2026/2027
NR 603 CEA Exam 2026/2027
Comprehensive Study Guide, Practice
Questions, Test Bank Review, and Final
Exam Preparation Manual
Question 1:
A 60-year-old woman with a history of hypertension and diabetes presents with
progressive fatigue and laboratory findings of microcytic, hypochromic anemia.
Which of the following is the most likely diagnosis?
A. Vitamin B12 deficiency anemia
B. Iron deficiency anemia
C. Aplastic anemia
D. Hemolytic anemia
Correct Answer: B. Iron deficiency anemia
Rationale:
Microcytic, hypochromic anemia is most commonly caused by iron deficiency. This
condition results from inadequate iron availability for hemoglobin synthesis, leading
to smaller and paler red blood cells. Vitamin B12 deficiency typically causes
macrocytic anemia, while aplastic anemia presents with pancytopenia. Hemolytic
anemia involves destruction of red blood cells rather than impaired production.
Therefore, iron deficiency anemia is the most consistent diagnosis.
Question 2:
Which of the following is an appropriate treatment for symptomatic aplastic anemia?
A. Oral iron supplementation
B. Bone marrow transplant and supportive transfusions
C. Beta-blocker therapy
D. Antiviral therapy only
Correct Answer: B. Bone marrow transplant and supportive transfusions
Rationale:
Aplastic anemia is characterized by bone marrow failure, leading to pancytopenia.
Definitive treatment includes bone marrow transplantation, particularly in younger
patients. Supportive care includes transfusions of PRBCs, platelets, and prophylactic
antibiotics to prevent infection. Iron supplementation is ineffective because the issue
,2026/2027
is marrow failure, not iron deficiency. Beta-blockers and antivirals are not standard
treatments.
Question 3:
A patient presents with fatigue, shortness of breath, and chest pain. Laboratory results
show hemoglobin of 6.5 g/dL. Which findings would support iron deficiency anemia?
A. MCV 105, MCHC 36
B. MCV 67, MCHC 29
C. MCV 90, MCHC 33
D. MCV 110, MCHC 30
Correct Answer: B. MCV 67, MCHC 29
Rationale:
Iron deficiency anemia is characterized by microcytic (low MCV) and hypochromic
(low MCHC) red blood cells. The values MCV 67 and MCHC 29 clearly indicate this
pattern. Macrocytic values (MCV >100) suggest B12 or folate deficiency, while
normal indices suggest other causes such as anemia of chronic disease.
Question 4:
A 78-year-old patient presents with pancytopenia and dysplastic cells on peripheral
smear. Which diagnostic test is most appropriate?
A. CT scan
B. Bone marrow biopsy with flow cytometry
C. Urinalysis
D. ECG
Correct Answer: B. Bone marrow biopsy with flow cytometry
Rationale:
Pancytopenia with dysplasia suggests a bone marrow disorder such as
myelodysplastic syndrome or leukemia. A bone marrow biopsy provides direct
evaluation of marrow structure and function, while flow cytometry helps characterize
abnormal cell populations. Imaging and urinalysis do not assess hematopoiesis.
Question 5:
A patient with intrinsic factor autoantibodies is most at risk for:
A. Iron deficiency anemia
B. Pernicious anemia
C. Hemolytic anemia
D. Sickle cell disease
,2026/2027
Correct Answer: B. Pernicious anemia
Rationale:
Intrinsic factor is necessary for vitamin B12 absorption. Autoantibodies against
intrinsic factor lead to B12 deficiency, causing pernicious anemia. Iron deficiency
involves different mechanisms, while hemolytic anemia and sickle cell disease are
unrelated.
Question 6:
A patient with sickle cell disease presents with severe pain crisis. What is the most
appropriate initial management?
A. Oral antibiotics
B. IV fluids and opioids
C. Immediate surgery
D. Anticoagulation
Correct Answer: B. IV fluids and opioids
Rationale:
Sickle cell crisis is managed with hydration and pain control. IV fluids reduce blood
viscosity, and opioids manage severe pain. Antibiotics are used only if infection is
suspected. Surgery and anticoagulation are not first-line treatments.
