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APEA PRE-PREDICTOR TEST EXAM ALL QUESTIONS AND
100% CORRECT ANSWERS|| MOST RECENT AND COMPLET
VERSION ALREADY GRADED A+
1) A 15 years old high school student with a mild sore throat and low-grade
fever that has persisted for about 3 weeks. She reports general malaise, fatigue,
and loss of appetite. The NP suspects mononucleosis. Which of the following is
the LEAST appropriate intervention?
a. Palpate the lymph nodes and spleen
b. Examine the posterior oropharynx for petechiae
c. Obtain a CBC, throat culture, and heterophil antibody test.
d. Obtain an urinalyses and serum for LFTs and amylase
Explanation: mononucleosis is a symptomatic infection caused by the Epstein-Bar
virus. Common is people 15-24 years of age. Common signs and symptoms
following incubation period (1-2 months) include fatigue, chills, malaise, anorexia,
white tonsillar exudates and lymphadenopathy or posterior cervical region.
Splenomegaly can be present. A maculopapular or occasionally a petechial rash
occurs in less than 15% of patients. A diagnosis is usually made using the
Monospot. In addition, neutropenia and lymphocytosis are usually detected in the
CBC.
2) A 32 years old male patient complaint of urinary frequency and burning on
urination for 3 days. Urinalyses reveals bacteriuria and positive nitrites. He denies
any past hx. Of urinary tract infections. The initial treatment should be:
a. trimethoprim-sulfamethoxazole (Bactrim, Sulfatrim) for 7-10 day
b. ciprofloxacin (Cipro) for 3-5 days
c. Trimethoprim-Sulfamethoxazole for 3 days
d. 750 mg ciprofloxacin as a one-time dose
Explanation: trimethoprim-sulfamethoxazole (TMPS) is usually n appropriate
medication to treat urinary tract infections in most patients. In the case of
community resistance to TMPS
>20%^, another medication should be substituted. In men, the appropriate length
of time is 7-10 days. Women may be treated for 3 days for uncomplicated UTI
3) Which agent is most effective for the treatment of nodulocystic acne?
a. Benzoyl peroxide (Benzac)
b. Retinoic acid (Retin A)
c. Topical tetracycline
d. Isotretinoin)
Explanation: Isotretinoin (Accutane) is a systemic agent indicated for treatment
with severe inflammatory acne. Guidelines for its use must be clearly understood
by the patient. A woman of childbearing age must use an effective method of
contraception because isotretinoin is teratogenic. There are many restrictions in
prescribing this medication because of the teratogenic effects is given during
pregnancy. Therefore, it is a pregnancy category X.
4) An 18 y/o woman is taking a combined hormonal oral contraceptive.
She should be instructed to use a backup method for the prevention of
pregnancy
a. Throughout the week of placebo pills
b. If prescribed topiramate (Topamax) for the treatment of migraines.
,c. If prescribed amoxicillin/clavulanate (Augmentin) for a sinus infection
d. if she forgets to take a single dose of the contraceptive
Explanation: Anticonvulsant including phenytoin (Dilantin), carbamazepine
(Tegretol), primidone (Mysoline), topiramate (Topamax) and oxcarbazepine
(Trileptal) reduce the effectiveness of contraceptives. Depo-medroxyprogesterone
acetate injections or levonorgestrel- releasing intrauterine devices would be a
better method of contraceptive for patients taking anticonvulsants. Most commonly
used antibiotics have not been proven to reduce the effectiveness of
contraceptives. Rifampin is an exception, and additional …. Be used by women
taking this drug and using oral contraceptives, transdermal, or vaginal ring
preparations.
Additional backup contraception should be used if taking antifungal agents. No
additional protection is needed thought the week of placebo pills. Missing one
single dose of contraceptive does not require additional protection, missing more
than one doses does.
5) A 44 years old female patient has diabetes. Her total cholesterol (TC) is 250
mg/dl (6.5 mmol/L), LDL= 190 mg/dL (4.94 mmol/L), HDL= 25 mg/dL (65 mmol/L),
and triglycerides= 344 mg/dL (8.94 mmol/L). What agent have the greatest effect
on improving her lipid profile and reducing morbidity and mortality associates with
dyslipidemia?
a. Niacin (Niaspan)
b. Atorvastatin
c. Omega 3 fatty acids
d. Fenofibrates
Explanation: First and foremost, it is essential to educate individuals on a heart-
healthy lifestyle. LDL-C is one of the major culprits in the development of
atherosclerotic heart disease. The target level of LDL-C is between 50 to 70mg/dl to
prevent plaque formation in the blood vessels. Guidelines strongly recommend
statin therapy because they primarily lower LDL-C levels, but they also have the
secondary effects of lowering triglyceride and increasing HDL-C levels.
