CEA FNP EXAM TEST BANK 2026 500+
QUESTIONS WITH VERIFIED ANSWERS
AND RATIONALES GRADED A+
⩥The inability to fully relax the myocardium during relaxation is a
trademark of which of the following diagnoses? Answer: 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?. Answer: 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?. Answer: 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?. Answer: phenylephrine
Rationale: Phenylephrine only stimulates alpha 1 receptors. The
remaining three all have beta receptor activity.
⩥A 50-year-old woman with a history of hypertension presents with
dyspnea on exertion and orthopnea. On examination, she has jugular
venous distention and bilateral crackles on lung auscultation. What is the
most likely diagnosis?. Answer: Congestive heart failure
Rationale: Of the available options, the most accurate response is
congestive heart failure as it is signifying both a right ventricular back
up with jugular venous extension and crackles on lung assault, which are
suggestive of left ventricular back up. it is possible the patient may have
an acute myocardial infarction that precipitated this, however, a patient
has not described that, rather is only describing dyspnea on exertion and
orthopnea, which both speak to a state of fluid overload. The only
appropriate response of these available is congestive heart failure.
,⩥Your patient with a history of HFrEF (heart failure with reduced
ejection fraction) with an ejection fraction of 40% who is also not on
optimal medical therapy has been diagnosed with a myocardial
infarction this admission and received emergent placement of a drug-
eluting stent to the left anterior descending artery. As the medical home
who will manage this patient after discharge, which medication strategy
would you expect to be a priority in the patient's care?. Answer:
Ordering a transthoracic echocardiogram and order a Lifevest if EF is
less than 35%
Rationale: The patient should have a protective mechanism such as an
implantable automated cardioverter defibrillator (AICD) or a Lifevest if
the EF is less than 35% due to the increased risk of sudden cardiac death
with low EF states. Since most patients are not eligible for 90 days for
an AICD in this state, optimizing their medication regimen and repeating
an echo in 2-3 months to re-evaluate for improvement in their EF is
required by most insurance companies. A baseline echo is needed at
discharge to provide a baseline for improvement vs their repeat echo in
2-3 months.
Dual anti-platelet therapy is required for 12 months minimum post-MI.
A Holter monitor does not provide any conceivable benefit for this
patient as presented.
⩥Which of the following people groups represent the least risk of
cardiac disease?. Answer: Caucasians
Rationale: Statistically African Americans, Native Hawaiians, and
American Indians are at at increased risk of cardiac disease due to higher
rates of hypertension, diabetes, and obesity than Caucasians.
, ⩥A 65-year-old woman presents for a follow-up examination. She is a
smoker, and her hypertension is now adequately controlled with
medication. Her mother died at age 40 from a heart attack. The fasting
lipid profile shows cholesterol = 240 mg/dL, HDL = 30, and LDL = 200.
In addition to starting therapeutic lifestyle changes, the nurse
practitioner should start the patient on:. Answer: a statin drug.
Rationale: Bile acid sequestrants and cholesterol absorption inhibitors
may be useful in reducing ASVD risk, but for a patient who is an active
smoker with premature coronary disease history (less than age 65 for
women), has hypertension and is far from an LDL goal, this patient is
most certainly a candidate for statin therapy, which represents the most
aggressive therapy option of these four listed.
⩥Which of the following end-organ sequelae is not directly caused by
uncontrolled hypertension?. Answer: Peripheral neuropathy
Ratioanle: Although patients with hypertension frequently have
peripheral neuropathy, it is only directly attributed to patients who are
also diabetic and is commonly found in non-hypertensive diabetic
patients. Proteinuria, AV nicking, and hemorrhagic stroke are all caused
by uncontrolled hypertension.
