CEA Final Exam 2025 | Clinical Evaluation Assignment Study Guide,
Verified Questions, Answers & Rationales | Best for Nurse
Practitioner Exit Exams | Chamberlain, Walden, and Herzing
Students – Accurate & Updated
During a post-hospital discharge visit, you notice your 71 year old female patient has been diagnosed with a
"new murmur" found by the hospitalist during their recent hospitalization for CHF exacerbation. In evaluating
the patient, during which phase of the cardiac cycle would you anticipate auscultation of a S3 or S4 heart
sound?
*Diastole
*53 in systole while S4 in diastole
*Systole
*S4 in diastole while S3 in systole
Diastole
The point of maximum impulse (PMI) is MOST often palpable in healthy adults when positioned in the supine
or left lateral decubitus position. Which one of the following locations is most commonly described as the PMI
in a healthy adult?
*Left 2nd intercostal space, midaxillary line.
*Left 5th intercostal space, midclavicular line.
*Right 4th intercostal space, midaxillary line.
*Right 2nd intercostal space, midclavicular line.
Left 5th intercostal space, midclavicular line
The nurse practitioner assessing the patient with a rapid cardiac rhythm may assess for a pulse deficit by
auscultating the patient's heart while watching the EKG rhythm. Where would the S1 heart sounds correlate
with the electrocardiographic waves?
*At the end of the T wave.
*At the start of the T wave.
*Peak of the R wave.
*At the start of the P wave.
Peak of the R wave.
Michael, a 72 year old male patient who previously presented with stable cardiac-type chest pain has underwent
a stress test. He presents today to review the stress test results, which show EKG findings of ST segment
depression during the exam in leads V3 and V4 as well as some concurrent chest discomfort. Based on these
findings, which of the following are NOT priority medical decisions?
*Prescribe metoprolol (Lopressor) 12.5mg PO BID
*Prescribe aspirin 81mg PO daily
*Refer to cardiology for angiography
• Check for thyroid dysfunction
Check for thyroid dysfunction
,While examining a 53 year old female patient, you auscultate abnormal breath sounds over all fields, and now
assess transmission of voice sounds by having the patient say "ee" while auscultating the chest with the
diaphragm of your stethoscope. Normally, you should auscultate a muffled "e" sound, however, you hear hear a
nasally "a" sound. Which one of the following will you document is present?
*Positive stereognosis.
*Positive for egophony.
*Negative for bronchophony.
*Negative for egophony
Positive for egophony
While assessing the 19 year old patient for a new onset cough, the nurse practitioner may inspect, auscultate,
palpate, and/or percuss.
How does performing percussion of the thorax assist the provider during the physical examination?
*To assist with the confirmation of cardiac origin of angina.
*To assess for deep-seated lesion and tumors.
*To assess for any pain or discomfort prior to palpitation of the chest wall.
*To identify if underlying tissue are air-filled, fluid-filled or consolidated
To identify if underlying tissue are air-filled, fluid-filled or consolidated
Your 42 year old male patient has been referred to your clinic for establishing care and on his intake survey, you
note he has documented diagnosis of interstitial lung disease. You have decided to perform a diaphragmatic
excursion test on the patient. Which one of the following results would you expect to see in this patient?
*Approximately equal level of change in the descent of the diaphragm bilaterally during maximal inspiration
and expiration. with a decreased overall inspiratory capacity.
*Ascension of 8-12 inches of the diaphragm noted bilaterally on expiration, though often much less on the right
side due to the location of the heart and great vessels.
*Much greater descent of the diaphragm on the right side due to the liver present (two-three times larger).
*Absent or no change in movement of the diaphragm noted between full inspiration and full expiration
measurement.
Approximately equal level of change in the descent of the diaphragm bilaterally during maximal inspiration and
expiration. with a decreased overall inspiratory capacity
Your 50 year old Caucasian male patient has not seen a primary care giver in 20+ years and is here for a history
and physical examination. While examining the head and face, you see your patient has nonpitting periorbital
edema, particularly underneath their eyes and very dry, thinned hair, including the lateral third of eyebrows (as
pictured below: Sparse hairline, thin lateral eyebrows, Periobital edema). Which one of the folowing would you
expect to cause this finding?