6) A 30 years old female comes into a clinic with classic signs and symptoms of
appendicitis. The NP fails to refer the patient to a surgeon. The appendix ruptures
and the woman die. This is an example of
a. Failure of diligence
b. Professional liability
c. Negligence
d. Malpractice
Explanation: malpractice, a negligence tort, occurs when a health care
professional’s actions fall bellow the appropriate standard of care and hurts the
patient. In this case the patient came with sings and symptoms indicating
appendicitis and the NP failed to refer the patient..
7) A NP has recently been hired to work in a fast track facility. The NP
employer asked if she has “a problem prescribing medications for emergency
contraception.” The NP replies affirmatively. This is:
a. Grounds for dismissal
b. An ethical dilemma for the NP
b. Illegal according to the standards of nursing
c. Patient abandonment.
Explanation: in this instance, the NP has a difference of opinion with her employer
based on her religious or moral belief about providing emergency contraception.
,This situation is an example of an ethical dilemma. Failure to participate in the
provision of care to the patient based on the NP’s beliefs is neither against the law
nor a violation of the standards of practice
8) A patient presents with pruritic lesions on both knees. There are visible silver
scales. How Should this condition be managed?
a. Topical antifungal cream or ointment
b. Oral antibiotics
c. Topical corticosteroids cream
d. Topical anti-fungal/ steroid cream
Explanation: Psoriasis is characterized by erythematous papules, as well as itchy,
red, precisely defined plaques with silvery scales. Auspitz sings is another common
finding. Topical agents containing tar and salicylic acid may be used. Topical
steroids, such as betamethasone, may also be ordered.
9) Antidepressant discontinuation syndrome is less likely if the patient
a. Is male
b. Is less than 35 y/o
c. Has taken an SSRI with a short half life
d. Gradually tapers SSRI use
Explanation: Antidepressant discontinuation syndrome is most often seen in the
primary care office in association with SSRI discontinuation, because SSRIs are the
most commonly prescribed class of antidepressant medications. Interruption of
treatment with an anti-depressant medication is sometimes associated with an
antidepressant discontinuation syndrome; in early reports it was referred to as a
“withdrawal reaction. Symptoms of antidepressant discontinuation syndrome can
include flu-like symptoms, insomnia, nausea, imbalance, sensory disturbances,
and hyperarousal. Tapering is recommended by experts.
10) Patient with benign prostatic hyperplasia (BPH) should be taught to avoid
which one of the following drug classes?
a. Alpha adrenergic antagonist
b. Anti-androgen agents
c. Tricyclic antidepressant (TCA)
d. Sulfonamides
Explanation: tricyclic antidepressant should not be used by men with benign
prostatic hyperplasia because of the increased risk of urinary retention secondary
to the anticholigergic effects of TCAs.
11) Which of the following is the best response to a woman who has just
admitted she is a victim of spousal abuse?
a. What was if you did to make him angry?
b. You must seek refuge immediately
c. I am concerned about your safety
d. I am going to call a shelter for you
Explanation: The first step is to establish trust in the therapeutic relationship.
without trust future collaboration, intervention and client outcome cannot be
accomplished to facilitate appropriate and safe behavior. The experience of abuse
is a traumatic psychological crisis that must be addressed as such. The healthcare
providers must emphasize the fact that the victim has not done anything wrong and
they must also emphasize the fact that the victim's life and the lives of their
children can be in danger if the abuse is not addressed. It will not disappear with a
lack of action. An order of protection against the perpetrator is often
recommended.
, 12) For which patient group does the US Preventive Services Task Force
recommend routine screening for asymptomatic bacteriuria
a. pregnant woman
b. Children
c. Patients with diabetes
d. patients over the age of 70
Explanation: an increased incidence of bacteriuria is found in all the population
listed. However, bacteriuria in pregnant women increases the mother…..Also
increased is the risk of a pre-term delivery, which then increases perinatal and fetal
morbidity and mortality. The recommended it….
