NR 667 CEA (Capstone/Clinical Evaluation
Assessment) Final Exam Questions and Answers
Question 1
A 52-year-old patient presents with fatigue, pallor, and spoon-shaped nails. Which lab
test best confirms the suspected diagnosis?
A. Serum ferritin
B. Vitamin B12 level
C. Hemoglobin A1c
D. Thyroid-stimulating hormone
Rationale: Spoon nails (koilonychia) suggest iron-deficiency anemia. Serum ferritin is
the most specific test for iron stores.
Question 2
Which antihypertensive is preferred in a patient with diabetes and proteinuria?
A. Beta-blocker
B. ACE inhibitor
C. Calcium channel blocker
D. Thiazide diuretic
Rationale: ACE inhibitors reduce intraglomerular pressure and slow progression of
diabetic nephropathy.
Question 3
A child presents with barking cough and inspiratory stridor. What is the most likely
diagnosis?
A. Epiglottitis
B. Croup
C. Asthma
D. Bronchiolitis
Rationale: Classic presentation of viral croup includes barking cough and stridor due to
subglottic inflammation.
Question 4
Which screening is recommended for women aged 21–29?
A. HPV testing every 3 years
B. Pap smear every 3 years
C. Mammogram annually
D. Colonoscopy every 10 years
Rationale: Cervical cancer screening begins at age 21 with Pap smears every 3 years
until age 29.
Question 5
Which vaccine is contraindicated in pregnancy?
A. Influenza (inactivated)
,B. Tdap
C. MMR
D. Hepatitis B
Rationale: Live vaccines (MMR, varicella) are contraindicated during pregnancy.
Question 6
A 65-year-old smoker presents with hematuria. What is the most likely diagnosis to rule
out?
A. Bladder cancer
B. Kidney stone
C. UTI
D. BPH
Rationale: Painless hematuria in older smokers is a red flag for bladder cancer.
Question 7
Which medication is first-line for generalized anxiety disorder?
A. Benzodiazepines
B. SSRIs
C. Beta-blockers
D. Buspirone
Rationale: SSRIs are first-line due to efficacy and safety profile compared to
benzodiazepines.
Question 8
Which lab finding is most consistent with hypothyroidism?
A. Low TSH, high T4
B. High TSH, low T4
C. High TSH, high T4
D. Low TSH, low T4
Rationale: Primary hypothyroidism shows elevated TSH with low free T4.
Question 9
Which diagnostic test confirms COPD?
A. Chest X-ray
B. Spirometry
C. CT scan
D. ABG
Rationale: Spirometry showing FEV1/FVC < 0.70 confirms airflow obstruction.
Question 10
Which antibiotic is contraindicated in children under 8 years old?
A. Amoxicillin
B. Azithromycin
C. Tetracycline
D. Ceftriaxone
Rationale: Tetracyclines cause permanent tooth discoloration and impaired bone growth
, in children.
Question 11
Which medication is first-line for osteoporosis in postmenopausal women?
A. Bisphosphonates
B. Calcitonin
C. Estrogen therapy
D. Teriparatide
Rationale: Bisphosphonates (e.g., alendronate) are first-line due to proven reduction in
fracture risk.
Question 12
A patient with atrial fibrillation has a CHA₂DS₂-VASc score of 3. What is the
recommended management?
A. Aspirin only
B. No therapy
C. Oral anticoagulation
D. Dual antiplatelet therapy
Rationale: Score ≥2 in men or ≥3 in women warrants anticoagulation to reduce stroke
risk.
Question 13
Which finding is most consistent with nephrotic syndrome?
A. Hematuria
B. Proteinuria >3.5 g/day
C. Pyuria
D. Elevated creatinine
Rationale: Nephrotic syndrome is defined by heavy proteinuria, hypoalbuminemia, and
edema.
Question 14
Which diagnostic test is most sensitive for pulmonary embolism?
A. Chest X-ray
B. D-dimer
C. CT pulmonary angiography
D. V/Q scan
Rationale: Gold standard for PE diagnosis is CT pulmonary angiography.
Question 15
Which drug class is contraindicated in asthma?
A. Beta-blockers
B. ACE inhibitors
C. Calcium channel blockers
D. Statins
Rationale: Non-selective beta-blockers can precipitate bronchospasm in asthmatic
patients.
