APEA PREDICTOR ACTUAL EXAM 2 VERSIONS NEWEST 2024 WITH COMPLETE SOLUTIONS You note the following result on a routine urinalysis of a 37 -year old primigravida who is at 30 weeks gestation. Leukocyte=trace, nitrite=negative, protein=2+, blood=negative. Her weight has increased by 5 lbs during the past week. Which of the following is most likely? A.HELLP syndrome B. Pregnancy -induced hypertension (pre -eclampsia) C. Eclampsia of pregnancy D. Primary hypertension - B. Pregnancy -induced hypertension (pre -eclamp sia). Classic triad of symptoms of preeclampsia include hypertension, edema (weight gain), and proteinuria. The mother of a 12 month old infant reports to the nurse practitioner that her child had a high fever for several days, which spontaneously resolve d. After the fever resolved, the child developed a maculopapular rash. Which of the following is the most likely diagnosis? A. Fifth Disease (erythema infectiosum) B. Roseola infantum (exanthema subitum) C. Varicella D. Infantile maculopapular rashes - B. Roseola Infantum (Exanthema subitum) A 70-year old male patient complains of a bright red -colored spot in his left eye for 2 days. He denies eye pain, visual changes, or headaches. He has a new onset of cough from a recent viral upper respiratory infecti on. The only medicine he is on Bayer aspirin, 1 tablet a day. Which of the following is most likely? A. Corneal abrasion B. Acute bacterial conjunctivitis C. Acute uveitis D. Subconjunctival hemorrhage - D. Subconjunctival hemorrhage. Bright red blood in a sharply defined area surrounded by normal -appearing conjunctiva indicates subconjunctival hemorrhage. A woman is being evaluated by the nurse practitioner for complaints of dyspareunia. A microscopy slide reveals a large number of atrophic squamous epit helial cells. The vaginal pH is 4.0. There are very few leukocytes and no RBCs are seen on the wet smear. Which of the following is most likely? A. Atrophic vaginitis B. Bacterial Vaginosis C. Trichomoniasis D. This is a normal finding. - A. Atrophic vagi nitis. Symptoms of atrophic vaginitis include painful intercourse, atrophic squamous epithelial cells, and a decrease in pH. Vaginal atrophy is caused by lack of or imbalance of estrogen. Normal pH of the vagina is 4.0 -5.0 (acidic) The most common type of skin malignancy is: A. Squamous cell cancer B. Basal skin cancer C. Melanoma D. Dysplastic nevi - B. Basal skin cancer. It is several times more common that squamous cell skin cancer according to the NIH. Cranial Nerve VIII - Acoustic (Hearing and balan ce) Cranial nerve IX - Glossopharyngeal - swallowing and rise of the palate, gag reflex Cranial Nerve XI - Spinal Accessory (upper trapezius) Deep tendon reflex - Ankle - S1 primarily Knee - Lumbar 2,3,4 Supinator(brachioradialis) -C5,6 BicepTriceps -C6,7 Stroke risk scale - CHADS2 C-Congestive heart failure H-Hypertension A-Age >75 years D- Diabetes S-prior Stroke/TIA In the majority of children, the first permanent teeth start to erupt at the age of 6 years. Which of the following are the first permanent teeth to erupt in this time period? A. First Molars B. Second Molars C. Lower or upper incisors D. Canines - A. First Molars All of the following are classified as activities of daily living (ADLs) except: A. ability to feed self B. Ability to manage bl adder and bowel elimination C. Personal hygiene and grooming D. Grocery Shopping - D. Grocery shopping Koplik's spots are associated with: A. Poxvirius infections B. Measles C. Kawasaki's disease D. Reye's syndrome - B. Measles. S/S include fever over 1 01, coryza, cough, conjunctivitis, rash, and koplik's spots on buccal mucosa At what level of prevention would you classify for lung cancer? A. Primary prevention B. Secondary prevention C. Tertiary prevention D. Primordial prevention - D. primordial pre vention. Screening for lung cancer is not currently recommended in the general population, but it is secondary prevention. A test called the visual fields by confrontation is used to evaluate for: A. Peripheral vision B. Central vision C. Visual acuity D. Accomodation - A. Peripheral vision What is the most common cause of Cushing's syndrome? - Administration of a glucocorticoid or ACTH. Iatrogenic Cushing's syndrome is the most common type. Exogenous glucocorticoid administration produces a Cushing's S yndrome that is reversible by discontinuation of the medication. A patient with no significant medical history has vericose veins. She complains of '"aching legs". The intervention that will provide the greatest relief for her complaint is to: - Elevate her legs periodically. The intervention that will provide the greatest relief for this patient is elevating her legs periodically. This will facilitate venous return. Use of support stockings will prolong the length of time she is able to stand in place, b ut will not provide relief after her legs begin aching. Support stockings should be applied prior to getting out of bed. Atenolol (Tenormin) should be avoided in: - a 43-yo female with asthma. Atenolol is a beta blocker. It should be avoided in pateints with asthma or other bronchospastic conditions. These patients often require beta stimulation, not beta blockade. Although atenolol is a beta 1 -selective agent, at higher doses beta 2 receptors (bronchial and vascular) are blocked. Beta blockers, specific ally atenolol, are beneficial post -myocardial infarction because they have demonstrated a reduction in morbidity and mortality. All of the following interventions with pediatric patients are appropriate EXCEPT: - Pre-
medicate the patient prior to all pain ful interventions. Pre-medication is not warranted prior to all painful interventions. For example, premedication is not warranted prior to routine immunizations but it certainly is prior to suturing. Pain management should be an integral part of patient management. Infants with veliac disease (gluten eneteropathy) are at risk for multiple complications. The most urgen complication of this disease is: - Intususseption or volvulus. Intuseusseption and volvulus are surgical emergencies. Delay releasing the invaginated or "telescoped" bowel (intususseption), or releasing the twisted bowel (volvulus) may result in
medicate the patient prior to all pain ful interventions. Pre-medication is not warranted prior to all painful interventions. For example, premedication is not warranted prior to routine immunizations but it certainly is prior to suturing. Pain management should be an integral part of patient management. Infants with veliac disease (gluten eneteropathy) are at risk for multiple complications. The most urgen complication of this disease is: - Intususseption or volvulus. Intuseusseption and volvulus are surgical emergencies. Delay releasing the invaginated or "telescoped" bowel (intususseption), or releasing the twisted bowel (volvulus) may result in
