NR 667 CHAMBERLAIN CEA STUDY GUIDE EXAM
NR 667/ NR 667 Chamberlain CEA Study Guide Exam
Updated 2025 (A+ Graded 100% Verified Detailed Answers)
An older adult with diabetes mellitus presents with leg cramps. She states that the cramps
as worst when walking to the supermarket. If she stops to rest, the pain subsides. The nurse
practitioner knows that this patient needs a workup for:
*Benign nocturnal leg cramps
*Popliteal aneurism
*Intermittent claudication
*Deep vein thrombosis - ANSWER✅ Intermittent claudication
An adult female who recently returned from a business trip to Japan presents for a recheck
appointment. The only remarkable laboratory result is for thyroid-stimulating hormone
(TSH), at 0.3 microunits/mL (normal = 0.4-6 microunits/mL). The patient reports that her
neck hurts; examination reveals thyroid tenderness. Which of the following laboratory tests
should the nurse practitioner order now?
*Triiodothyronine (T3) and free thyroxine (FT4)
*Triiodothyronine (T3) and free triiodothyronine (FT3)
*Triiodothyronine (T3) only
*Triiodothyronine (T3) resin uptake assay - ANSWER✅ Triiodothyronine (T3) and free
thyroxine (FT4)
Rationale: The patient has a low TSH which when paired with elevated T3 and T4, suggest
hyperthyroidism. The next steps for this patient are to check the T3 and T4 levels which
would presumably be high and clinically correlate the findings for a diagnosis of
hyperthyroidism.
, NR 667 CHAMBERLAIN CEA STUDY GUIDE EXAM
A patient has a 2 cm pituitary adenoma on MRI. Deficiency of one of the pituitary hormones
can cause immediate hemodynamic instability and has a risk of death. Which is the most
critical hormone deficiency to rule out?
*FSH/LH
*ACTH
*Prolactin
*TSH - ANSWER✅ ACTH
Rationale: Adrenal crisis is a life-threatening emergency and needs to be ruled out.
Unrecognized/untreated adrenal insufficiency can result in death. ACTH is the pituitary
hormone responsible for cortisol production.
All the following are symptoms of hypocalcemia except:
*Tetany
*Visual field deficits
*Paresthesia in fingers and toes
*Abdominal pain - ANSWER✅ Visual field deficits
Rationale: Visual field deficits is a potential symptom of pituitary adenoma. All other are
symptoms related to hypocalcemia.
A 39-year-old male with type 1 DM is seen in the urgent care after a recent hospitalization
for DKA. Treated with IV fluids, IV insulin, and potassium correction, His BS decreases to 120
mg/dL and is transitioned from IV insulin to Sub Q. After 6 hours he begins vomiting and ABG
is done: pH 7.19, CO2 13, K+ 5.5, glucose 180. Which of the following is the most likely reason
for persistent acidosis?
, NR 667 CHAMBERLAIN CEA STUDY GUIDE EXAM
*Premature discontinuation of insulin drip
*Lack of absorption of Sub Q insulin
*Failure to correct hyperkalemia
*Failure to give bicarbonate - ANSWER✅ Premature discontinuation of insulin drip
Rationale: Glucose is only one of the parameters that needs to be followed in DKA, it takes
longer for ketones to clear than glucose to normalize, insulin drip should be continued until
ketonemia has resolved and the anion gap has closed, if IV insulin is discontinued
prematurely the patient may have rebound acidosis, bicarbonate replacement has been
controversial in DKA.
Which of the following is at highest risk for DMII?
*An adult woman with a BMI of 27 who just delivered a baby weighing 9 1/2 lbs
*A 50-year-old black female with a BMI of 23 who walks daily at least 30 minutes
*A 75-year-old Caucasian male with a BMI of 25 who is sedentary
*A 62-year-old Hispanic male with a BMI of 24 who works as a day laborer - ANSWER✅ An
adult woman with a BMI of 27 who just delivered a baby weighing 9 1/2 lbs
Rationale: Of these options, an adult woman with a BMI of 27 who just delivered a baby
weighing 9 1/2 lbs is the most likely due to their increased BMI and the large size of the
baby. giving birth to a large baby, also known as a large-for-gestational-age (LGA) baby, can
increase the risk of developing type 2 diabetes later in life. Women who give birth to a LGA
baby are 10% more likely to develop DMII 10-14 years after pregnancy compared to women
who give birth to babies of average gestational age (AGA). This increased risk is even after
adjusting for other risk factors, such as age, obesity, high blood pressure, and family history
of diabetes.