Assessment) Final Exam Questions and Answers
Question 1
A 52-year-old patient presents with fatigue, pallor, and spoon-shaped nails. Which lab
test best confirms the suspected diagnosis?
A. Serum ferritin
B. Vitamin B12 level
C. Hemoglobin A1c
D. Thyroid-stimulating hormone
Rationale: Spoon nails (koilonychia) suggest iron-deficiency anemia. Serum ferritin is
the most specific test for iron stores.
Question 2
Which antihypertensive is preferred in a patient with diabetes and proteinuria?
A. Beta-blocker
B. ACE inhibitor
C. Calcium channel blocker
D. Thiazide diuretic
Rationale: ACE inhibitors reduce intraglomerular pressure and slow progression of
diabetic nephropathy.
Question 3
A child presents with barking cough and inspiratory stridor. What is the most likely
diagnosis?
A. Epiglottitis
B. Croup
C. Asthma
D. Bronchiolitis
Rationale: Classic presentation of viral croup includes barking cough and stridor due to
subglottic inflammation.
Question 4
Which screening is recommended for women aged 21–29?
A. HPV testing every 3 years
B. Pap smear every 3 years
C. Mammogram annually
D. Colonoscopy every 10 years
Rationale: Cervical cancer screening begins at age 21 with Pap smears every 3 years
until age 29.
Question 5
Which vaccine is contraindicated in pregnancy?
A. Influenza (inactivated)
,B. Tdap
C. MMR
D. Hepatitis B
Rationale: Live vaccines (MMR, varicella) are contraindicated during pregnancy.
Question 6
A 65-year-old smoker presents with hematuria. What is the most likely diagnosis to rule
out?
A. Bladder cancer
B. Kidney stone
C. UTI
D. BPH
Rationale: Painless hematuria in older smokers is a red flag for bladder cancer.
Question 7
Which medication is first-line for generalized anxiety disorder?
A. Benzodiazepines
B. SSRIs
C. Beta-blockers
D. Buspirone
Rationale: SSRIs are first-line due to efficacy and safety profile compared to
benzodiazepines.
Question 8
Which lab finding is most consistent with hypothyroidism?
A. Low TSH, high T4
B. High TSH, low T4
C. High TSH, high T4
D. Low TSH, low T4
Rationale: Primary hypothyroidism shows elevated TSH with low free T4.
Question 9
Which diagnostic test confirms COPD?
A. Chest X-ray
B. Spirometry
C. CT scan
D. ABG
Rationale: Spirometry showing FEV1/FVC < 0.70 confirms airflow obstruction.
Question 10
Which antibiotic is contraindicated in children under 8 years old?
A. Amoxicillin
B. Azithromycin
C. Tetracycline
D. Ceftriaxone
Rationale: Tetracyclines cause permanent tooth discoloration and impaired bone growth
, in children.
Question 11
Which medication is first-line for osteoporosis in postmenopausal women?
A. Bisphosphonates
B. Calcitonin
C. Estrogen therapy
D. Teriparatide
Rationale: Bisphosphonates (e.g., alendronate) are first-line due to proven reduction in
fracture risk.
Question 12
A patient with atrial fibrillation has a CHA₂DS₂-VASc score of 3. What is the
recommended management?
A. Aspirin only
B. No therapy
C. Oral anticoagulation
D. Dual antiplatelet therapy
Rationale: Score ≥2 in men or ≥3 in women warrants anticoagulation to reduce stroke
risk.
Question 13
Which finding is most consistent with nephrotic syndrome?
A. Hematuria
B. Proteinuria >3.5 g/day
C. Pyuria
D. Elevated creatinine
Rationale: Nephrotic syndrome is defined by heavy proteinuria, hypoalbuminemia, and
edema.
Question 14
Which diagnostic test is most sensitive for pulmonary embolism?
A. Chest X-ray
B. D-dimer
C. CT pulmonary angiography
D. V/Q scan
Rationale: Gold standard for PE diagnosis is CT pulmonary angiography.
Question 15
Which drug class is contraindicated in asthma?
A. Beta-blockers
B. ACE inhibitors
C. Calcium channel blockers
D. Statins
Rationale: Non-selective beta-blockers can precipitate bronchospasm in asthmatic
patients.
