NR 603 CEA Midterm Exam (2026) |
Chamberlain Advanced Clinical
Diagnosis – Actual Questions (PDF)
Midterm and Finals Examplify Online
Proctored Exam Questions and Answers |
100% Pass Guaranteed | Graded A+
Question 1: A 58-year-old male with a history of
hypertension presents to the ED with substernal chest
pressure radiating to his left arm, accompanied by
diaphoresis. What is the most appropriate initial diagnostic
test?
o A. Chest X-ray
o B. 12-lead ECG
o C. Cardiac troponin
o D. Stress echocardiogram
o Answer: B. 12-lead ECG
o Rationale: For any patient with symptoms suggesting
acute coronary syndrome (ACS), a 12-lead ECG should
be obtained within 10 minutes of arrival. It can
immediately identify an ST-elevation myocardial
infarction (STEMI), which requires urgent reperfusion
therapy. While troponin is important, the ECG provides
immediate, time-sensitive information.
Question 2: Which cardiac biomarker is the most specific for
myocardial infarction?
, o A. CK-MB
o B. BNP
o C. Troponin I
o D. D-dimer
o Answer: C. Troponin I
o Rationale: Cardiac troponins I and T are the most
specific biomarkers for myocardial injury. Troponin I is
not normally found in the blood of healthy individuals
and rises within hours of myocardial necrosis. CK-MB is
less specific, BNP indicates heart failure, and D-dimer is
for thromboembolism.
Question 3: A 75-year-old man involved in a motor vehicle
accident strikes his forehead. He complains of neck pain and
severe burning in his shoulders and arms, with upper
extremity weakness. What type of spinal cord injury does this
patient most likely have?
o A. Anterior cord syndrome
o B. Central cord syndrome
o C. Brown-Séquard syndrome
o D. Cauda equina syndrome
o Answer: B. Central cord syndrome
o Rationale: Central cord syndrome is characterized by
motor weakness that is more severe in the upper
extremities than the lower, often accompanied by
burning dysesthesia. It typically occurs after
hyperextension injuries, particularly in older adults with
underlying cervical spondylosis.
Question 4: A 22-year-old male patient states that his
scrotum feels "full of worms." He is a power lifter. What is the
most likely diagnosis?
, o A. Meningocele
o B. Varicocele
o C. Hydrocele
o D. Rectocele
o Answer: B. Varicocele
o Rationale: Varicoceles often present as a "bag of
worms" sensation within the scrotum due to
incompetent valves in the pampiniform venous plexus.
This condition is frequently exacerbated by activities
that increase intra-abdominal pressure, such as heavy
lifting.
Question 5
A 62-year-old woman reports progressive dyspnea on exertion
and fatigue for 6 months. On auscultation, you hear a harsh,
late-peaking systolic murmur at the right sternal border, radiating
to the carotids. What is the most likely diagnosis?
A. Mitral regurgitation
B. Aortic stenosis
C. Hypertrophic cardiomyopathy
D. Pulmonic stenosis
Answer: B. Aortic stenosis
Rationale: The murmur of aortic stenosis is classically harsh,
crescendo-decrescendo, late-peaking, and best heard at the right
sternal border (aortic area) with radiation to the carotids.
Exertional dyspnea and fatigue are common symptoms.
, Question 6
Which ECG finding is most specific for acute pericarditis?
A. ST elevation in leads V1–V4 that resolves with sitting forward
B. Diffuse ST elevation with reciprocal ST depression in aVR
C. Deep Q waves in leads II, III, aVF
D. Tall, peaked T waves
Answer: B. Diffuse ST elevation with reciprocal ST depression
in aVR
Rationale: Acute pericarditis typically shows diffuse concave ST
elevation (often in most leads except aVR and V1) with PR
segment depression. While sitting forward improves pain, the ECG
pattern itself is diffuse, not localized. Option A describes
positional relief, not the ECG finding.
Question 7
A 45-year-old smoker presents with acute onset of sharp, pleuritic
chest pain and shortness of breath after a long flight. Vital signs:
HR 110, BP 130/85, RR 22, O2 sat 92% on room air. What is the
most appropriate initial diagnostic test?