*Severe hypothyroidism
*Addison's disease
*Grave's disease
*Alzhemiers.
Severe hypothyroidism
A40 year old, female, African American patient presents for history and physical. Upon your initial assessment,
you notice she has severe exophthalmos as pictured below. Which one of the following diagnoses below would
,be the highest on your differential diagnose of this physical examination finding? (eyes bulging out of her head)
*Bilateral conjunctivitis.
*Hyperthyroidism.
*hypothyroidism
*myexedma
Hyperthyroidism.
Your patient with a suspected diagnosis of COPD has been seen by pulmonology and has underwent a
pulmonary function test (PFT) with spirometry. As the patient's primary healthcare provider, you have been
asked to explain the findings of the PFT to the patient in a
follow-up visit at which time the patient asks what the study was evaluating. To describe the PFT to the patient
in more useful terms, you state that the large inspiration of air to the furthest extent they could reasonably
accomplish followed by a full exhalation is referred to as which of the following measurements during the PFT?
*Forced Expiratory Volume over 1 second (FEV1).
*Functional Reserve Capacity.
*Inspiratory Reserve
*Forced Vital Capacity.
Forced Vital Capacity.
Your newly established patient states in the past year, they have progressively developed a noticeable bump on
their neck and when asked about symptoms, they report feeling very anxious, have developed a tremor, and are
commonly feeling palpitations in their chest.
On examination, you identify an enlarged thyroid gland suspicious for a goiter. Of the following diagnoses,
which is most likely for the patient to develop based on these findings above?
*Thyrotoxicosis.
*lodine Excess.
*Myxedema Coma.
*Hashimotos Thyroiditis...not this one
?
Your 32 year old female patient presented for a routine health exam states they have a diagnoses of
hyperthyroidism by another
provider a year ago. In addition to evaluation with TSH and T4 labwork, which of the following represent
typical signs of hyperthyroidism expected on your exam of this patient?
*Hypersomnia
*Tachycardia.
*Lethargy.
*Recent unplanned weight gain.
Tachycardia
Your patient has a diagnosis of Addison's disease. Which of the following might you expect to find during
examination?
*Abdominal striae.
*Dowager hump.
, *Low body temperature.
*Moon face...not this one
?
The nurse practitioner's evaluation of apatient with Diabetes Mellitus type 2 should include which of the
folowing while evaluating
for end organ dysfunction of the disease?
*Renal function panel.
*Urinalysis.
*Non-dilated eye exam.
*All of these are appropriate options.
All of these are appropriate options.
Your patient with a diagnosis of autoimmune hepatitis is being
seen in your clinic for routine liver serology and follow-up examination. Which of the following correctly
identifies the normal liver span when percussing the liver of a HEALTHY adult?
*6-12 cm in the midsternal line
*4-8 in the left midclavicular line...not this one
*4-8 cm in the right midclavicular line
*6-12 cm in the right midclavicular line.
?
The 33 year old male patient presents with complaints of abdominal pain after a recent birthday party where
other guests also
suspected food borne illness and gastroenteritis. To elicit the most accurate evaluation of this patient, which is
the order of assessment which should be done for the abdomen?
*Inspection, auscultation, palpation, percussion.
*Inspection, auscultation, percussion, palpation.
*Percussion, auscultation, palpation, inspection.
*Auscultation, palpation, percussion, inspection
Inspection, auscultation, palpation, percussion
The 19 year old male patient presents with acute symptoms
of abdominal pain and a history of intermittent heartburn and spicy food
intolerance, as well as anxiety due to his college athletic performance. You have a concern the patient may have
a perforated gastric ulcer and is experiencing peritonitis. Which of the following exam findings is NOT
supportive of this diagnosis?
*Guarding.
*Rebound tenderness.
*Absence of pain with withdrawal of palpation.
*Rigidity.
?Absence of pain with withdrawal of palpation.
