Pre-Predictor exam review EXAM
2025 QUESTIONS AND ANSWERS
GRADED A+
1. Prescriptiveauthority: ,/
,/ Ans:maybeexercisedbygivingaverbalmedicationorderto a pharmacist.
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
Rationale Anexampleofexercisingprescriptiveauthorityisgivingaverbalordertoa
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
pharma- cistorwritinganorderforaprescriptionmedication.Prescriptiveauthorityrules
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
and regulations vary from state to state.Prescriptive authority is granted only to those
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
APRNswhomeetthe requirementsofthegoverningbodyforthe state inwhich the APRN
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
practices.
,/
2. When examining a pregnant patient,where should the fundal height be at 22
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
weeks?
,/ ,/
Ans : Above the umbilicus
,/ ,/ ,/ ,/
Rationale Between 18 and 32 weeks, there is good correlation between fundal height
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
and gestationalageofthefetus.Theexpectedheightsare:10-12weeks:fundusslightly
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
mailto:https://www.stuvia.com/user/Wisdoms
,/ ,/
, abovethesymphysispubis16weeks:fundusmidwaybetweenthesymphysispubis and
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
umbilicus 20 weeks: fundus at the level of umbilicus 28 weeks: fundus 3 fingerbreadths
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
abovetheumbilicus36weeks:fundusjustbelowthexiphoidprocess
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
3. WhatinterventiondoestheAmericanCollegeofRheumatologyrecommend as ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
first-line therapy for osteoarthritis?
,/ ,/ ,/ ,/
Ans: Exercise and weight loss ,/ ,/ ,/ ,/
Rationale Exercise, weight loss, and rest are recommended by the American College ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
of Rheumatologyguidelinesfortheinitialmanagementofosteoarthritis(OA).Giventhe
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
adverse effects of medications used to treat OA, it is best to minimize dosage and delay
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
useaslongaspossible.Anextensivediagnosticworkupisnotrecommended 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
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
conservativetherapies maybe candidatesfor 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 stiffness
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
become worse with activity. On examination, he is noted to have Heberden's
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
nodesbutnootherbonydeformities.Whichofthefollowingisthe most probable
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
diagnosis?
,/
Ans: Osteoarthritis (OA) ,/ ,/
Rationale Although his vocation involved sedentary activity, this patient is not at great ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
risk forosteoarthritis.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.
,/ ,/ ,/ ,/ ,/ ,/
mailto:https://www.stuvia.com/user/Wisdoms ,/ ,/
, 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 blocksaway.On
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
examination,heispleasantbutmildlyconfused.Whichofhis medications is
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
LEAST likely contributing to his behavior?
,/ ,/ ,/ ,/ ,/ ,/
Ans: ramipril (Altace®) ,/ ,/
Rationale Tricyclic antidepressants, like amitriptyline, have anticholinergic side ,/ ,/ ,/ ,/ ,/ ,/ ,/
effects which areespeciallyproblematicintheelderlybecausetheycontributetourinary
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
retention. Hydrochlorothiazideisadiureticandmaycontributetohisincontinence.
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
Cimetidine is well known to produce adverse reactions such as confusion in elders.
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
Ramipril, an ACEinhibitor,isunlikelytocontributetothispatient'sincontinenceor
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
confusion. Toiletingmaybeacomplicatedbytheanticholinergicmedicationand/orthe
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
diuretic causing diuresis, urge incontinence, and inability to void at will.
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
6. A patient with no significant medical history has varicose veins. She com-
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
plains of "aching legs". The intervention that will provide the greatest relief for her
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
complaint is to:
,/ ,/ ,/
Ans: elevate her legs periodically.
,/ ,/ ,/ ,/
Rationale 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, but will not provide
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
relief afterherlegsbeginaching.Supportstockingsshouldbeappliedpriortogettingout
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
of bed.
