NR 603 CEA Midterm (2026) | Chamberlain Adv
Clinical Dx – Actual Q&A (3 Exams PDF)
1. A 58-year-old man with HTN and DM presents with
substernal chest pressure when walking briskly in cold
weather; relieved by rest. ECG normal. What is the next
best diagnostic test?
A) Coronary angiography
B) Exercise stress test
C) High-sensitivity troponin
D) Echocardiogram
Answer: B
Rationale: This is stable angina. In a patient who can
exercise and has a normal interpretable ECG, an
exercise ECG stress test is first-line to confirm ischemia.
Coronary angiography is reserved for high-risk features
or failed medical therapy.
1
,2. A 72-year-old woman reports dyspnea on exertion
and orthopnea. Exam: JVD, S3 gallop, bilateral crackles,
+LE edema. What is the most likely diagnosis?
A) COPD exacerbation
B) HFpEF
C) Decompensated HFrEF
D) Pericarditis
Answer: C
Rationale: S3 gallop, JVD, crackles, and peripheral
edema indicate acute decompensated systolic heart
failure (HFrEF). S3 is specific for reduced ejection fraction.
3. Which finding on ECG is most specific for acute
pericarditis?
A) Diffuse ST elevation
B) Q waves in inferior leads
C) Prolonged QT interval
D) ST depression in V1-V4
2
,Answer: A
Rationale: Diffuse concave-up ST elevation with PR
depression is classic for acute pericarditis. Q waves
suggest prior MI.
4. A 65-year-old with HTN and CKD stage 3 has BP
162/94 on lisinopril 40 mg daily. Next step?
A) Add HCTZ
B) Switch to amlodipine
C) Add spironolactone
D) Increase lisinopril to 80 mg
Answer: A
Rationale: In CKD with eGFR >30, add a thiazide (HCTZ)
for synergistic effect. Max lisinopril dose is 40 mg;
spironolactone risks hyperkalemia.
5. Most common arrhythmia in a patient with palpitations,
fatigue, and irregularly irregular pulse?
3
, A) Atrial flutter
B) Atrial fibrillation
C) SVT
D) PVCs
Answer: B
Rationale: Atrial fibrillation is the most common sustained
arrhythmia and presents with an irregularly irregular
pulse without discernible P waves.
6. A 55-year-old smoker has BP 148/90, LDL 190, no
DM. 10-year ASCVD risk score = 12%. Next step after
lifestyle counseling?
A) Aspirin 81 mg daily
B) Statin (moderate intensity)
C) Refer for coronary CTA
D) Stress test
Answer: B
4
Clinical Dx – Actual Q&A (3 Exams PDF)
1. A 58-year-old man with HTN and DM presents with
substernal chest pressure when walking briskly in cold
weather; relieved by rest. ECG normal. What is the next
best diagnostic test?
A) Coronary angiography
B) Exercise stress test
C) High-sensitivity troponin
D) Echocardiogram
Answer: B
Rationale: This is stable angina. In a patient who can
exercise and has a normal interpretable ECG, an
exercise ECG stress test is first-line to confirm ischemia.
Coronary angiography is reserved for high-risk features
or failed medical therapy.
1
,2. A 72-year-old woman reports dyspnea on exertion
and orthopnea. Exam: JVD, S3 gallop, bilateral crackles,
+LE edema. What is the most likely diagnosis?
A) COPD exacerbation
B) HFpEF
C) Decompensated HFrEF
D) Pericarditis
Answer: C
Rationale: S3 gallop, JVD, crackles, and peripheral
edema indicate acute decompensated systolic heart
failure (HFrEF). S3 is specific for reduced ejection fraction.
3. Which finding on ECG is most specific for acute
pericarditis?
A) Diffuse ST elevation
B) Q waves in inferior leads
C) Prolonged QT interval
D) ST depression in V1-V4
2
,Answer: A
Rationale: Diffuse concave-up ST elevation with PR
depression is classic for acute pericarditis. Q waves
suggest prior MI.
4. A 65-year-old with HTN and CKD stage 3 has BP
162/94 on lisinopril 40 mg daily. Next step?
A) Add HCTZ
B) Switch to amlodipine
C) Add spironolactone
D) Increase lisinopril to 80 mg
Answer: A
Rationale: In CKD with eGFR >30, add a thiazide (HCTZ)
for synergistic effect. Max lisinopril dose is 40 mg;
spironolactone risks hyperkalemia.
5. Most common arrhythmia in a patient with palpitations,
fatigue, and irregularly irregular pulse?
3
, A) Atrial flutter
B) Atrial fibrillation
C) SVT
D) PVCs
Answer: B
Rationale: Atrial fibrillation is the most common sustained
arrhythmia and presents with an irregularly irregular
pulse without discernible P waves.
6. A 55-year-old smoker has BP 148/90, LDL 190, no
DM. 10-year ASCVD risk score = 12%. Next step after
lifestyle counseling?
A) Aspirin 81 mg daily
B) Statin (moderate intensity)
C) Refer for coronary CTA
D) Stress test
Answer: B
4