Question 7:
Which medication class reduces mortality in heart failure?
A. NSAIDs
B. Beta-blockers
C. Antihistamines
D. Antibiotics
Correct Answer: B. Beta-blockers
Rationale:
Beta-blockers improve survival in heart failure by reducing myocardial workload and
neurohormonal activation. NSAIDs may worsen heart failure by causing fluid
retention. Antihistamines and antibiotics have no role in mortality reduction.
Question 8:
A patient with rheumatoid arthritis presents with abdominal pain and dark stools
while taking NSAIDs. What is the likely diagnosis?
, 2026/2027
A. Pancreatitis
B. Gastric ulceration
C. Appendicitis
D. Hepatitis
Correct Answer: B. Gastric ulceration
Rationale:
NSAIDs inhibit prostaglandin synthesis, reducing gastric mucosal protection and
increasing risk of ulcers. Dark stools indicate gastrointestinal bleeding. Other
conditions do not typically present with NSAID-related GI bleeding.
Question 9:
Which biopsy finding confirms Barrett’s esophagus?
A. Squamous hyperplasia
B. Intestinal metaplasia with goblet cells
C. Dysplastic adenoma
D. Ulcer formation
Correct Answer: B. Intestinal metaplasia with goblet cells
Rationale:
Barrett’s esophagus is defined by replacement of normal squamous epithelium with
intestinal-type columnar cells containing goblet cells. This is a precancerous condition.
Other findings are not diagnostic.
Question 10:
Which intervention is used to flush a chemical from the eye?
A. Warm compress
B. Morgan lens irrigation
C. Eye patch
D. Antibiotic drops only
Correct Answer: B. Morgan lens irrigation
Rationale:
A Morgan lens allows continuous irrigation of the eye to remove harmful substances.
This is critical in chemical exposure. Compresses and patches do not remove irritants.
Question 11:
A complication of a Le Fort III fracture includes:
NR 603 CEA Exam 2026/2027
Comprehensive Study Guide, Practice
Questions, Test Bank Review, and Final
Exam Preparation Manual
Question 1:
A 60-year-old woman with a history of hypertension and diabetes presents with
progressive fatigue and laboratory findings of microcytic, hypochromic anemia.
Which of the following is the most likely diagnosis?
A. Vitamin B12 deficiency anemia
B. Iron deficiency anemia
C. Aplastic anemia
D. Hemolytic anemia
Correct Answer: B. Iron deficiency anemia
Rationale:
Microcytic, hypochromic anemia is most commonly caused by iron deficiency. This
condition results from inadequate iron availability for hemoglobin synthesis, leading
to smaller and paler red blood cells. Vitamin B12 deficiency typically causes
macrocytic anemia, while aplastic anemia presents with pancytopenia. Hemolytic
anemia involves destruction of red blood cells rather than impaired production.
Therefore, iron deficiency anemia is the most consistent diagnosis.
Question 2:
Which of the following is an appropriate treatment for symptomatic aplastic anemia?
A. Oral iron supplementation
B. Bone marrow transplant and supportive transfusions
C. Beta-blocker therapy
D. Antiviral therapy only
Correct Answer: B. Bone marrow transplant and supportive transfusions
Rationale:
Aplastic anemia is characterized by bone marrow failure, leading to pancytopenia.
Definitive treatment includes bone marrow transplantation, particularly in younger
patients. Supportive care includes transfusions of PRBCs, platelets, and prophylactic
antibiotics to prevent infection. Iron supplementation is ineffective because the issue
,2026/2027
is marrow failure, not iron deficiency. Beta-blockers and antivirals are not standard
treatments.
Question 3:
A patient presents with fatigue, shortness of breath, and chest pain. Laboratory results
show hemoglobin of 6.5 g/dL. Which findings would support iron deficiency anemia?