13) What diabetic complications result from hyperglycemia?
1. Retinopathy
2. Hypertension resistant to treatment
3. Peripheral neuropathy
4. Accelerated atherosclerosis
a. 1,2,3
b. 2,3,4
c. 1,3,4
d. 1,2,4
explanation: Complications of untreated or uncontrolled hyperglycemia over a
prolonged period of time include:
Microvascular complications: Retinopathy, Nephropathy, Neuropathy
Macrovascular complications: Coronary artery disease, Cerebrovascular disease,
Peripheral vascular disease
14) A 6 y/o presents w/ complaints of sore throat and fever for 2 days. He has
multiple vesiculated ulcerations on his tonsils and uvula. There are no other
remarkable findings. What is the most likely diagnosis?
a. Viral pharyngitis
b. Herpangina
c. Epiglottitis
d. Tonsillitis
Explanation: Herpangina is a viral infection common in toddlers and young
children caused by Coxsackie virus. The clinical findings of numerous, small (1-2
mm) ulcerations on the tonsils and uvula are typical of herpangina. The ulcerations
can be very painful but usually resolve in 7 to 10 days. Treatment is symptomatic.
15) A patient has Kawasaki syndrome. Which characteristics would be UNUSUAL?
a. Age > 15 years
b. Fever > 101 F (38.3 C)
c. Exudative pharyngitis
d. Painful rash
explanation: Kawasaki disease is an acute febrile vasculitis syndrome that
evolves inflammation of the blood vessels. This condition often causes cardiac
complication in children by damaging the coronary arteries is most prevalent in
children of Asian ethnicity. Diagnosis of Kawasaki disease requires presentation of
fever and 4 of the following criteria: bilateral bulbar conjunctival injection, oral
mucous membrane changes, peripheral extremity changes, polymorphous rash,
and cervical lymphadenopathy.
16) According to the JNC 8 guideline hypertension in a 40 y/o can be diagnosed
when blood pressure exceeds
a. 140/90
b. 130/90
c. 125/85
d. 150/100
Explanation: According to JNC 8 guidelines, hypertension is a sustained elevation
APEA PRE-PREDICTOR TEST EXAM ALL QUESTIONS AND
100% CORRECT ANSWERS|| MOST RECENT AND COMPLET
VERSION ALREADY GRADED A+
1) A 15 years old high school student with a mild sore throat and low-grade
fever that has persisted for about 3 weeks. She reports general malaise, fatigue,
and loss of appetite. The NP suspects mononucleosis. Which of the following is
the LEAST appropriate intervention?
a. Palpate the lymph nodes and spleen
b. Examine the posterior oropharynx for petechiae
c. Obtain a CBC, throat culture, and heterophil antibody test.
d. Obtain an urinalyses and serum for LFTs and amylase
Explanation: mononucleosis is a symptomatic infection caused by the Epstein-Bar
virus. Common is people 15-24 years of age. Common signs and symptoms
following incubation period (1-2 months) include fatigue, chills, malaise, anorexia,
white tonsillar exudates and lymphadenopathy or posterior cervical region.
Splenomegaly can be present. A maculopapular or occasionally a petechial rash
occurs in less than 15% of patients. A diagnosis is usually made using the
Monospot. In addition, neutropenia and lymphocytosis are usually detected in the
CBC.
2) A 32 years old male patient complaint of urinary frequency and burning on
urination for 3 days. Urinalyses reveals bacteriuria and positive nitrites. He denies
any past hx. Of urinary tract infections. The initial treatment should be:
a. trimethoprim-sulfamethoxazole (Bactrim, Sulfatrim) for 7-10 day
b. ciprofloxacin (Cipro) for 3-5 days
c. Trimethoprim-Sulfamethoxazole for 3 days
d. 750 mg ciprofloxacin as a one-time dose
Explanation: trimethoprim-sulfamethoxazole (TMPS) is usually n appropriate
medication to treat urinary tract infections in most patients. In the case of
community resistance to TMPS
>20%^, another medication should be substituted. In men, the appropriate length
of time is 7-10 days. Women may be treated for 3 days for uncomplicated UTI
3) Which agent is most effective for the treatment of nodulocystic acne?
a. Benzoyl peroxide (Benzac)
b. Retinoic acid (Retin A)
c. Topical tetracycline
d. Isotretinoin)
Explanation: Isotretinoin (Accutane) is a systemic agent indicated for treatment
with severe inflammatory acne. Guidelines for its use must be clearly understood
by the patient. A woman of childbearing age must use an effective method of
contraception because isotretinoin is teratogenic. There are many restrictions in
prescribing this medication because of the teratogenic effects is given during
pregnancy. Therefore, it is a pregnancy category X.
