2026 CEA Prep: Full Practice Exam Latest Update| Questions
and Correct Detailed Answers (100% Verified Already Graded
A+||Brand New!!!
An adult female who recently returned for a recheck appointment.
The only remarkable laboratory result is for thyroid-stimulating
hormone (TSH), at 0.3 microunits/mL (normal = 0.4-6
microunits/mL). The patient reports that her neck hurts; examination
reveals thyroid tenderness. Which of the following laboratory tests
should the nurse practitioner order now?
Triiodothyronine (T3) and free thyroxine (FT4)
Rationale: Remember that a patient with low TSH is suspicious of
hyperthyroidism with a corresponding finding of elevated 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:
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:
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.
pg. 1
,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:
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?
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 diagnosis of
hypothyroidism is suspected. Which of the following physical
findings would support this diagnosis?
Dry skin, bradycardia, and hypoactive deep tendon reflexes
Rationale: Dry skin, bradycardia, and hypoactive deep tendon reflexes are all
fairly classic signs of hypothyroidism. To further substantiate these concerns,
the patient should have their TSH and T3 and Free T4 checked, and it is likely
their TSH would be elevated, T3/T4 low.
An older adult patient with new onset GERD, cough, heartburn. Initial
tx
Antacid and lifestyle modification/weight loss
Rationale: Before initiating a PPI or H2RA, it would always be wise to initiate
diet/exercise and symptom management when present with an antacid. Loss of
weight/dieting is most likely to deal with obesity as the most common
underlying cause of GERD.
pg. 2
,A 59-year-old male presents with symptoms of abdominal pain,
jaundice, and weight loss which he has not been trying to lose weight.
What would be a malignancy associated with these symptoms?
Pancreatic cancer
Rationale: Pancreatic cancer, the most typically presentation includes abdominal
pain, jaundice, and weight loss. Although 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 oesophageal
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?
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.
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
Left upper lobe lingula
pg. 3
, 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?
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?
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?
CT angiography of the chest
Rationale: CT angiography is considered the standard of care for measuring
vascular luminal dimensions with contrast. CT PE protocol is not timed
properly for the aorta (it's timed for the pulmonary artery). Although a plain film
is able to catch large aneurysms at times, they are not able to provide multi-axis
reconstruction needed to accurately measure the size. Transesophageal echo is
not needed to accurately measure the aorta and requires the patient to undergo
sedation which is unnecessary.
Which of the following medications does not cause beta 1
stimulation?
pg. 4
and Correct Detailed Answers (100% Verified Already Graded
A+||Brand New!!!
An adult female who recently returned for a recheck appointment.
The only remarkable laboratory result is for thyroid-stimulating
hormone (TSH), at 0.3 microunits/mL (normal = 0.4-6
microunits/mL). The patient reports that her neck hurts; examination
reveals thyroid tenderness. Which of the following laboratory tests
should the nurse practitioner order now?
Triiodothyronine (T3) and free thyroxine (FT4)
Rationale: Remember that a patient with low TSH is suspicious of
hyperthyroidism with a corresponding finding of elevated 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:
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:
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.
pg. 1
,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:
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?
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 diagnosis of
hypothyroidism is suspected. Which of the following physical
findings would support this diagnosis?
Dry skin, bradycardia, and hypoactive deep tendon reflexes
Rationale: Dry skin, bradycardia, and hypoactive deep tendon reflexes are all
fairly classic signs of hypothyroidism. To further substantiate these concerns,
the patient should have their TSH and T3 and Free T4 checked, and it is likely
their TSH would be elevated, T3/T4 low.
An older adult patient with new onset GERD, cough, heartburn. Initial
tx
Antacid and lifestyle modification/weight loss
Rationale: Before initiating a PPI or H2RA, it would always be wise to initiate
diet/exercise and symptom management when present with an antacid. Loss of
weight/dieting is most likely to deal with obesity as the most common
underlying cause of GERD.
pg. 2
,A 59-year-old male presents with symptoms of abdominal pain,
jaundice, and weight loss which he has not been trying to lose weight.
What would be a malignancy associated with these symptoms?
Pancreatic cancer
Rationale: Pancreatic cancer, the most typically presentation includes abdominal
pain, jaundice, and weight loss. Although 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 oesophageal
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?
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.
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
Left upper lobe lingula
pg. 3
, 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?
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?
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?
CT angiography of the chest
Rationale: CT angiography is considered the standard of care for measuring
vascular luminal dimensions with contrast. CT PE protocol is not timed
properly for the aorta (it's timed for the pulmonary artery). Although a plain film
is able to catch large aneurysms at times, they are not able to provide multi-axis
reconstruction needed to accurately measure the size. Transesophageal echo is
not needed to accurately measure the aorta and requires the patient to undergo
sedation which is unnecessary.
Which of the following medications does not cause beta 1
stimulation?
pg. 4