, NR 667 CHAMBERLAIN CEA STUDY GUIDE EXAM
A 64-year-old female with a past medical history significant for hepatitis C and Cirrhosis
presents to your office with abdominal pain and distention. Exam reveals tense ascites.
Which is indicated for treatment?
*Midodrine 10mg PO TID
*Labetalol 200mg PO BID
*Transfer to the hospital for large Volume paracentesis
*Furosemide 40mg PO BID - ANSWER✅ Transfer to the hospital for large Volume
paracentesis
Rationale: Large Volume Paracentesis will provide immediate relief for the patient, it will
also allow for testing of fluid for spontaneous bacterial peritonitis.
A 64-year-old female with a past medical history significant for hepatitis C and Cirrhosis
presents to the urgent care with abdominal pain and distention. Exam reveals tense ascites.
After transfer to the emergency department, large volume paracentesis was performed.
What regimen should you place patient on for further maintenance of her ascites?
*Midodrine 10mg TID
*Labetalol 200mg BID
*Furosemide 40mg BID
*Flagyl 500mg PO TID - ANSWER✅ Furosemide 40mg BID
Rationale: Furosemide is typically prescribed for a patient for continued maintenance of
ascites once a paracentesis is performed to help reduce chances of recurrence
A 70-year-old patient presents to the clinic with dyspnea, palpitations, and fatigue. The
patient reports a 2-week history of blackened stools, which the patient attributes to drinking
berry juice. Assessment reveals vital signs of BP = 110/60, P = 100, R = 24; Hgb = 4.5 g/dL;
Hct = 16%. What is the most appropriate immediate intervention?
NR 667/ NR 667 Chamberlain CEA Study Guide Exam
Updated 2025 (A+ Graded 100% Verified Detailed Answers)
An older adult with diabetes mellitus presents with leg cramps. She states that the cramps
as worst when walking to the supermarket. If she stops to rest, the pain subsides. The nurse
practitioner knows that this patient needs a workup for:
*Benign nocturnal leg cramps
*Popliteal aneurism
*Intermittent claudication
*Deep vein thrombosis - ANSWER✅ Intermittent claudication
An adult female who recently returned from a business trip to Japan presents for a recheck
appointment. The only remarkable laboratory result is for thyroid-stimulating hormone
(TSH), at 0.3 microunits/mL (normal = 0.4-6 microunits/mL). The patient reports that her
neck hurts; examination reveals thyroid tenderness. Which of the following laboratory tests
should the nurse practitioner order now?
*Triiodothyronine (T3) and free thyroxine (FT4)
*Triiodothyronine (T3) and free triiodothyronine (FT3)
*Triiodothyronine (T3) only
*Triiodothyronine (T3) resin uptake assay - ANSWER✅ Triiodothyronine (T3) and free
thyroxine (FT4)
Rationale: The patient has a low TSH which when paired with elevated T3 and T4, suggest
hyperthyroidism. The next steps for this patient are to check the T3 and T4 levels which
would presumably be high and clinically correlate the findings for a diagnosis of
hyperthyroidism.
, NR 667 CHAMBERLAIN CEA STUDY GUIDE EXAM
A patient has a 2 cm pituitary adenoma on MRI. Deficiency of one of the pituitary hormones
can cause immediate hemodynamic instability and has a risk of death. Which is the most
critical hormone deficiency to rule out?
*FSH/LH
*ACTH
*Prolactin
*TSH - ANSWER✅ ACTH
Rationale: Adrenal crisis is a life-threatening emergency and needs to be ruled out.
Unrecognized/untreated adrenal insufficiency can result in death. ACTH is the pituitary
hormone responsible for cortisol production.