⩥Preventive cardiac care should focus primarily on addressing all the
following except?. Answer: Genetic predisposition
Rationale: Smoking cessation, exercise, and medication compliance all
represent modifiable risk factors and should be the focus of preventive
QUESTIONS WITH VERIFIED ANSWERS
AND RATIONALES GRADED A+
⩥The inability to fully relax the myocardium during relaxation is a
trademark of which of the following diagnoses? Answer: 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?. Answer: 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?. Answer: 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?. Answer: phenylephrine
Rationale: Phenylephrine only stimulates alpha 1 receptors. The
remaining three all have beta receptor activity.
⩥A 50-year-old woman with a history of hypertension presents with
dyspnea on exertion and orthopnea. On examination, she has jugular
venous distention and bilateral crackles on lung auscultation. What is the
most likely diagnosis?. Answer: Congestive heart failure
Rationale: Of the available options, the most accurate response is
congestive heart failure as it is signifying both a right ventricular back
up with jugular venous extension and crackles on lung assault, which are
suggestive of left ventricular back up. it is possible the patient may have
an acute myocardial infarction that precipitated this, however, a patient
has not described that, rather is only describing dyspnea on exertion and
orthopnea, which both speak to a state of fluid overload. The only
appropriate response of these available is congestive heart failure.
,⩥Your patient with a history of HFrEF (heart failure with reduced
ejection fraction) with an ejection fraction of 40% who is also not on
optimal medical therapy has been diagnosed with a myocardial
infarction this admission and received emergent placement of a drug-
eluting stent to the left anterior descending artery. As the medical home
who will manage this patient after discharge, which medication strategy
would you expect to be a priority in the patient's care?. Answer:
Ordering a transthoracic echocardiogram and order a Lifevest if EF is
less than 35%
Rationale: The patient should have a protective mechanism such as an
implantable automated cardioverter defibrillator (AICD) or a Lifevest if
the EF is less than 35% due to the increased risk of sudden cardiac death
with low EF states. Since most patients are not eligible for 90 days for
an AICD in this state, optimizing their medication regimen and repeating
an echo in 2-3 months to re-evaluate for improvement in their EF is
required by most insurance companies. A baseline echo is needed at
discharge to provide a baseline for improvement vs their repeat echo in
2-3 months.
Dual anti-platelet therapy is required for 12 months minimum post-MI.
A Holter monitor does not provide any conceivable benefit for this
patient as presented.
⩥Which of the following people groups represent the least risk of
cardiac disease?. Answer: Caucasians
Rationale: Statistically African Americans, Native Hawaiians, and
American Indians are at at increased risk of cardiac disease due to higher
rates of hypertension, diabetes, and obesity than Caucasians.
, ⩥A 65-year-old woman presents for a follow-up examination. She is a
smoker, and her hypertension is now adequately controlled with
medication. Her mother died at age 40 from a heart attack. The fasting
lipid profile shows cholesterol = 240 mg/dL, HDL = 30, and LDL = 200.
In addition to starting therapeutic lifestyle changes, the nurse
practitioner should start the patient on:. Answer: a statin drug.
Rationale: Bile acid sequestrants and cholesterol absorption inhibitors
may be useful in reducing ASVD risk, but for a patient who is an active
smoker with premature coronary disease history (less than age 65 for
women), has hypertension and is far from an LDL goal, this patient is
most certainly a candidate for statin therapy, which represents the most
aggressive therapy option of these four listed.
⩥Which of the following end-organ sequelae is not directly caused by
uncontrolled hypertension?. Answer: Peripheral neuropathy
Ratioanle: Although patients with hypertension frequently have
peripheral neuropathy, it is only directly attributed to patients who are
also diabetic and is commonly found in non-hypertensive diabetic
patients. Proteinuria, AV nicking, and hemorrhagic stroke are all caused
by uncontrolled hypertension.
⩥Preventive cardiac care should focus primarily on addressing all the
following except?. Answer: Genetic predisposition
Rationale: Smoking cessation, exercise, and medication compliance all
represent modifiable risk factors and should be the focus of preventive
