NR 511 CEA Exam | Chamberlain University | 2026 | Actual Exam Questions with Verified Answers

Your 22 year old male patient states during his review of systems thathis scrotum is very enlarged and feels like it is full a powerlifter and works as a trash collector. You suspect the patient likely has which of the following diagnoses?

A -Varicocele

B -Meningocele

C -Rectocele

D -Hydrocele

A -Varicocele

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?

A -Left 2nd intercostal space, midaxillary line

B -Left 5th intercostal space, midclavicular line

C -Right 4th intercostal space, midaxillary line

D -Right 2nd intercostal space, midclavicular line

B -Left 5th intercostal space, midclavicular line

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?

A -Bilateral conjunctivitis

B -Hyperthyroidism

C -hypothyroidism

D -Myexedma

B -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 afollow-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?

A -Forced Expiratory Volume over 1 second (FEV1)

B -Functional Reserve Capacity

C -Inspiratory Reserve

D -Forced Vital Capacity

D -Forced vital capacity

Your patient has a diagnosis of Addison's disease. Which of the following might you expect to find during examination?

A -Abdominal striae

B -Dowager hump

C -Low body temperature

D -Moon face

B -Dowager hump

The nurse practitioner's evaluation of a patient with Diabetes Mellitus type 2 should include which of the following while evaluating for end organ dysfunction of the disease?

A -Renal function panel

B -Urinalysis

C -Non-dilated eye exam

D -All of these are appropriate options

D -All of these are appropriate options

During your visit with a 19 year old patient for a college health physical, your health history includes a diagnosis of angioedema. What of the following parts of the body are were likely involved?

A -Isolated to the colon

B -Anywhere in the enteral tract

C -Chest

D -Face and Lips

D -Face and Lips

Which of the following dermatologic lesions is precancerous and likely due to prolonged exposure to UV-B?

A -Actinic Keratosis

B -Basal cell carcinoma

C -Verucca

D -Seborrheic dermatitis

A -Actinic Keratosis

Based on your evaluation of ABCDE for melanoma, which of the following represents a suspicous finding?

A -Irregular borders

B -Symmetrical nature

C -Brown color

D -Diameter of 0.4 cm

A -Irregular borders

Your patient is complaining of hypersomnia, lack of motivation, weight gain, and anhedonia. Suspecting a diagnosis of clinical depression, you anticipate the patient will benefit from treating their underlying deficit of which of the following neurotransmitters?

A -GABA

B -Serotonin

C -Dobutamine

D -Glutamate

B -Serotonin

As a prudent nurse practitioner, the diabetic, hypertensive patient you are seeing should be evaluated for early evidence of renal damage from both diabetes and hypertension. Which of the following assessment tools should the nurse practitioner order first for the evaluation of early renal dysfunction secondary to diabetes or hypertension?

A -BUN/creatinine ratio

B -Urinalysis with micro/macro albumin

C -Renal biopsy

D -Urine sodium

B -Urinalysis with micro/macro albumin

While evaluating a patient in your clinic for a routine health visit, you auscultate crackles in the poster left lower lobe, have the patient cough, with follow-up auscultation revealing clear breath sounds. Which one of the following would you suspect?

A -Congestive heart failure

B -Atelectasis

C -Laryngospasm

D -Bronchiactasis.

B -Atelectasis

Your 39 year old patient who has recently been hospitalized for an appendectomy and is being seen in your clinic for post-operative follow-up with primary care. On assessment, the patient complains of some incisional pain and otherwise examination is normal, with the exception of dull percussion sounds noted on the thorax over lung tissue. Which of the following diagnoses would be explained by this finding in post-operative patient?

A -Left-sided heart failure

B -Chronic bronchitis

C -Atelectasis

D -Healthy patient with no coexising disease

C -Atelectasis

You are evaluating a 41 year old female patient in your clinic with symptoms of right upper quadrant pain which worsens with deep breathing. The patient exhibits a positive Murphy sign. These findings are most consistent which one of the following?

A -Appendicitis

B -Cholecystitis

C -Crohn's flare

D -Pancreatitis

B -Cholecystitis

In educating your patient about the non-pharmacologic management of gastroesophageal reflux disease, you include teaching to the patient that their heartburn is aggravated by al of the following except which one?

A -Activities including lifting or bending over

B -Alcohol intake

C -Foods, such as citrus, onions and coffee

D -Gastric dumping, or increased emptying into the small intestines

D -Gastric dumping, or increased emptying into the small intestines

The patient is experiencing acute closed angle glaucoma. Which of the following examination findings by the nurse practitioner is most consistent with their diagnosis?

