NSG 6998
APEA Post Predictor Final Exam
Questions and Answers | South University| Latest Update
Q1. A 50-year-old average-risk patient asks when to begin colorectal cancer
screening. What is the most appropriate response?
A. At age 40
B. At age 45
C. Only if symptomatic
D. At age 55
Correct Answer: B. At age 45
Rationale: Current guidelines (USPSTF/ACS) recommend average-risk adults
begin colorectal cancer screening at age 45, reflecting rising colorectal cancer
incidence in younger adults.
Q2. Which lipid screening interval is appropriate for an average-risk adult with a
normal initial lipid panel?
A. Only once in a lifetime
B. Every 10 years
C. Annually
D. Every 4-6 years
Correct Answer: D. Every 4-6 years
Rationale: For average-risk adults with normal results, repeat lipid screening
every 4 to 6 years is generally recommended unless risk factors change.
Q3. A 65-year-old male who has never smoked asks about lung cancer screening.
What is the most appropriate response?
A. He should have annual low-dose CT regardless of smoking history
B. He should have a chest x-ray annually
C. Screening is not indicated because he lacks a significant smoking history
D. He should be screened only if he develops a cough
, Correct Answer: C. Screening is not indicated because he lacks a significant
smoking history
Rationale: USPSTF lung cancer screening criteria require a significant pack-year
smoking history (current or former smoker within 15 years) in addition to age
criteria; screening is not recommended for never-smokers.
Q4. What is the recommended screening interval for cervical cytology alone
(Pap test without HPV co-testing) in a healthy 25-65 year old woman?
A. Every 10 years
B. Every 6 months
C. Every 3 years
D. Every year
Correct Answer: C. Every 3 years
Rationale: For average-risk women aged 25-65, cytology alone every 3 years is
one acceptable strategy (alternatively, primary HPV testing every 5 years or co-
testing every 5 years).
Q5. A patient asks about the recommended age to begin routine screening
mammography for average-risk women. What should the nurse practitioner
recommend?
A. Beginning at age 30
B. Beginning at age 40
C. Beginning only after menopause
D. Beginning at age 50 only
Correct Answer: B. Beginning at age 40
Rationale: Updated USPSTF guidance recommends biennial mammography
screening beginning at age 40 for average-risk women, reflecting a lowered
starting age from prior recommendations.
Q6. Which vaccine is recommended for all adults age 19-59 without prior
vaccination as part of routine adult immunization, particularly given rising
incidence?
A. Hepatitis B vaccine
B. BCG vaccine
C. Yellow fever vaccine
, D. Japanese encephalitis vaccine
Correct Answer: A. Hepatitis B vaccine
Rationale: Hepatitis B vaccination is now recommended for all previously
unvaccinated adults aged 19-59 as part of universal adult immunization
recommendations.
Q7. An asymptomatic 68-year-old male former smoker is being evaluated for
abdominal aortic aneurysm screening. What is the recommended one-time
screening approach?
A. MRI every 5 years
B. No screening is recommended
C. Annual CT scan of the abdomen
D. One-time abdominal ultrasound
Correct Answer: D. One-time abdominal ultrasound
Rationale: USPSTF recommends a one-time abdominal ultrasound screening
for AAA in men aged 65-75 who have ever smoked.
Cardiovascular
Q8. A 58-year-old with hypertension and type 2 diabetes has an LDL of 110
mg/dL. According to ACC/AHA guidelines, what is the most appropriate initial
pharmacologic therapy?
A. Fibrate therapy
B. Niacin therapy
C. Moderate-to-high intensity statin
D. Bile acid sequestrant
Correct Answer: C. Moderate-to-high intensity statin
Rationale: Statins are first-line therapy for LDL reduction and cardiovascular
risk reduction in patients with diabetes and additional risk factors such as
hypertension.
Q9. A patient presents with crushing substernal chest pain radiating to the left
arm, diaphoresis, and ST-elevation on ECG in leads II, III, and aVF. Which
coronary artery is most likely involved?
A. Right coronary artery
, B. Left main coronary artery
C. Left circumflex artery
D. Left anterior descending artery
Correct Answer: A. Right coronary artery
Rationale: ST elevation in the inferior leads (II, III, aVF) typically corresponds to
occlusion of the right coronary artery, which supplies the inferior wall in most
individuals.
Q10. Which physical exam finding is most consistent with aortic stenosis?
A. Holosystolic murmur best heard at the apex radiating to the axilla
B. Harsh crescendo-decrescendo systolic murmur radiating to the carotids
C. Diastolic decrescendo murmur at the left sternal border
D. Mid-systolic click with late systolic murmur
Correct Answer: B. Harsh crescendo-decrescendo systolic murmur radiating
to the carotids
Rationale: Aortic stenosis classically produces a harsh, crescendo-decrescendo
(diamond-shaped) systolic ejection murmur best heard at the right upper
sternal border that radiates to the carotid arteries.
Q11. A patient with atrial fibrillation has a CHA2DS2-VASc score of 3. What is
the most appropriate management recommendation?
A. Initiate anticoagulation therapy
B. Anticoagulation only if symptomatic
C. No anticoagulation needed
D. Aspirin alone is sufficient
Correct Answer: A. Initiate anticoagulation therapy
Rationale: A CHA2DS2-VASc score of 2 or greater in men (3 or greater in
women) indicates a sufficiently elevated stroke risk to warrant anticoagulation
therapy.
Q12. Which finding on physical examination is most consistent with heart
failure with reduced ejection fraction?