Your 22 year old male patient states during his review of systems that
his scrotum is very enlarged and feels like it is full a powerlifter and works as a trash collector. You suspect the
Verified Questions, Answers & Rationales | Best for Nurse
Practitioner Exit Exams | Chamberlain, Walden, and Herzing
Students – Accurate & Updated
During a post-hospital discharge visit, you notice your 71 year old female patient has been diagnosed with a
"new murmur" found by the hospitalist during their recent hospitalization for CHF exacerbation. In evaluating
the patient, during which phase of the cardiac cycle would you anticipate auscultation of a S3 or S4 heart
sound?
*Diastole
*53 in systole while S4 in diastole
*Systole
*S4 in diastole while S3 in systole
Diastole
The point of maximum impulse (PMI) is MOST often palpable in healthy adults when positioned in the supine
or left lateral decubitus position. Which one of the following locations is most commonly described as the PMI
in a healthy adult?
*Left 2nd intercostal space, midaxillary line.
*Left 5th intercostal space, midclavicular line.
*Right 4th intercostal space, midaxillary line.
*Right 2nd intercostal space, midclavicular line.
Left 5th intercostal space, midclavicular line
The nurse practitioner assessing the patient with a rapid cardiac rhythm may assess for a pulse deficit by
auscultating the patient's heart while watching the EKG rhythm. Where would the S1 heart sounds correlate
with the electrocardiographic waves?
*At the end of the T wave.
*At the start of the T wave.
*Peak of the R wave.
*At the start of the P wave.
Peak of the R wave.
Michael, a 72 year old male patient who previously presented with stable cardiac-type chest pain has underwent
a stress test. He presents today to review the stress test results, which show EKG findings of ST segment
depression during the exam in leads V3 and V4 as well as some concurrent chest discomfort. Based on these
findings, which of the following are NOT priority medical decisions?
*Prescribe metoprolol (Lopressor) 12.5mg PO BID
*Prescribe aspirin 81mg PO daily
*Refer to cardiology for angiography
• Check for thyroid dysfunction
Check for thyroid dysfunction
,While examining a 53 year old female patient, you auscultate abnormal breath sounds over all fields, and now
assess transmission of voice sounds by having the patient say "ee" while auscultating the chest with the
diaphragm of your stethoscope. Normally, you should auscultate a muffled "e" sound, however, you hear hear a
nasally "a" sound. Which one of the following will you document is present?
*Positive stereognosis.
*Positive for egophony.
*Negative for bronchophony.
*Negative for egophony
Positive for egophony
While assessing the 19 year old patient for a new onset cough, the nurse practitioner may inspect, auscultate,
palpate, and/or percuss.
How does performing percussion of the thorax assist the provider during the physical examination?
*To assist with the confirmation of cardiac origin of angina.
*To assess for deep-seated lesion and tumors.
*To assess for any pain or discomfort prior to palpitation of the chest wall.
*To identify if underlying tissue are air-filled, fluid-filled or consolidated
To identify if underlying tissue are air-filled, fluid-filled or consolidated
Your 42 year old male patient has been referred to your clinic for establishing care and on his intake survey, you
note he has documented diagnosis of interstitial lung disease. You have decided to perform a diaphragmatic
excursion test on the patient. Which one of the following results would you expect to see in this patient?
*Approximately equal level of change in the descent of the diaphragm bilaterally during maximal inspiration
and expiration. with a decreased overall inspiratory capacity.
*Ascension of 8-12 inches of the diaphragm noted bilaterally on expiration, though often much less on the right
side due to the location of the heart and great vessels.
*Much greater descent of the diaphragm on the right side due to the liver present (two-three times larger).
*Absent or no change in movement of the diaphragm noted between full inspiration and full expiration
measurement.
Approximately equal level of change in the descent of the diaphragm bilaterally during maximal inspiration and
expiration. with a decreased overall inspiratory capacity
Your 50 year old Caucasian male patient has not seen a primary care giver in 20+ years and is here for a history
and physical examination. While examining the head and face, you see your patient has nonpitting periorbital
edema, particularly underneath their eyes and very dry, thinned hair, including the lateral third of eyebrows (as
pictured below: Sparse hairline, thin lateral eyebrows, Periobital edema). Which one of the folowing would you
expect to cause this finding?