A -Macular degeneration

B -Increase in intraocular pressure

C -AV nicking

D -Loss of aqueous humor volume

B -Increase in intraocular pressure

While managing the care of the patient with chronic alcoholism, the nurse practitioner would likely anticipate which findings on the CBC with differential?

A -Low MCV and MCH

B -Normal MCV and MCH

C -Chronic alcoholism will not affect the differential

D -Elevated MCV and MCH

D -Elevated MCV and MCH

The nurse practitioner is caring for a patient with an elevated WBC, fever, chills, and malaise. When developing a differential diagnosis for this finding, which of the following is not a potential cause of the elevated WBC?

A -Sepsis

B -Diabetes Mellitus Type 2

C -Leukemia

D -Recent oral corticosteroid therapy

B -Diabetes Mellitus Type 2

Your 21 year old sexually active female patient states during a routine health exam that they have some "weird bumps" on their vulva.She is concerned she has a sexually transmitted infection. You notify her that condyloma are caused by exposure to which of the following?

A -Chlamydia

B -Herpes zoster

C -Human papilomavirus type 6 and 1

D -Parvovirus B19

C -Human papilomavirus type 6 and 1

Yourpatient who has underwent a recent major medical medical procedure is at a rehabilitation center and is having a hard time being motivated to do therapy. When you interview them as the nurse practitioner on staff for the subacute rehab center, they appeardespondent, and are having a hard time being wakeful during therapy sessions. They have stable vital signs, temperature, urine output, and are not ill-appearing. As a prudent nurse practitioner, you understand this may represent which of the following?

A -Cushing syndrome

B -Situation depression

C -Addison's disease

D -Untreated anxiety

B -Situation depression

The 18 year old female patient who inappropriately exhibits fear of abandonment, intense interpersonal relationships, affective instability, and recurrent self-harm describes which of the following diagnoses:

A -Borderline personality disorder

B -Seasonal affective disorder

C -Reactive attachment disorder

D -Bipolar disorder

A -Borderline personality disorder

You are treating a patient who has stopped taking their diuretic regimen against medical advice while they are on vacation since it made them urinate too frequently for their plans. Now they are 21 pounds heavier than their baseline weight, have respiratory crackles in bilateral bases, and have severe generalized lower extremity and truncal edema extending to the sacrum and abdomen. On your documentation, this is referred to as which of the following conditions?

A -Nephrotic syndrome

B -Syndrome of inappropriate antidiuretic hormone (SAIDH)

C -Ascites

D -Anasarca

D -Anasarca

The 84 year old lethargic patient who lives alone accidentally overdosed their amlodipine (Norvasc) was found by their daughter and taken to your clinic for evaluation. On exam, you found her blood pressure of 80/42 which the daughter says was "about what she found on her home cuff for the last 6 hours before bringing her in to be evaluated". The patient was then transferred to the hospital for evaluation. During her hospitalization she was also evaluated with CBC, BMP, and a UA. The results reflect normal labs except the UA showed trace WBCs in urine and no leukocyte esterases or nitrites and the BMP showed a creatinine of 1.9 with her normal baseline of1.2 (normal range 0.5-1.2mg/dL) and BUN of 34, with a baseline of 20 (normal range 10-20 mg/dL). What si likely to cause which of her renal issues? A -Pyelonephritis

B -Chronic kidney disease

C -Acute tubular necrosis

D -Glomerulonephritis

C -Acute tubular necrosis

Your 52 year old male patient Gus has a diagnosis of heart failure with a low ejection fraction (HFrEF) (EF 30%) following a recent myocardial infarction and has been started on optimal medical therapy. Assuming he tolerates all the following medicines without side effects or contraindications, which one of the following agents should be avoided for optimal medical therapy specifically aimed at optimizing his HFrEF?

A -Amlodipine (Norvasc)

B -Entresto (Sacubitril/Valsartan)

C -Furosemide (Lasix)

D -Carvedilol (Coreg)

A -Amlodipine (Norvasc)

Your 19 year old otherwise healthy male patient Vivek has been monitoring their peak flow at home after a recent visit at which time his symptoms suggest a new diagnosis of asthma. Which of the following is the most likely drug to be the first prescription?