A. MCV 105, MCHC 36
B. MCV 67, MCHC 29
C. MCV 90, MCHC 33
D. MCV 110, MCHC 30
Correct Answer: B. MCV 67, MCHC 29
Rationale:
Iron deficiency anemia is characterized by microcytic (low MCV) and hypochromic
(low MCHC) red blood cells. The values MCV 67 and MCHC 29 clearly indicate this
pattern. Macrocytic values (MCV >100) suggest B12 or folate deficiency, while
normal indices suggest other causes such as anemia of chronic disease.
Question 4:
A 78-year-old patient presents with pancytopenia and dysplastic cells on peripheral
smear. Which diagnostic test is most appropriate?
A. CT scan
B. Bone marrow biopsy with flow cytometry
C. Urinalysis
D. ECG
Correct Answer: B. Bone marrow biopsy with flow cytometry
Rationale:
Pancytopenia with dysplasia suggests a bone marrow disorder such as
myelodysplastic syndrome or leukemia. A bone marrow biopsy provides direct
evaluation of marrow structure and function, while flow cytometry helps characterize
abnormal cell populations. Imaging and urinalysis do not assess hematopoiesis.
Question 5:
A patient with intrinsic factor autoantibodies is most at risk for:
A. Iron deficiency anemia
B. Pernicious anemia
C. Hemolytic anemia
D. Sickle cell disease
,2026/2027
Correct Answer: B. Pernicious anemia
Rationale:
Intrinsic factor is necessary for vitamin B12 absorption. Autoantibodies against
intrinsic factor lead to B12 deficiency, causing pernicious anemia. Iron deficiency
involves different mechanisms, while hemolytic anemia and sickle cell disease are
unrelated.
Question 6:
A patient with sickle cell disease presents with severe pain crisis. What is the most
appropriate initial management?
A. Oral antibiotics
B. IV fluids and opioids
C. Immediate surgery
D. Anticoagulation
Correct Answer: B. IV fluids and opioids
Rationale:
Sickle cell crisis is managed with hydration and pain control. IV fluids reduce blood
viscosity, and opioids manage severe pain. Antibiotics are used only if infection is
suspected. Surgery and anticoagulation are not first-line treatments.
Question 7:
Which medication class reduces mortality in heart failure?
A. NSAIDs
B. Beta-blockers
C. Antihistamines
D. Antibiotics
Correct Answer: B. Beta-blockers
Rationale:
Beta-blockers improve survival in heart failure by reducing myocardial workload and
neurohormonal activation. NSAIDs may worsen heart failure by causing fluid
retention. Antihistamines and antibiotics have no role in mortality reduction.
Question 8:
A patient with rheumatoid arthritis presents with abdominal pain and dark stools
while taking NSAIDs. What is the likely diagnosis?
, 2026/2027
A. Pancreatitis
B. Gastric ulceration
C. Appendicitis
D. Hepatitis
Correct Answer: B. Gastric ulceration
Rationale:
NSAIDs inhibit prostaglandin synthesis, reducing gastric mucosal protection and
increasing risk of ulcers. Dark stools indicate gastrointestinal bleeding. Other
conditions do not typically present with NSAID-related GI bleeding.
Question 9:
Which biopsy finding confirms Barrett’s esophagus?
A. Squamous hyperplasia
B. Intestinal metaplasia with goblet cells
C. Dysplastic adenoma
D. Ulcer formation
Correct Answer: B. Intestinal metaplasia with goblet cells
Rationale:
Barrett’s esophagus is defined by replacement of normal squamous epithelium with
intestinal-type columnar cells containing goblet cells. This is a precancerous condition.
Other findings are not diagnostic.
Question 10:
Which intervention is used to flush a chemical from the eye?
A. Warm compress
B. Morgan lens irrigation
C. Eye patch
D. Antibiotic drops only
Correct Answer: B. Morgan lens irrigation
Rationale:
A Morgan lens allows continuous irrigation of the eye to remove harmful substances.
This is critical in chemical exposure. Compresses and patches do not remove irritants.
Question 11:
A complication of a Le Fort III fracture includes:
