NR667 CEA Final Exam
Comprehensive Evaluation Assessment
Adult-Gerontology Primary Care Nurse Practitioner
Chamberlain University | 2026/2027 Academic Cycle
150 Questions with 100% Verified Answers
Guaranteed A+ Pass | Evidence-Based Guidelines
, Table of Contents
Section 1: Advanced Clinical Decision-Making (Q1–Q8) (8 Q)
Section 2: Hypertension Management (Q9–Q16) (8 Q)
Section 3: Heart Failure Management (Q17–Q24) (8 Q)
Section 4: Coronary Artery Disease (Q25–Q32) (8 Q)
Section 5: Atrial Fibrillation (Q33–Q38) (6 Q)
Section 6: Diabetes Mellitus (Q39–Q45) (7 Q)
Section 7: Dyslipidemia (Q46–Q50) (5 Q)
Section 8: COPD & Asthma (Q51–Q58) (8 Q)
Section 9: Chronic Kidney Disease (Q59–Q65) (7 Q)
Section 10: Osteoarthritis & Osteoporosis (Q66–Q71) (6 Q)
Section 11: Dementia & Cognitive Impairment (Q72–Q78) (7 Q)
Section 12: Depression & Anxiety (Q79–Q84) (6 Q)
Section 13: Thyroid Disorders (Q85–Q89) (5 Q)
Section 14: Anemia (Q90–Q94) (5 Q)
Section 15: Geriatric Syndromes: Falls & Delirium (Q95–Q100) (6 Q)
Section 16: Polypharmacy & Beers Criteria (Q101–Q107) (7 Q)
Section 17: BPH & Urinary Incontinence (Q108–Q112) (5 Q)
Section 18: Preventive Care & Health Promotion (Q113–Q119) (7 Q)
Section 19: EKG & Diagnostic Interpretation (Q120–Q125) (6 Q)
Section 20: Ethical & Legal Issues (Q126–Q131) (6 Q)
Section 21: Cultural Competence & Health Literacy (Q132–Q135) (4 Q)
Section 22: Transitional Care & Interprofessional Collaboration (Q136–Q140) (5 Q)
Section 23: APRN Role Transition & Practice (Q141–Q145) (5 Q)
Section 24: Complex Multi-System Cases (Q146–Q150) (5 Q)
Total: 150 Questions
, NR667 CEA Final Exam Study Guide
Part 1 of 3 | Questions 1–50
AGPCNP Capstone Examination • Evidence-Based Clinical Practice
DOMAIN COVERAGE – PART 1
Domain Questions Count
Domain 1: Advanced Clinical Q1–Q8 8
Decision-Making
Domain 2: Hypertension Q9–Q16 8
Management
Domain 3: Heart Failure Q17–Q24 8
Management
Domain 4: Coronary Artery Q25–Q32 8
Disease
Domain 5: Atrial Fibrillation Q33–Q38 6
Domain 6: Diabetes Mellitus Q39–Q45 7
Domain 7: Dyslipidemia Q46–Q50 5
LEGEND
✓ Correct Answer = Bold + Green
Rationale = Italic text with guideline citations
Question Text = Bold Georgia 11pt
── DOMAIN 1: Advanced Clinical Decision-Making (Q1–Q8) ──
Q1. A 68-year-old woman presents with fatigue, weight loss of 15 lb over 3 months, and a
new-onset palpable left supraclavicular lymph node (Virchow node). She reports early
satiety and occasional dark stools. CBC reveals hemoglobin 9.2 g/dL, MCV 74 fL. What is
the most appropriate next step in management?
A) Prescribe iron supplementation and recheck CBC in 3 months
B) Order upper endoscopy with biopsy
C) Refer to oncology for lymphoma staging
D) Order CT chest/abdomen/pelvis with contrast
E) Initiate a PPI and schedule follow-up in 6 weeks
✓ Correct Answer: B) Order upper endoscopy with biopsy
, Rationale: Virchow node (left supraclavicular lymphadenopathy) is a classic red flag for gastric
malignancy, particularly when associated with iron deficiency anemia, weight loss, and early satiety.
The combination of microcytic anemia and melena suggests chronic GI blood loss. Upper endoscopy
with biopsy is the definitive diagnostic procedure of choice. The AGPCNP must recognize this clinical red
flag constellation. Delaying with PPIs or iron alone would miss a potentially curable early-stage gastric
cancer (NCCN Guidelines, Gastric Cancer, Version 2.2024).