A -fluticasone/salmeterol (Advair diskus) 250/50 BID PRN for shortness of breath

B -salmeterol (Serevent) 50mcg inhaled daily

C -albuterol (Xopenex) MDI PRN for wheezing

D -montelukast (Singulair) 10mg PO daily

C -albuterol (Xopenex) MDI PRN for wheezing

Margo, a 47 year old female patient recently underwent routine surveillance labs during her annual visit. From a routine screening lab of Hgb A1C of 7.2, you have diagnosed her with type 2 diabetes mellitus (T2DM) and anticipate discharging her with medication and referral to diabetic education. Your patient teaching should include notification of which common side effect of the most commonly prescribed first agent for T2DM?

A -diarrhea

B -delayed gastric emptying

C -mycotic infections

D -constipation

A -diarrhea

Oliver, a 62 year old otherwise healthy male patient with an active lifestyle presents to your clinic today with a chief complaint of gnawing abdominal pain with a history of orthopedic overuse injuries. In developing a working differential diagnosis for this patient, which of the following questions is most useful in probing this further to rule out more serious conditions?

A -What time of the day aer you taking your acetaminophen (Tylenol)?

B -Have you been taking any non-steroidal anti-inflammatory medications lately?

C -When was the last time you took topical corticosteroids for pain?

D -Have you noticed any particular food has made this worse?

B -Have you been taking any non-steroidal anti-inflammatory medications lately?

Zeke, a 2 year old male patient presented to your primary care clinic with unilateral leg swelling and tenderness after an "al nighter"playing video games. You suspect he has a provokedDVT from immobility and an ultrasound has been ordered. While awaiting thisexam to be performed, you preemptively discuss anticoagulation with the patient assuming he wil most likely be needing this therapy. Which of the following represents adequate understanding from the patient?

A -The goal for my INR on rivaroxaban (Xarelto) should be somewhere over 20

B -Regardless of the venous doppler findings, I can start warfarin(Coumadin) alone an it will take around 4-5 days to get the drug to properly anticoagulate me

C -If they find a blood clot, I will need to use enoxaparin (Lovenox) in addition to warfarin (Coumadin) until my INR is over 2.0

D -I will need to take enoxaparin (Lovenox) ifIma started on rivaroxaban Xarelto)

C -If they find a blood clot, I will need to use enoxaparin (Lovenox) in addition to warfarin (Coumadin) until my INR is over 2.0

Which of the following are common causes of a provoked deep vein thrombosis (DVT)?

A -Cancer

B -Factor V Leiden

C -Protein C or S deficiency

D -All of these are common causes of provoked DVT

D -All of these are common causes of provoked DVT

In discussing a new diagnosis of human immunodeficiency virus (HIV) for your patient, the patient demonstrates good understanding of the possible agents which may be used to include which of the following:

A -All of these may be used to manage my disease

B -Protease inhibitors

C -Nucleoside reverse transcriptase inhibitors

D -Non-nucleotide reverse transcriptase inhibitors

A -All of these may be used to manage my disease

Which class of medications are indicated as first line management of both post-traumatic stress disorder (PTSD) and major depressive disorder?

A -Selective serotonin reuptake inhibitors

B -Non-selective dopamine reuptake inhibitors

C -Mood stabilizers

D -Monoamine oxidase inhibitors.

A -Selective serotonin reuptake inhibitors

Dave, a 41 year old software engineer presents to your clinic with complaints of back spasms after being forced to return to their office instead of working from home. He believes the chair at his desk is the culprit and his causing him severe back spasms secondary to anaggravated old sports injury. nI addition to non-pharmacologic solutions, which of the following represents an agent appropriate for the managementof his spasms?

A -Prednisone (Deltasone)

B -Methy naltrexone (Relistor)

C -Gabapentin (Neurontin)

D -Cyclobenzaprine (amirx)

D -Cyclobenzaprine (amirx)

Which of the following concepts refers to where small differences in dose or blood concentration may lead to serious therapeutic failures and/or adverse drug reactions that are life-threatening or result in persistent or significant disability or incapacity?

A -Narrow therapeutic index

B -Wide therapeutic index

C -Post-antibiotic effect

D -Zero order kinetics

A -Narrow therapeutic index

Which of the following agents will have the effect of dilating the efferent arteriole of the kidney and thereby reducing elimination of creatinine during administration?

A -Valsartan (Diovan)

B -Misoprostol (Cytotec)

C -Furosemide (Lasix)

D -Ibuprofen (advil)

D -Ibuprofen (advil)

Patients with end-stage renal disease (ESRD) on dialysis experiencing anemiaof chronic disease may benefit from the administration of erythropoeitin (Epocrit). Immediate evidence that this is working as desired would be evident by elevation in which level?