A. Fixed split S2
B. Pulsus paradoxus only
APEA Post Predictor Final Exam
Questions and Answers | South University| Latest Update
Q1. A 50-year-old average-risk patient asks when to begin colorectal cancer
screening. What is the most appropriate response?
A. At age 40
B. At age 45
C. Only if symptomatic
D. At age 55
Correct Answer: B. At age 45
Rationale: Current guidelines (USPSTF/ACS) recommend average-risk adults
begin colorectal cancer screening at age 45, reflecting rising colorectal cancer
incidence in younger adults.
Q2. Which lipid screening interval is appropriate for an average-risk adult with a
normal initial lipid panel?
A. Only once in a lifetime
B. Every 10 years
C. Annually
D. Every 4-6 years
Correct Answer: D. Every 4-6 years
Rationale: For average-risk adults with normal results, repeat lipid screening
every 4 to 6 years is generally recommended unless risk factors change.
Q3. A 65-year-old male who has never smoked asks about lung cancer screening.
What is the most appropriate response?
A. He should have annual low-dose CT regardless of smoking history
B. He should have a chest x-ray annually
C. Screening is not indicated because he lacks a significant smoking history
D. He should be screened only if he develops a cough
, Correct Answer: C. Screening is not indicated because he lacks a significant
smoking history
Rationale: USPSTF lung cancer screening criteria require a significant pack-year
smoking history (current or former smoker within 15 years) in addition to age
criteria; screening is not recommended for never-smokers.
Q4. What is the recommended screening interval for cervical cytology alone
(Pap test without HPV co-testing) in a healthy 25-65 year old woman?
A. Every 10 years
B. Every 6 months
C. Every 3 years
D. Every year
Correct Answer: C. Every 3 years
Rationale: For average-risk women aged 25-65, cytology alone every 3 years is
one acceptable strategy (alternatively, primary HPV testing every 5 years or co-
testing every 5 years).
Q5. A patient asks about the recommended age to begin routine screening
mammography for average-risk women. What should the nurse practitioner
recommend?
A. Beginning at age 30
B. Beginning at age 40
C. Beginning only after menopause
D. Beginning at age 50 only
Correct Answer: B. Beginning at age 40
Rationale: Updated USPSTF guidance recommends biennial mammography
screening beginning at age 40 for average-risk women, reflecting a lowered
starting age from prior recommendations.
Q6. Which vaccine is recommended for all adults age 19-59 without prior
vaccination as part of routine adult immunization, particularly given rising
incidence?
A. Hepatitis B vaccine
B. BCG vaccine
C. Yellow fever vaccine
, D. Japanese encephalitis vaccine
Correct Answer: A. Hepatitis B vaccine
Rationale: Hepatitis B vaccination is now recommended for all previously
unvaccinated adults aged 19-59 as part of universal adult immunization
recommendations.
Q7. An asymptomatic 68-year-old male former smoker is being evaluated for
abdominal aortic aneurysm screening. What is the recommended one-time
screening approach?
A. MRI every 5 years
B. No screening is recommended
C. Annual CT scan of the abdomen
D. One-time abdominal ultrasound
Correct Answer: D. One-time abdominal ultrasound
Rationale: USPSTF recommends a one-time abdominal ultrasound screening
for AAA in men aged 65-75 who have ever smoked.
Cardiovascular
Q8. A 58-year-old with hypertension and type 2 diabetes has an LDL of 110
mg/dL. According to ACC/AHA guidelines, what is the most appropriate initial
pharmacologic therapy?
A. Fibrate therapy
B. Niacin therapy
C. Moderate-to-high intensity statin
D. Bile acid sequestrant
Correct Answer: C. Moderate-to-high intensity statin
Rationale: Statins are first-line therapy for LDL reduction and cardiovascular
risk reduction in patients with diabetes and additional risk factors such as
hypertension.
Q9. A patient presents with crushing substernal chest pain radiating to the left
arm, diaphoresis, and ST-elevation on ECG in leads II, III, and aVF. Which
coronary artery is most likely involved?
A. Right coronary artery
, B. Left main coronary artery
C. Left circumflex artery
D. Left anterior descending artery
Correct Answer: A. Right coronary artery
Rationale: ST elevation in the inferior leads (II, III, aVF) typically corresponds to
occlusion of the right coronary artery, which supplies the inferior wall in most
individuals.
Q10. Which physical exam finding is most consistent with aortic stenosis?
A. Holosystolic murmur best heard at the apex radiating to the axilla
B. Harsh crescendo-decrescendo systolic murmur radiating to the carotids
C. Diastolic decrescendo murmur at the left sternal border
D. Mid-systolic click with late systolic murmur
Correct Answer: B. Harsh crescendo-decrescendo systolic murmur radiating
to the carotids
Rationale: Aortic stenosis classically produces a harsh, crescendo-decrescendo
(diamond-shaped) systolic ejection murmur best heard at the right upper
sternal border that radiates to the carotid arteries.
Q11. A patient with atrial fibrillation has a CHA2DS2-VASc score of 3. What is
the most appropriate management recommendation?
A. Initiate anticoagulation therapy
B. Anticoagulation only if symptomatic
C. No anticoagulation needed
D. Aspirin alone is sufficient
Correct Answer: A. Initiate anticoagulation therapy
Rationale: A CHA2DS2-VASc score of 2 or greater in men (3 or greater in
women) indicates a sufficiently elevated stroke risk to warrant anticoagulation
therapy.
Q12. Which finding on physical examination is most consistent with heart
failure with reduced ejection fraction?
A. Fixed split S2
B. Pulsus paradoxus only