All the following are symptoms of hypocalcemia except:
*Tetany
*Visual field deficits
*Paresthesia in fingers and toes
*Abdominal pain - ANSWER✅ Visual field deficits
Rationale: Visual field deficits is a potential symptom of pituitary adenoma. All other are
symptoms related to hypocalcemia.
A 39-year-old male with type 1 DM is seen in the urgent care after a recent hospitalization
for DKA. Treated with IV fluids, IV insulin, and potassium correction, His BS decreases to 120
mg/dL and is transitioned from IV insulin to Sub Q. After 6 hours he begins vomiting and ABG
is done: pH 7.19, CO2 13, K+ 5.5, glucose 180. Which of the following is the most likely reason
for persistent acidosis?
, NR 667 CHAMBERLAIN CEA STUDY GUIDE EXAM
*Premature discontinuation of insulin drip
*Lack of absorption of Sub Q insulin
*Failure to correct hyperkalemia
*Failure to give bicarbonate - ANSWER✅ Premature discontinuation of insulin drip
Rationale: Glucose is only one of the parameters that needs to be followed in DKA, it takes
longer for ketones to clear than glucose to normalize, insulin drip should be continued until
ketonemia has resolved and the anion gap has closed, if IV insulin is discontinued
prematurely the patient may have rebound acidosis, bicarbonate replacement has been
controversial in DKA.
Which of the following is at highest risk for DMII?
*An adult woman with a BMI of 27 who just delivered a baby weighing 9 1/2 lbs
*A 50-year-old black female with a BMI of 23 who walks daily at least 30 minutes
*A 75-year-old Caucasian male with a BMI of 25 who is sedentary
*A 62-year-old Hispanic male with a BMI of 24 who works as a day laborer - ANSWER✅ An
adult woman with a BMI of 27 who just delivered a baby weighing 9 1/2 lbs
Rationale: Of these options, an adult woman with a BMI of 27 who just delivered a baby
weighing 9 1/2 lbs is the most likely due to their increased BMI and the large size of the
baby. giving birth to a large baby, also known as a large-for-gestational-age (LGA) baby, can
increase the risk of developing type 2 diabetes later in life. Women who give birth to a LGA
baby are 10% more likely to develop DMII 10-14 years after pregnancy compared to women
who give birth to babies of average gestational age (AGA). This increased risk is even after
adjusting for other risk factors, such as age, obesity, high blood pressure, and family history
of diabetes.
, NR 667 CHAMBERLAIN CEA STUDY GUIDE EXAM
A 64-year-old female with a past medical history significant for hepatitis C and Cirrhosis
presents to your office with abdominal pain and distention. Exam reveals tense ascites.
Which is indicated for treatment?
*Midodrine 10mg PO TID
*Labetalol 200mg PO BID
*Transfer to the hospital for large Volume paracentesis
*Furosemide 40mg PO BID - ANSWER✅ Transfer to the hospital for large Volume
paracentesis
Rationale: Large Volume Paracentesis will provide immediate relief for the patient, it will
also allow for testing of fluid for spontaneous bacterial peritonitis.
A 64-year-old female with a past medical history significant for hepatitis C and Cirrhosis
presents to the urgent care with abdominal pain and distention. Exam reveals tense ascites.
After transfer to the emergency department, large volume paracentesis was performed.
What regimen should you place patient on for further maintenance of her ascites?
*Midodrine 10mg TID
*Labetalol 200mg BID
*Furosemide 40mg BID
*Flagyl 500mg PO TID - ANSWER✅ Furosemide 40mg BID
Rationale: Furosemide is typically prescribed for a patient for continued maintenance of
ascites once a paracentesis is performed to help reduce chances of recurrence
A 70-year-old patient presents to the clinic with dyspnea, palpitations, and fatigue. The
patient reports a 2-week history of blackened stools, which the patient attributes to drinking
berry juice. Assessment reveals vital signs of BP = 110/60, P = 100, R = 24; Hgb = 4.5 g/dL;
Hct = 16%. What is the most appropriate immediate intervention?