A -Potassium

B -Total iron binding capacity (TIBC)

C -Lactate Dehydrogenase (LDH)

D -Red cell distribution width (RDW)

D -Red cell distribution width (RDW)

Karly, a 20 year old exchange student presents to your clinic with concerns of an unprotected sexual encounter and has concerns she has contracted a sexually transmitted infection. Her lab testing reveals a positive gonorrhea and chlamydia DNA probe. What medication should the prudent nurse practitioner include in the treatment plan?

A -Ceftriaxone (Rocephin) IM plus Axithromycin (Zithromax) PO

B -Amoxicillin (Amoxil) plus Metronidazole (Flagyl)

C -Cephalexin (Keflex) only

D -Doxycycline (Vibramycin) alone

A -Ceftriaxone (Rocephin) IM plus Axithromycin (Zithromax) PO

Jan, a 52 year old female patient is experiencing menopausal symptoms. Which non-prescription agent may be helpful during menopause to help with hot flashes?

A -Echinacea

B -Black cohosh

C -Dandelion root

D -St Johns Wart

B -Black cohosh

Your 38 year old male patient Mark is being seen in your clinic for routine health physical and complaints of heartburn. During your evaluation you identify darkened or velvety skin in the neck, groin, and/or axilla with associated achrocordons. This is most likely adiagnosis of which of the following?

A -Seborrheic Kerstosis

B -Actinic keratosis

C -Keratoacanthoma

D -Acanthuses nigricans

D -Acanthuses nigricans

The determination of topical corticosteroid potency is largely based on the unique drug as well as which of the following variables?

A -Vehicle of delivery (cream, lotion, elixir, etc)

B -None of these are correct

C -Duration of use (once, continuous, etc)

D -Site of use (back, face, arms, etc)

A -Vehicle of delivery (cream, lotion, elixir, etc)

The most commonly described non-life threatening side effect of HmgCo-A reductase inhibitor therapy is which of the following?

A -Tachycardia

B -Myalgia

C -Rhabdomyolysis

D -Airway swelling

B -Myalgia

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?

A -Diastole

B -S3 in systole while S4 in diastole

C -Systole

D -S4 in diastole while S3 in systole

A -Diastole

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?

A -At the end of the T wave

B -At the start of the T wave

C -Peak of the R wave

D -At the start of the P wave

C -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?

A -Prescribe metoprolol (Lopressor) 12.5mg PO BID

B -Prescribe aspirin 81mg PO daily

C -Refer to cardiology for angiography

D -Check for thyroid dysfunction

D -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?

A -Positive stereognosis

B -Positive for egophony

C -Negative for bronchophony

D -Negative for egophony

B -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?

A -To assist with the confirmation of cardiac origin of angina

B -To assess for deep-seated lesion and tumors

C -To assess for any pain or discomfort prior to palpitation of the chest wall

D -To identify if underlying tissue are air-filled, fluid-filled or consolidated

D -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?

A -Approximately equal level of change in the descent of the diaphragm bilaterally during maximal inspiration and expiration with a decreased overall inspiratory capacity

B -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

C -Much greater descent of the diaphragm on the right side due to the liver present (two-three times larger)

D -Absent or no change in movement of the diaphragm noted between full inspiration and full expiration measurement

A -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 following would you expect to cause this finding?

A -Severe hypothyroidism

B -Addison's disease

C -Grave's disease

D -Alzhemiers

A -Severe hypothyroidism

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?A -Thyrotoxicosis

B -lodine Excess

C -Myxedema Coma

D -Hashimotos Thyroiditis

C -Myxedema Coma

Your 32 year old female patient presented for a routine health exam states they have a diagnoses of hyperthyroidism by anotherprovider 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?

A -Hypersomnia

B -Tachycardia

C -Lethargy

D -Recent unplanned weight gain

B -Tachycardia

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?

A -6-12 cm in the midsternal line

B -4-8 in the left midclavicular line

C -4-8 cm in the right midclavicular line

D -6-12 cm in the right midclavicular line

D -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 alsosuspected 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?

A -Inspection, auscultation, palpation, percussion

B -Inspection, auscultation, percussion, palpation

C -Percussion, auscultation, palpation, inspection

D -Auscultation, palpation, percussion, inspection

A -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?

A -Guarding

B -Rebound tenderness

C -Absence of pain with withdrawal of palpation

D -Rigidity

C -Absence of pain with withdrawal of palpation

Your 22 year old female patient is seeing you for complaints of sinus pressure and congestion. Which one of the following sinuses should be palpated during your examination?