Q2. A 55-year-old man with a history of hypertension and type 2 diabetes presents with
acute onset severe sharp chest pain that began 2 hours ago. The pain radiates to his back
between the shoulder blades. BP is 170/100 mmHg in the right arm and 140/85 mmHg in
the left arm. Heart rate is 110 bpm. ECG shows sinus tachycardia without ST changes.
Chest X-ray reveals a widened mediastinum. What is the most critical next intervention?
A) Administer sublingual nitroglycerin and repeat BP
B) Order a high-sensitivity troponin and heparin drip
C) Obtain emergent CT angiography of the chest
D) Perform a bedside cardiac ultrasound
E) Administer aspirin 325 mg and clopidogrel 600 mg
✓ Correct Answer: C) Obtain emergent CT angiography of the chest
Rationale: This presentation is highly concerning for acute aortic dissection. Key distinguishing features
include: (1) severe tearing chest pain radiating to the back, (2) BP differential >20 mmHg between
arms, (3) widened mediastinum on CXR, and (4) absence of diagnostic ECG changes for ACS. The
constellation of these findings warrants emergent CT angiography, which has >95% sensitivity and
specificity. Nitroglycerin is relatively contraindicated if dissection is suspected, and
antiplatelet/anticoagulant therapy could be harmful if surgery is needed. The AGPCNP must
differentiate dissection from ACS (AHA/ACC Guidelines for Thoracic Aortic Disease, 2022).
Q3. A 72-year-old woman with a history of COPD, osteoarthritis, and GERD presents with a
2-week history of progressive dyspnea on exertion, bilateral lower extremity edema, and a
new 10 lb weight gain. On examination, JVP is elevated at 10 cm, bilateral crackles are
present at the lung bases, and 2+ pitting edema is noted. BNP is 950 pg/mL.
Echocardiogram reveals left ventricular ejection fraction (LVEF) of 55% with left atrial
enlargement and grade II diastolic dysfunction. Which of the following is the most likely
primary diagnosis?
A) Acute exacerbation of COPD with cor pulmonale
B) Heart failure with preserved ejection fraction (HFpEF)
C) Heart failure with reduced ejection fraction (HFrEF)
D) Pulmonary embolism with right heart strain
E) Valvular heart disease secondary to rheumatic fever
✓ Correct Answer: B) Heart failure with preserved ejection fraction (HFpEF)
Comprehensive Evaluation Assessment
Adult-Gerontology Primary Care Nurse Practitioner
Chamberlain University | 2026/2027 Academic Cycle
150 Questions with 100% Verified Answers
Guaranteed A+ Pass | Evidence-Based Guidelines
, Table of Contents
Section 1: Advanced Clinical Decision-Making (Q1–Q8) (8 Q)
Section 2: Hypertension Management (Q9–Q16) (8 Q)
Section 3: Heart Failure Management (Q17–Q24) (8 Q)
Section 4: Coronary Artery Disease (Q25–Q32) (8 Q)
Section 5: Atrial Fibrillation (Q33–Q38) (6 Q)
Section 6: Diabetes Mellitus (Q39–Q45) (7 Q)
Section 7: Dyslipidemia (Q46–Q50) (5 Q)
Section 8: COPD & Asthma (Q51–Q58) (8 Q)
Section 9: Chronic Kidney Disease (Q59–Q65) (7 Q)
Section 10: Osteoarthritis & Osteoporosis (Q66–Q71) (6 Q)
Section 11: Dementia & Cognitive Impairment (Q72–Q78) (7 Q)
Section 12: Depression & Anxiety (Q79–Q84) (6 Q)
Section 13: Thyroid Disorders (Q85–Q89) (5 Q)
Section 14: Anemia (Q90–Q94) (5 Q)
Section 15: Geriatric Syndromes: Falls & Delirium (Q95–Q100) (6 Q)
Section 16: Polypharmacy & Beers Criteria (Q101–Q107) (7 Q)
Section 17: BPH & Urinary Incontinence (Q108–Q112) (5 Q)
Section 18: Preventive Care & Health Promotion (Q113–Q119) (7 Q)
Section 19: EKG & Diagnostic Interpretation (Q120–Q125) (6 Q)
Section 20: Ethical & Legal Issues (Q126–Q131) (6 Q)
Section 21: Cultural Competence & Health Literacy (Q132–Q135) (4 Q)
Section 22: Transitional Care & Interprofessional Collaboration (Q136–Q140) (5 Q)
Section 23: APRN Role Transition & Practice (Q141–Q145) (5 Q)
Section 24: Complex Multi-System Cases (Q146–Q150) (5 Q)
Total: 150 Questions
, NR667 CEA Final Exam Study Guide
Part 1 of 3 | Questions 1–50
AGPCNP Capstone Examination • Evidence-Based Clinical Practice
DOMAIN COVERAGE – PART 1
Domain Questions Count
Domain 1: Advanced Clinical Q1–Q8 8
Decision-Making
Domain 2: Hypertension Q9–Q16 8
Management
Domain 3: Heart Failure Q17–Q24 8
Management
Domain 4: Coronary Artery Q25–Q32 8
Disease
Domain 5: Atrial Fibrillation Q33–Q38 6
Domain 6: Diabetes Mellitus Q39–Q45 7
Domain 7: Dyslipidemia Q46–Q50 5
LEGEND
✓ Correct Answer = Bold + Green
Rationale = Italic text with guideline citations
Question Text = Bold Georgia 11pt
── DOMAIN 1: Advanced Clinical Decision-Making (Q1–Q8) ──
Q1. A 68-year-old woman presents with fatigue, weight loss of 15 lb over 3 months, and a
new-onset palpable left supraclavicular lymph node (Virchow node). She reports early
satiety and occasional dark stools. CBC reveals hemoglobin 9.2 g/dL, MCV 74 fL. What is
the most appropriate next step in management?
