern for myelodysplastic syndrome or leukemia and
requires bone marrow biopsy.
7. Progression to Acute Myelogenous Leukemia (AML) is a risk for untreated or poorly responsive:
A. Pancytopenia
B. Aplastic anemia
C. Macrocytic anemia
D. Myelodysplastic syndrome
Answer: D
Rationale: Myelodysplastic syndrome carries a significant risk of progression to AML.
8. Treatment for symptomatic aplastic anemia includes all the following except:
A. Bone marrow transplant
B. PRBC/Platelet/WBC transfusions
C. Prophylactic antibiotics
D. Removal of bone marrow stimulants
Answer: D
Rationale: Removing bone marrow stimulants would worsen aplastic anemia rather than treat it.
9. A patient diagnosed with iron deficiency anemia requires iron supplementation. Which of the
following treatments would likely be ineffective?
A. Ferrous sulfate 325 mg PO BID for a 43 y.o. F s/p gastric bypass 2 years ago
B. Iron sucrose 200 mg IV infusion weekly x 8 weeks in a 26 y.o. F at 34 weeks of pregnancy
C. Ferrous sulfate 325 mg PO TID for a 25 y.o. F with menorrhagia
D. Ferrous sulfate 325 mg PO BID for a 63 y.o. M with ulcerative colitis
Answer: A
Rationale: Post–gastric bypass patients have impaired iron absorption, making oral iron ineffective.
10. Which of the following is not a common mechanism of neutrophil expenditure and resultant
neutropenia?
A. Decreased neutrophil production in the bone marrow
B. Redistribution of neutrophils to the spleen or vascular endothelium
C. Loss of circulating neutrophils in acute blood loss
D. Immune destruction