A -Mandibular

B -Ethmoid

C -Sphenoid

D -Frontal

D -Frontal

Your 49 year old male patient presents with weight loss, night sweats, anhedonia, and a CXR showing profoundly enlarged hilar adenopathy. Based on these findings, a diagnosis of lymphoma would be in your working differential. Which one of the following assessment findings when palpating lymph nodes would be INCONSISTENT with this diagnosis?

A -Hard nodes

B -Fixed nodes

C- Stationary or not moveable with palpation

D -Non-tender, minimally palpable anterior cervical chain node palpation

D -Non-tender, minimally palpable anterior cervical chain node palpation

Your new patient intake history of an elderly man includes a history of Ehlers-Danlos with complications of retinal detachment treated with gas pneumopexy. In discussing this history, you recall the transparent mass of gelatinous material where the gas pneumopexy is performed can be found in which chamber(s) of the eye?

A -None of the above; it's only seen as an abnormal finding with malignancy

B -Anterior only

C -Posterior only

D -Both but greater in the anterior chamber

B -Anterior only

While assessing the patient, you covered their right eye while you covered your left eye, then brought a set number of fingers or wiggling fingers into each quadrant of the patient's visual field while you had them identify when they saw your fingers/movement. A normal exam would be documented as which of the following?

A -Normal confrontation

B -Normal visual acuity

C -Normal refractory reflexes

D -Normal convergence test

A -Normal confrontation

Your late adolescent female patient presents with a history of heavy menses and pale conjunctiva. Your review of systems is fairly unremarkable other than she lives in a house built in 1965, has an unrestricted diet, and her family heredity is Italian. She denies any history of chronic health conditions. Initial CBC with differential shows a microcytic hypochromic anemia which has not yet been diagnosed or treated and the red cell distribution width (RDW) is elevated at 15%. Based on the most common cause of microcytic hypochromic anemia, which of the following labs will you order first?

A -B12 and Folate

B -Gel Electrophoresis

C -Serum Lead

D -TIBC and Ferritin

D -TIBC and Ferritin

A patient of Mediterranean descent who presents with microcytic anemia with normal red cell distribution width should be evaluated using gel electrophoresis to confirm which of the following types of anemia?

A -Aplastic

B -Thalassemia

C -Iron deficiency

D -Pernicious

B -Thalassemia

The 43 year old male patient with macrocytic anemia should be evaluated for which of the following lab levels to help narrow down the etiology?

A -Vitamin B12

B -Lead level

C -Ferritin

D -TIBC

A -Vitamin B12

While assessing the complete metabolic profile of the 66 year old female patient with end stage renal disease (ESRD) on dialysis, you find a creatinine of 4.3, BUN of 62, phos of 5.2. On review of the CBC with differential, you would anticipate which of the following levels?

A -Normal MCH, Hemoglobin 9.6

B -Elevated MCH. Hemoglobin 14.5

C -Low RDW, Elevated MCV

D -Low MCV, Hemoglobin 13.4

A -Normal MCH, Hemoglobin 9.6

Your patient has just been diagnosed with Hepatitis A. Which of the following immunoglobulin are first to be elevated in the serum?

A -IgD

B -IgG

C -IgA

D -IgM

D -IgM

Your patient had a history of Hepatitis A approximately one year ago. Which of the following immunoglobulin is most likely to be elevated at this time?

A -IgD

B -IgA

C -IgG

D -IgM

C -IgG

Your 32 year old female patient presents with a suspected diagnosis of systemic lupus erythematous (SLE). Which of the useful labs in making the diagnosis of SLE?

A -Gel electrophoresis

B -Antinuclear antibody

C -Rheumatoid factor lab

D -Spectrophotometric assay

B -Antinuclear antibody

Which one of the following sweat glands concentrated in the palms of the hands and soles of the feet and is involved in temperature regulation?

A -Sebaceous

B -Apocrine

C -Eccrine

D -Epidermis

C -Eccrine

Your 53 year old female patient with pale skin and easy freckling presents for a skin survey due to their family history of skin cancer. When screening for melanoma, which one of the following findings would be considered a suspicious feature of a mole characteristic of a possible melanoma?

A -Regular border

B -Diameter of 0.3 cm

C -Dual color, particularly white-reddish or blue-black

D -Symmetry of the lesion, mirror-like image when divided in half

C -Dual color, particularly white-reddish or blue-black

The diagnosis of anxiety in your 28-year-old male patient may be differentiated from hyperthyroidism following testing?

A -Free cortisol

B -Electrocardiogram

C -PHQ-9 screening

D -TSH and free T4

D -TSH and free T4

Your schizophrenic patient is agitated during your exam and states "what is that awful taste?" This is an example of which of the types of hallucinations?