4) An 18 y/o woman is taking a combined hormonal oral contraceptive.
She should be instructed to use a backup method for the prevention of
pregnancy
a. Throughout the week of placebo pills
b. If prescribed topiramate (Topamax) for the treatment of migraines.
,c. If prescribed amoxicillin/clavulanate (Augmentin) for a sinus infection
d. if she forgets to take a single dose of the contraceptive
Explanation: Anticonvulsant including phenytoin (Dilantin), carbamazepine
(Tegretol), primidone (Mysoline), topiramate (Topamax) and oxcarbazepine
(Trileptal) reduce the effectiveness of contraceptives. Depo-medroxyprogesterone
acetate injections or levonorgestrel- releasing intrauterine devices would be a
better method of contraceptive for patients taking anticonvulsants. Most commonly
used antibiotics have not been proven to reduce the effectiveness of
contraceptives. Rifampin is an exception, and additional …. Be used by women
taking this drug and using oral contraceptives, transdermal, or vaginal ring
preparations.
Additional backup contraception should be used if taking antifungal agents. No
additional protection is needed thought the week of placebo pills. Missing one
single dose of contraceptive does not require additional protection, missing more
than one doses does.
5) A 44 years old female patient has diabetes. Her total cholesterol (TC) is 250
mg/dl (6.5 mmol/L), LDL= 190 mg/dL (4.94 mmol/L), HDL= 25 mg/dL (65 mmol/L),
and triglycerides= 344 mg/dL (8.94 mmol/L). What agent have the greatest effect
on improving her lipid profile and reducing morbidity and mortality associates with
dyslipidemia?
a. Niacin (Niaspan)
b. Atorvastatin
c. Omega 3 fatty acids
d. Fenofibrates
Explanation: First and foremost, it is essential to educate individuals on a heart-
healthy lifestyle. LDL-C is one of the major culprits in the development of
atherosclerotic heart disease. The target level of LDL-C is between 50 to 70mg/dl to
prevent plaque formation in the blood vessels. Guidelines strongly recommend
statin therapy because they primarily lower LDL-C levels, but they also have the
secondary effects of lowering triglyceride and increasing HDL-C levels.
6) A 30 years old female comes into a clinic with classic signs and symptoms of
appendicitis. The NP fails to refer the patient to a surgeon. The appendix ruptures
and the woman die. This is an example of
a. Failure of diligence
b. Professional liability
c. Negligence
d. Malpractice
Explanation: malpractice, a negligence tort, occurs when a health care
professional’s actions fall bellow the appropriate standard of care and hurts the
patient. In this case the patient came with sings and symptoms indicating
appendicitis and the NP failed to refer the patient..
7) A NP has recently been hired to work in a fast track facility. The NP
employer asked if she has “a problem prescribing medications for emergency
contraception.” The NP replies affirmatively. This is:
a. Grounds for dismissal
b. An ethical dilemma for the NP
b. Illegal according to the standards of nursing
c. Patient abandonment.
Explanation: in this instance, the NP has a difference of opinion with her employer
based on her religious or moral belief about providing emergency contraception.
,This situation is an example of an ethical dilemma. Failure to participate in the
provision of care to the patient based on the NP’s beliefs is neither against the law
nor a violation of the standards of practice
8) A patient presents with pruritic lesions on both knees. There are visible silver
scales. How Should this condition be managed?
a. Topical antifungal cream or ointment
b. Oral antibiotics
c. Topical corticosteroids cream
d. Topical anti-fungal/ steroid cream
Explanation: Psoriasis is characterized by erythematous papules, as well as itchy,
red, precisely defined plaques with silvery scales. Auspitz sings is another common
finding. Topical agents containing tar and salicylic acid may be used. Topical
steroids, such as betamethasone, may also be ordered.