*Severe hypothyroidism
*Addison's disease
*Grave's disease
*Alzhemiers.
Severe hypothyroidism
A40 year old, female, African American patient presents for history and physical. Upon your initial assessment,
you notice she has severe exophthalmos as pictured below. Which one of the following diagnoses below would
,be the highest on your differential diagnose of this physical examination finding? (eyes bulging out of her head)
*Bilateral conjunctivitis.
*Hyperthyroidism.
*hypothyroidism
*myexedma
Hyperthyroidism.
Your patient with a suspected diagnosis of COPD has been seen by pulmonology and has underwent a
pulmonary function test (PFT) with spirometry. As the patient's primary healthcare provider, you have been
asked to explain the findings of the PFT to the patient in a
follow-up visit at which time the patient asks what the study was evaluating. To describe the PFT to the patient
in more useful terms, you state that the large inspiration of air to the furthest extent they could reasonably
accomplish followed by a full exhalation is referred to as which of the following measurements during the PFT?
*Forced Expiratory Volume over 1 second (FEV1).
*Functional Reserve Capacity.
*Inspiratory Reserve
*Forced Vital Capacity.
Forced Vital Capacity.
Your newly established patient states in the past year, they have progressively developed a noticeable bump on
their neck and when asked about symptoms, they report feeling very anxious, have developed a tremor, and are
commonly feeling palpitations in their chest.
On examination, you identify an enlarged thyroid gland suspicious for a goiter. Of the following diagnoses,
which is most likely for the patient to develop based on these findings above?
*Thyrotoxicosis.
*lodine Excess.
*Myxedema Coma.
*Hashimotos Thyroiditis...not this one
?
Your 32 year old female patient presented for a routine health exam states they have a diagnoses of
hyperthyroidism by another
provider a year ago. In addition to evaluation with TSH and T4 labwork, which of the following represent
typical signs of hyperthyroidism expected on your exam of this patient?
*Hypersomnia
*Tachycardia.
*Lethargy.
*Recent unplanned weight gain.
Tachycardia
Your patient has a diagnosis of Addison's disease. Which of the following might you expect to find during
examination?
*Abdominal striae.
*Dowager hump.
, *Low body temperature.
*Moon face...not this one
?
The nurse practitioner's evaluation of apatient with Diabetes Mellitus type 2 should include which of the
folowing while evaluating
for end organ dysfunction of the disease?
*Renal function panel.
*Urinalysis.
*Non-dilated eye exam.
*All of these are appropriate options.
All of these are appropriate options.
Your patient with a diagnosis of autoimmune hepatitis is being
seen in your clinic for routine liver serology and follow-up examination. Which of the following correctly
identifies the normal liver span when percussing the liver of a HEALTHY adult?
*6-12 cm in the midsternal line
*4-8 in the left midclavicular line...not this one
*4-8 cm in the right midclavicular line
*6-12 cm in the right midclavicular line.
?
The 33 year old male patient presents with complaints of abdominal pain after a recent birthday party where
other guests also
suspected food borne illness and gastroenteritis. To elicit the most accurate evaluation of this patient, which is
the order of assessment which should be done for the abdomen?
*Inspection, auscultation, palpation, percussion.
*Inspection, auscultation, percussion, palpation.
*Percussion, auscultation, palpation, inspection.
*Auscultation, palpation, percussion, inspection
Inspection, auscultation, palpation, percussion
The 19 year old male patient presents with acute symptoms
of abdominal pain and a history of intermittent heartburn and spicy food
intolerance, as well as anxiety due to his college athletic performance. You have a concern the patient may have
a perforated gastric ulcer and is experiencing peritonitis. Which of the following exam findings is NOT
supportive of this diagnosis?
*Guarding.
*Rebound tenderness.
*Absence of pain with withdrawal of palpation.
*Rigidity.
?Absence of pain with withdrawal of palpation.
Your 22 year old male patient states during his review of systems that
his scrotum is very enlarged and feels like it is full a powerlifter and works as a trash collector. You suspect the