A. D-dimer
B. Chest X-ray
C. CT pulmonary angiography
D. Ventilation/perfusion (V/Q) scan
Answer: A. D-dimer
Rationale: The patient has risk factors (smoking, recent
immobilization) and symptoms concerning for pulmonary
embolism (PE). D-dimer is highly sensitive and is the
Chamberlain Advanced Clinical
Diagnosis – Actual Questions (PDF)
Midterm and Finals Examplify Online
Proctored Exam Questions and Answers |
100% Pass Guaranteed | Graded A+
Question 1: A 58-year-old male with a history of
hypertension presents to the ED with substernal chest
pressure radiating to his left arm, accompanied by
diaphoresis. What is the most appropriate initial diagnostic
test?
o A. Chest X-ray
o B. 12-lead ECG
o C. Cardiac troponin
o D. Stress echocardiogram
o Answer: B. 12-lead ECG
o Rationale: For any patient with symptoms suggesting
acute coronary syndrome (ACS), a 12-lead ECG should
be obtained within 10 minutes of arrival. It can
immediately identify an ST-elevation myocardial
infarction (STEMI), which requires urgent reperfusion
therapy. While troponin is important, the ECG provides
immediate, time-sensitive information.
Question 2: Which cardiac biomarker is the most specific for
myocardial infarction?
, o A. CK-MB
o B. BNP
o C. Troponin I
o D. D-dimer
o Answer: C. Troponin I
o Rationale: Cardiac troponins I and T are the most
specific biomarkers for myocardial injury. Troponin I is
not normally found in the blood of healthy individuals
and rises within hours of myocardial necrosis. CK-MB is
less specific, BNP indicates heart failure, and D-dimer is
for thromboembolism.
Question 3: A 75-year-old man involved in a motor vehicle
accident strikes his forehead. He complains of neck pain and
severe burning in his shoulders and arms, with upper
extremity weakness. What type of spinal cord injury does this
patient most likely have?
o A. Anterior cord syndrome
o B. Central cord syndrome
o C. Brown-Séquard syndrome
o D. Cauda equina syndrome
o Answer: B. Central cord syndrome
o Rationale: Central cord syndrome is characterized by
motor weakness that is more severe in the upper
extremities than the lower, often accompanied by
burning dysesthesia. It typically occurs after
hyperextension injuries, particularly in older adults with
underlying cervical spondylosis.
Question 4: A 22-year-old male patient states that his
scrotum feels "full of worms." He is a power lifter. What is the
most likely diagnosis?
, o A. Meningocele
o B. Varicocele
o C. Hydrocele
o D. Rectocele
o Answer: B. Varicocele
o Rationale: Varicoceles often present as a "bag of
worms" sensation within the scrotum due to
incompetent valves in the pampiniform venous plexus.
This condition is frequently exacerbated by activities
that increase intra-abdominal pressure, such as heavy
lifting.
Question 5
A 62-year-old woman reports progressive dyspnea on exertion
and fatigue for 6 months. On auscultation, you hear a harsh,
late-peaking systolic murmur at the right sternal border, radiating
to the carotids. What is the most likely diagnosis?
A. Mitral regurgitation
B. Aortic stenosis
C. Hypertrophic cardiomyopathy
D. Pulmonic stenosis
Answer: B. Aortic stenosis
Rationale: The murmur of aortic stenosis is classically harsh,
crescendo-decrescendo, late-peaking, and best heard at the right
sternal border (aortic area) with radiation to the carotids.
Exertional dyspnea and fatigue are common symptoms.
, Question 6
Which ECG finding is most specific for acute pericarditis?
A. ST elevation in leads V1–V4 that resolves with sitting forward
B. Diffuse ST elevation with reciprocal ST depression in aVR
C. Deep Q waves in leads II, III, aVF
D. Tall, peaked T waves
Answer: B. Diffuse ST elevation with reciprocal ST depression
in aVR
Rationale: Acute pericarditis typically shows diffuse concave ST
elevation (often in most leads except aVR and V1) with PR
segment depression. While sitting forward improves pain, the ECG
pattern itself is diffuse, not localized. Option A describes
positional relief, not the ECG finding.
Question 7
A 45-year-old smoker presents with acute onset of sharp, pleuritic
chest pain and shortness of breath after a long flight. Vital signs:
HR 110, BP 130/85, RR 22, O2 sat 92% on room air. What is the
most appropriate initial diagnostic test?
A. D-dimer
B. Chest X-ray
C. CT pulmonary angiography
D. Ventilation/perfusion (V/Q) scan
Answer: A. D-dimer
Rationale: The patient has risk factors (smoking, recent
immobilization) and symptoms concerning for pulmonary
embolism (PE). D-dimer is highly sensitive and is the