A -Visual

B -Limbic

C -Olfactory

D -Gustatory

D -Gustatory

Your patient has made an attempt on their own life, and has survived. In assessing them, it is important the nurse practitioner recognize that patients with a history of self-harm need to be evaluated for which of the following underlying disease states, which is the most common co-diagnosis in patients who have made attempts of self-harm?

A -Depression

B -Anxiety

C -Schizophrenia

D -Bipolar Disorder

A -Depression

You are assessing a 26-year-old male patient who complains that his arm hurts. When assessing ROM of the shoulder, you ask him to

touch the opposite scapula by placing his arm up and over the back of his neck, but the patient reports tremendous pain when attempting to do this. Which one of the following would you suspect?

A -Humeral malignancy

B -Rotator cuff injury

C -Ulnar nerve injury

D -Biceps brachii injury

B -Rotator cuff injury

The 19 year old female patient complains of jaw pain anterior and inferior to the ear bilaterally. All of the following are common symptoms of a tempromandibular joint (TMJ) disorder EXCEPT which one?

A -Pain and tenderness with palpation, often increases with chewing

B -Facial asymmetry and unilateral pain with jaw clenching

C -Palpable swelling and tenderness of the joint

D -Relief from pain with joint displacement

D -Relief from pain with joint displacement

Unequal shoulder height with a lateral and rotary curvature of the spine would be associated with which one of the following spinal deformity diagnosis?

A -Scoliosis

B -Rhuematoid Arthritis (RA)

C -Kyphosis

D -Lordosis

A -Scoliosis

You perform a sensory assessment on the face and notice abnormal sensation to sharp/dull testing on the left cheek. Which one of the

following cranial nerves would you expect to cause this abnormality?

A -Cranial nerve V

B -Cranial nerve XI

C -Cranial nerve VI

D -Cranial nerve X

A -Cranial nerve V

During you neurologic examination portion of your comprehensive physical of the new patient to your panel, you perform cranial nerve assessments. Which of the following represents the most effective protocol for assessment of cranial nerve I?

A -Have the patient cover one nostril, take a breath, and then repeat on the other side to assess air flow

B -Examine both the inferior and middle turbinates with a speculum

C -Apply gentle pressure to the nasal tip or alae

D -Have the patient close their eyes and accurately identify two different scents with one nostril closed at a time

D -Have the patient close their eyes and accurately identify two different scents with one nostril closed at a time

While performing sensory cortex testing on your patient, you gave them close their eyes and place a familiar object such as a paper clip, key or pencil in their hand, having them manipulate it skillfully and identify it within 5 seconds. This is known as which of the following tests?

A -Monognometrics

B -Graphesthesia

C -Two Point discrimination

D -Stereognosis

D -Stereognosis

During your physical examination of a 49 year old brain cancer patient, you notice their gag reflex is impaired during the exam. This suggests damage to which one of the following cranial nerves?

A -Abducens

B -Hypoglossal

C -Glossopharyngeal

D -Trigeminal

C -Glossopharyngeal

Your 18 year old patient has recently been diagnosed with streptococcal infection and has been successfully treated with an appropriate

antimicrobial agent. They have no other noteworthy health history, chronic illness, or medications on record. They are complaining to day of hematuria. RBC casts on urinalysis with microscopy have been identified during this visit. Based on this finding, you can make the diagnosis of which of the following?

A -Pyelonephritis

B -Bladder cancer

C -Glomerulonephritis

D -Gram negative bacteremia

C -Glomerulonephritis

In addition to patient symptoms of painful urination and frequency, which of the following findings confirms a diagnosis of pyelonephritis?

A -Gram positive bacteria in bloodstream

B -RBC casts on urinalysis with microscopy

C -Enterococcus in urine

D -WBC casts on urinalysis with microscopy

D -WBC casts on urinalysis with microscopy

In assessing your patient with suspected pyelonephritis, the following test may be sensitive to elicit a confirmatory response.

A -Renal punch test

B -Morton's test

C -Murphy's test

D -Romberg test

A -Renal punch test

Your 19 year old female patient presents with groin pain, states they were recently involved with a sexual partner who was sexually promiscuous. You notice they are walking with a shuffling gait and their STI testing was positive for Gonorrhea and Chlamydia. Which of the following evaluations should be considered fi this were left untreated for a prolonged period of time?

A -Echocardiogram

B -Colposcopy

C -Pap smear

D -Hysterosalpingogram

D -Hysterosalpingogram

Your patient has presented with dysfunctional uterine bleeding (DUB). Based on the most common cause of DUB, which of the following lab tests should be ordered by the nurse practitioner first?