A) Prescribe iron supplementation and recheck CBC in 3 months
B) Order upper endoscopy with biopsy
C) Refer to oncology for lymphoma staging
D) Order CT chest/abdomen/pelvis with contrast
E) Initiate a PPI and schedule follow-up in 6 weeks
✓ Correct Answer: B) Order upper endoscopy with biopsy
, Rationale: Virchow node (left supraclavicular lymphadenopathy) is a classic red flag for gastric
malignancy, particularly when associated with iron deficiency anemia, weight loss, and early satiety.
The combination of microcytic anemia and melena suggests chronic GI blood loss. Upper endoscopy
with biopsy is the definitive diagnostic procedure of choice. The AGPCNP must recognize this clinical red
flag constellation. Delaying with PPIs or iron alone would miss a potentially curable early-stage gastric
cancer (NCCN Guidelines, Gastric Cancer, Version 2.2024).
Q2. A 55-year-old man with a history of hypertension and type 2 diabetes presents with
acute onset severe sharp chest pain that began 2 hours ago. The pain radiates to his back
between the shoulder blades. BP is 170/100 mmHg in the right arm and 140/85 mmHg in
the left arm. Heart rate is 110 bpm. ECG shows sinus tachycardia without ST changes.
Chest X-ray reveals a widened mediastinum. What is the most critical next intervention?
A) Administer sublingual nitroglycerin and repeat BP
B) Order a high-sensitivity troponin and heparin drip
C) Obtain emergent CT angiography of the chest
D) Perform a bedside cardiac ultrasound
E) Administer aspirin 325 mg and clopidogrel 600 mg
✓ Correct Answer: C) Obtain emergent CT angiography of the chest
Rationale: This presentation is highly concerning for acute aortic dissection. Key distinguishing features
include: (1) severe tearing chest pain radiating to the back, (2) BP differential >20 mmHg between
arms, (3) widened mediastinum on CXR, and (4) absence of diagnostic ECG changes for ACS. The
constellation of these findings warrants emergent CT angiography, which has >95% sensitivity and
specificity. Nitroglycerin is relatively contraindicated if dissection is suspected, and
antiplatelet/anticoagulant therapy could be harmful if surgery is needed. The AGPCNP must
differentiate dissection from ACS (AHA/ACC Guidelines for Thoracic Aortic Disease, 2022).
Q3. A 72-year-old woman with a history of COPD, osteoarthritis, and GERD presents with a
2-week history of progressive dyspnea on exertion, bilateral lower extremity edema, and a
new 10 lb weight gain. On examination, JVP is elevated at 10 cm, bilateral crackles are
present at the lung bases, and 2+ pitting edema is noted. BNP is 950 pg/mL.
Echocardiogram reveals left ventricular ejection fraction (LVEF) of 55% with left atrial
enlargement and grade II diastolic dysfunction. Which of the following is the most likely
primary diagnosis?
A) Acute exacerbation of COPD with cor pulmonale
B) Heart failure with preserved ejection fraction (HFpEF)
C) Heart failure with reduced ejection fraction (HFrEF)
D) Pulmonary embolism with right heart strain
E) Valvular heart disease secondary to rheumatic fever
✓ Correct Answer: B) Heart failure with preserved ejection fraction (HFpEF)