9) Antidepressant discontinuation syndrome is less likely if the patient
a. Is male
b. Is less than 35 y/o
c. Has taken an SSRI with a short half life
d. Gradually tapers SSRI use
Explanation: Antidepressant discontinuation syndrome is most often seen in the
primary care office in association with SSRI discontinuation, because SSRIs are the
most commonly prescribed class of antidepressant medications. Interruption of
treatment with an anti-depressant medication is sometimes associated with an
antidepressant discontinuation syndrome; in early reports it was referred to as a
“withdrawal reaction. Symptoms of antidepressant discontinuation syndrome can
include flu-like symptoms, insomnia, nausea, imbalance, sensory disturbances,
and hyperarousal. Tapering is recommended by experts.
10) Patient with benign prostatic hyperplasia (BPH) should be taught to avoid
which one of the following drug classes?
a. Alpha adrenergic antagonist
b. Anti-androgen agents
c. Tricyclic antidepressant (TCA)
d. Sulfonamides
Explanation: tricyclic antidepressant should not be used by men with benign
prostatic hyperplasia because of the increased risk of urinary retention secondary
to the anticholigergic effects of TCAs.
11) Which of the following is the best response to a woman who has just
admitted she is a victim of spousal abuse?
a. What was if you did to make him angry?
b. You must seek refuge immediately
c. I am concerned about your safety
d. I am going to call a shelter for you
Explanation: The first step is to establish trust in the therapeutic relationship.
without trust future collaboration, intervention and client outcome cannot be
accomplished to facilitate appropriate and safe behavior. The experience of abuse
is a traumatic psychological crisis that must be addressed as such. The healthcare
providers must emphasize the fact that the victim has not done anything wrong and
they must also emphasize the fact that the victim's life and the lives of their
children can be in danger if the abuse is not addressed. It will not disappear with a
lack of action. An order of protection against the perpetrator is often
recommended.
, 12) For which patient group does the US Preventive Services Task Force
recommend routine screening for asymptomatic bacteriuria
a. pregnant woman
b. Children
c. Patients with diabetes
d. patients over the age of 70
Explanation: an increased incidence of bacteriuria is found in all the population
listed. However, bacteriuria in pregnant women increases the mother…..Also
increased is the risk of a pre-term delivery, which then increases perinatal and fetal
morbidity and mortality. The recommended it….
13) What diabetic complications result from hyperglycemia?
1. Retinopathy
2. Hypertension resistant to treatment
3. Peripheral neuropathy
4. Accelerated atherosclerosis
a. 1,2,3
b. 2,3,4
c. 1,3,4
d. 1,2,4
explanation: Complications of untreated or uncontrolled hyperglycemia over a
prolonged period of time include:
Microvascular complications: Retinopathy, Nephropathy, Neuropathy
Macrovascular complications: Coronary artery disease, Cerebrovascular disease,
Peripheral vascular disease
14) A 6 y/o presents w/ complaints of sore throat and fever for 2 days. He has
multiple vesiculated ulcerations on his tonsils and uvula. There are no other
remarkable findings. What is the most likely diagnosis?
a. Viral pharyngitis
b. Herpangina
c. Epiglottitis
d. Tonsillitis
Explanation: Herpangina is a viral infection common in toddlers and young
children caused by Coxsackie virus. The clinical findings of numerous, small (1-2
mm) ulcerations on the tonsils and uvula are typical of herpangina. The ulcerations
can be very painful but usually resolve in 7 to 10 days. Treatment is symptomatic.
15) A patient has Kawasaki syndrome. Which characteristics would be UNUSUAL?
a. Age > 15 years
b. Fever > 101 F (38.3 C)
c. Exudative pharyngitis
d. Painful rash
explanation: Kawasaki disease is an acute febrile vasculitis syndrome that
evolves inflammation of the blood vessels. This condition often causes cardiac
complication in children by damaging the coronary arteries is most prevalent in
children of Asian ethnicity. Diagnosis of Kawasaki disease requires presentation of
fever and 4 of the following criteria: bilateral bulbar conjunctival injection, oral
mucous membrane changes, peripheral extremity changes, polymorphous rash,
and cervical lymphadenopathy.
16) According to the JNC 8 guideline hypertension in a 40 y/o can be diagnosed
when blood pressure exceeds
a. 140/90
b. 130/90
c. 125/85
d. 150/100
Explanation: According to JNC 8 guidelines, hypertension is a sustained elevation