A -Vitamin K

B -Serum urine ketones

C -Serum beta human chorionic gonadotropin (HCG)

D -СВС

C -Serum beta human chorionic gonadotropin (HCG)

Your 25 year old female patient presents with a recent history of malodorous discharge from their vagina. Their review of systems includes recent history of douching and multiple sexual partners without protection. Which of the following is not a test used to identify bacterial vaginosis?

A -Gonorrhea and Chlamydia DNA probe

B -pH

C -Whiff test.

D -Clue cells

A -Gonorrhea and Chlamydia DNA probe

The patient with congestive heart failure with an ejection fraction of 35% has become symptomatic with shortness of breath when performing activities of daily living but does not have any symptoms at rest. This is suggestive of New York Heart Association heart

failure classification?

A -Class I

B -Class III

C -Class IV

D -Class I

B -Class III

Your patient has presented with a new onset rapid heart rate that

is irregularly irregular, heart rate 100, BP 120/74, R 16 non labored, and SP02 is 99%. They state this has been going on for a week or so intermittently, but for the last 4 days straight it hasn't stopped. Your first priority intervention for this patient is to do which of the following:

A -Treat with vagal maneuvers for suspected supraventricular tachycardia (SVT)

B -Maintain rate control and anticoagulate prior to rhythm conversion

C -Notify EMS to initiate transport for emergency evaluation

D -Ask about their family cardiac history

B -Maintain rate control and anticoagulate prior to rhythm conversion

You are evaluating a 63 year old male patient with symptoms of chest pressure, arm numbness and tingling, as well as shortness of breath with excursion. Their health history includes diabetes mellitus, hypertension, hyperlipidemia, and rheumatoid arthritis. This

relieves with rest and is not becoming more frequent in the episodes. Based on these findings, you diagnose and plan for the patient includes which of the following?

A -Stable angina, and initiate a long-acting oral nitrate

B -Acute myocardial infarction, and transfer to the hospital via EMS

C -Heart failure, and initiate carvedilol and a loop diuretic

D -Unstable angina, and treat with sublingual nitroglycerin and order a cardiac stress test

D -Unstable angina, and treat with sublingual nitroglycerin and order a cardiac stress test

Your 72 year old female patient with a pertinent medical history of coronary artery bypass grafting (CABG) and aortic valve replacement 7 years ago with a porcine bioprosthetic valve has been previously stable on their medical regimen. Today she complains of near syncope when standing, which she states has been getting worse over the past 6 months but failed to tell anyone as she felt it was just part of natural aging and taking medications. Your workup should include evaluation of which of the following potential cardiac complications?

A -Hypertrophic obstructive cardiomyopathy

B -Coronary arterial disease progression

C -Bioprosthetic aortic valve stenosis

D -Tricuspid regurgitation

C -Bioprosthetic aortic valve stenosis

You are working in an urgent care setting as a NP when a patient presents with shortness of breath after a fall from a ladder earlier this morning. You obtain a chest xray and radiologist on call notifies you that it appears to be a tension pneumothorax. Which one of the following findings would you expect to see on the xray if this was the correct diagnosis?

A -The trachea shifted toward the unaffected side

B -The trachea shifting toward the pneumothorax on inspiration and away from the pneumothorax on expiration

C -The trachea shifted toward the side of the pneumothorax

D -Midline with no movement due to changes in intrapleural pressure

A -The trachea shifted toward the unaffected side

Which one of the following patients would you most anticipate to complain of hemoptysis?

A -Acute asthmatic

B -Acute laryngitis

C -Lung cancer

D -Acute bronchitis

C -Lung cancer

Gladys, a 72 year old patient with a history of anemia of chronic disease from kidney failure, diabetes mellitus, and hypothyroidism presents today with concerns her thyroid medication is not working well enough. Her most recent labs reflect her TSH is 5.9 (normal range 0.5-5 kU/mL) and Free T4 is 0.3 ng/dL (normal range 0.8-2.8 ng/dL). Which one of the following clinical signs and/or symptoms would you expect a patient with these findings to present with?

A -Weight loss

B -Excessive sweating

C -Cold intolerance

D -Palpitations

C -Cold intolerance

The patient you just saw in the clinic a week ago was just admitted to the hospital in hyperthyroid crisis. The nurse practitioner at the

emergency department calls your office to let you know and also ask some information about the patient. They asked about what the patient symptoms were during their most recent a visit a week ago. Which one of the following signs and symptoms would suggest a patient undergoing a hyperthyroid crisis?

