20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
APEA PRE-PREDICTOR NP EXAM
1. Prescriptive authority:: may be exercised by giving a verbal medication order to
a pharmacist.
An example of exercising prescriptive authority is giving a verbal order to a pharma-
cist or writing an order for a prescription medication. Prescriptive authority rules and
regulations vary from state to state. Prescriptive authority is granted only to those
APRNs who meet the requirements of the governing body for the state in which the
APRN practices.
2. When examining a pregnant patient, where should the fundal height be at
22 weeks?: Above the umbilicus
Between 18 and 32 weeks, there is good correlation between fundal height and
gestational age of the fetus. The expected heights are: 10-12 weeks: fundus slightly
20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
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, 20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
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above the symphysis pubis 16 weeks: fundus midway between the symphysis pubis
and umbilicus 20 weeks: fundus at the level of umbilicus 28 weeks: fundus 3
fingerbreadths above the umbilicus 36 weeks: fundus just below the xiphoid process
3. What intervention does the American College of Rheumatology recommend
as first-line therapy for osteoarthritis?: Exercise and weight loss
Exercise, weight loss, and rest are recommended by the American College of
Rheumatology guidelines for the initial management of osteoarthritis (OA). Given the
adverse effects of medications used to treat OA, it is best to minimize dosage and
delay use as long as possible. An extensive diagnostic workup is not recommended
unless the presentation is in question. Patients who have severe degenerative
joint disease (DJD), joint fusion, or whose pain severity is not relieved by more
conservative therapies may be candidates for joint replacement. Acetaminophen is
recommended as a first-line medication.
4. A 63-year-old male retired accountant complains of pain and stiffness in
his feet and hands of several years duration. He reports that the pain and
20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
, 20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
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20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
stiffness become worse with activity. On examination, he is noted to have
Heberden's nodes but no other bony deformities. Which of the following is the
most probable diagnosis?: Osteoarthritis (OA)
Although his vocation involved sedentary activity, this patient is not at great risk
for osteoarthritis. Rheumatoid arthritis is characterized by several joint deformities,
usually bilaterally symmetrical. RA is characterized by inflammatory processes,
while OA is not. RA and OA are chronic conditions. Gout is characterized by
acute exacerbations related to a defect in purine metabolism, increased uric acid
production, or decreased uric acid excretion.
20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
, 20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
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5. The family of a 78-year-old man moved him into an assisted living center
because he can no longer be left at home alone. He is unable to toilet when
asked to do so and he has had several episodes of incontinence. He has
walked out of the facility twice and been unable to find his way back from 3
blocks away. On examination, he is pleasant but mildly confused. Which of his
medications is LEAST likely contributing to his behavior?: ramipril (Altace)
Tricyclic antidepressants, like amitriptyline, have anticholinergic side effects which
are especially problematic in the elderly because they contribute to urinary retention.
Hydrochlorothiazide is a diuretic and may contribute to his incontinence. Cimetidine
is well known to produce adverse reactions such as confusion in elders. Ramipril,
an ACE inhibitor, is unlikely to contribute to this patient's incontinence or confusion.
Toileting may be a complicated by the anticholinergic medication and/or the diuretic
causing diuresis, urge incontinence, and inability to void at will.
6. A patient with no significant medical history has varicose veins. She com-
20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
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20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
APEA PRE-PREDICTOR NP EXAM
1. Prescriptive authority:: may be exercised by giving a verbal medication order to
a pharmacist.
An example of exercising prescriptive authority is giving a verbal order to a pharma-
cist or writing an order for a prescription medication. Prescriptive authority rules and
regulations vary from state to state. Prescriptive authority is granted only to those
APRNs who meet the requirements of the governing body for the state in which the
APRN practices.
2. When examining a pregnant patient, where should the fundal height be at
22 weeks?: Above the umbilicus
Between 18 and 32 weeks, there is good correlation between fundal height and
gestational age of the fetus. The expected heights are: 10-12 weeks: fundus slightly
20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
, 20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
above the symphysis pubis 16 weeks: fundus midway between the symphysis pubis
and umbilicus 20 weeks: fundus at the level of umbilicus 28 weeks: fundus 3
fingerbreadths above the umbilicus 36 weeks: fundus just below the xiphoid process
3. What intervention does the American College of Rheumatology recommend
as first-line therapy for osteoarthritis?: Exercise and weight loss
Exercise, weight loss, and rest are recommended by the American College of
Rheumatology guidelines for the initial management of osteoarthritis (OA). Given the
adverse effects of medications used to treat OA, it is best to minimize dosage and
delay use as long as possible. An extensive diagnostic workup is not recommended
unless the presentation is in question. Patients who have severe degenerative
joint disease (DJD), joint fusion, or whose pain severity is not relieved by more
conservative therapies may be candidates for joint replacement. Acetaminophen is
recommended as a first-line medication.
4. A 63-year-old male retired accountant complains of pain and stiffness in
his feet and hands of several years duration. He reports that the pain and
20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
, 20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
stiffness become worse with activity. On examination, he is noted to have
Heberden's nodes but no other bony deformities. Which of the following is the
most probable diagnosis?: Osteoarthritis (OA)
Although his vocation involved sedentary activity, this patient is not at great risk
for osteoarthritis. Rheumatoid arthritis is characterized by several joint deformities,
usually bilaterally symmetrical. RA is characterized by inflammatory processes,
while OA is not. RA and OA are chronic conditions. Gout is characterized by
acute exacerbations related to a defect in purine metabolism, increased uric acid
production, or decreased uric acid excretion.
20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
, 20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
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20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
5. The family of a 78-year-old man moved him into an assisted living center
because he can no longer be left at home alone. He is unable to toilet when
asked to do so and he has had several episodes of incontinence. He has
walked out of the facility twice and been unable to find his way back from 3
blocks away. On examination, he is pleasant but mildly confused. Which of his
medications is LEAST likely contributing to his behavior?: ramipril (Altace)
Tricyclic antidepressants, like amitriptyline, have anticholinergic side effects which
are especially problematic in the elderly because they contribute to urinary retention.
Hydrochlorothiazide is a diuretic and may contribute to his incontinence. Cimetidine
is well known to produce adverse reactions such as confusion in elders. Ramipril,
an ACE inhibitor, is unlikely to contribute to this patient's incontinence or confusion.
Toileting may be a complicated by the anticholinergic medication and/or the diuretic
causing diuresis, urge incontinence, and inability to void at will.
6. A patient with no significant medical history has varicose veins. She com-
20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
20241007204521_6704486147d6e_apea_pre_predictor_np_exam.docx