A -Hypothermia

B -Lethargy

C -Tachycardia

D -Decreased systolic blood pressure

C -Tachycardia

In evaluating a patient with suspicion of mononucleosis, the nurse

practitioner percusses the left upper quadrant of the abdomen. Which of the following would raise your suspicion of splenomegaly when percussing the spleen?

A -Percussion that changes from tympany to dull as you percuss from the right midaxillary line to the right anterior axillary line

B -Percussion that changes from dull to tympany as you percuss from the left anterior axillary line to the left sternal border

C -Percussion that changes from tympany to dull as you percuss from the right midaxillary line to the right anterior axillary line

D -Percussion that changes from tympany to dull as your percuss from the left anterior axillary line to the left midaxillary line

B -Percussion that changes from dull to tympany as you percuss from the left anterior axillary line to the left sternal border

Your patient has been diagnosed with acanthosis nigricans. Which of the following exam findings would be consistent with the typical presentation of this?

A -Central obesity

B -Severe malnutrion

C -Scaphoidal abdomen

D -Body mass index (BMI) of 22

A -Central obesity

Mike, your 48 year old construction worker patient presents to your clinic with a chief complaint of floaters, some flashes of light, and a curtain coming down over the visual field. As a prudent nurse practitioner, you notify Mike that he needs to be seen by ophthalmology immediately as these are al signs and symptoms of what condition?

A -Cataract

B -Acute angle closure glaucoma

C -Retinal detachment

D -Diabetic retinopathy

C -Retinal detachment

When performing a health history, your 52 year old male patient complains of difficulty hearing people when spoken in the right ear. During physical examination, you perform a Weber test with your patient reporting increased hearing of vibrations in the right ear. Which one of the following would you suspect based on these findings?

A -Left side conductive hearing loss

B -Left side sensorineural hearing loss

C -Bilateral conductive hearing loss

D -Bilateral sensorineural hearing loss

B -Left side sensorineural hearing loss

Your patient has provided you with a research paper about a new treatment plan that is being used, somewhat controversially, in other

areas of the world to treat sinus infections. She asks for your opinion. In reviewing the article, you educate the patient that they should look for which of the following, which are considered the highest level of research quality?

A -Unblinded retrospective analysis

B -Expert opinion statement

C -Cohort study

D -Systematic review

D -Systematic review

A 16-year-old female patient with heavy menses has been diagnosed with iron deficiency anemia. She is also having longer and more irregular periods than is typical as well as extremely painful cramping. You would likely need to consider which of the following diagnoses in your workup:

A -Sarcoidosis

B -Endometriosis

C -Pelvic inflammatory disease

D -Thalassemia

B -Endometriosis

Your 43 year old female patient with no otherwise remarkable health history has a routine health visit and when evaluating the labwork, you notice a platelet count of 80,000. Which of the following is a correct diagnosis for this patient?

A -Thrombastemia

B -Pancytopenia

C -Thrombocytopenia

D -Thrombocytosis

C -Thrombocytopenia

After a recent hospitalization for weakness, a diagnosis of myasthenia gravis has been made in a patient under your long term management. In the process of the examination, a CT of the chest was performed, and an object was identified as enlarged and wasremarked that it needs to be removed as it is thought to be related to this diagnosis. The patient now in your clinic states they don't remember what the object was and hoped you might know. The prudent nurse practitioner understands that the item likely represents which of the following?

A -Potts tumor

B -Coumeral's diverticulum

C -Arenal tumor

D -Thymic remnant

D -Thymic remnant

While working as a volunteer nurse practitioner at a college football game, a 17 year old female patient who was at the football game has received a bee sting. She is experiencing swelling of the face and is having difficulty breathing. Which of the following represents

the most common diagnosis?

A -Type 2 hypersensitivity reaction

B -Angioedema

C -Tachyphylaxis

D -IgE mediated type 1 hypersensitivity reaction

D -IgE mediated type 1 hypersensitivity reaction

As a prudent nurse practitioner, you know that a 28 year old male patient with human immunodeficiency virus (HIV) would be considered well managed when they have which of the following in addition to having undetectable or very low viral copies?

A -CD4 count of 100

B -CD4 count undetectable

C -CD4 count of 500

D -CD4 count of 50

C -CD4 count of 500

Your 22 year old female patient has been identified by lab work for a diagnosis of Systemic Lupus Erythematous (SLE). In addition to lab work, SLE is most commonly identified by which of the following findings?

A -Butterfly rash on the face

B -Myoglobinuria

C -Elevated WBC count

D -Diffuse rash on the torso

A -Butterfly rash on the face