,/ ,/
7. Stress urinary incontinence is: ,/ ,/ ,/
Ans:may be aggravated by caffeine or alcohol. ,/ ,/ ,/ ,/ ,/ ,/ ,/
Rationale Stressurinaryincontinenceisnotexpectedasaresultofthenormalaging ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
process. Theprimaryproblemissphincterincompetence.Theingestionofcaffeineor
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
alcohol decreases sphincter control. Anticholinergic and antidepressant medications
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
are causativefactorsrelatedtooverflowincontinence.Detrusormuscleinstabilityisthe
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
primary underlying problem causing urge incontinence.
,/ ,/ ,/ ,/ ,/ ,/
8. Which commonly used herbal remedy is NOT associated with anxiety and/or ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
mailto:https://www.stuvia.com/user/Wisdoms
,/ ,/
, ,/ depressive symptom relief? ,/ ,/
Ans: Ginkgo biloba
,/ ,/
Rationale Ginkgobilobaisacommonherbalremedyassociatedwithenhancementof
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
vascular and cerebral perfusion and memory.The nurse practitioner should be aware
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
when the patient is taking any herbal supplement to avoid risk of drug interactions.
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
9. Upon ophthalmoscopic examination of a 78-year-old patient, the nurse
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
practitioner observes dark spots against a red retina.What diagnosis is this
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
finding most consistent with?: Cataract
,/ ,/ ,/ ,/ ,/
mailto:https://www.stuvia.com/user/Wisdoms
,/ ,/
2025 QUESTIONS AND ANSWERS
GRADED A+
1. Prescriptiveauthority: ,/
,/ Ans:maybeexercisedbygivingaverbalmedicationorderto a pharmacist.
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
Rationale Anexampleofexercisingprescriptiveauthorityisgivingaverbalordertoa
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
pharma- cistorwritinganorderforaprescriptionmedication.Prescriptiveauthorityrules
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
and regulations vary from state to state.Prescriptive authority is granted only to those
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
APRNswhomeetthe requirementsofthegoverningbodyforthe state inwhich the APRN
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
practices.
,/
2. When examining a pregnant patient,where should the fundal height be at 22
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
weeks?
,/ ,/
Ans : Above the umbilicus
,/ ,/ ,/ ,/
Rationale Between 18 and 32 weeks, there is good correlation between fundal height
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
and gestationalageofthefetus.Theexpectedheightsare:10-12weeks:fundusslightly
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
mailto:https://www.stuvia.com/user/Wisdoms
,/ ,/
, abovethesymphysispubis16weeks:fundusmidwaybetweenthesymphysispubis and
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
umbilicus 20 weeks: fundus at the level of umbilicus 28 weeks: fundus 3 fingerbreadths
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
abovetheumbilicus36weeks:fundusjustbelowthexiphoidprocess
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
3. WhatinterventiondoestheAmericanCollegeofRheumatologyrecommend as ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
first-line therapy for osteoarthritis?
,/ ,/ ,/ ,/
Ans: Exercise and weight loss ,/ ,/ ,/ ,/
Rationale Exercise, weight loss, and rest are recommended by the American College ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
of Rheumatologyguidelinesfortheinitialmanagementofosteoarthritis(OA).Giventhe
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
adverse effects of medications used to treat OA, it is best to minimize dosage and delay
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
useaslongaspossible.Anextensivediagnosticworkupisnotrecommended 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
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
conservativetherapies maybe candidatesfor 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 stiffness
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
become worse with activity. On examination, he is noted to have Heberden's
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
nodesbutnootherbonydeformities.Whichofthefollowingisthe most probable
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
diagnosis?
,/
Ans: Osteoarthritis (OA) ,/ ,/
Rationale Although his vocation involved sedentary activity, this patient is not at great ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
risk forosteoarthritis.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.
,/ ,/ ,/ ,/ ,/ ,/
mailto:https://www.stuvia.com/user/Wisdoms ,/ ,/
, 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 blocksaway.On
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
examination,heispleasantbutmildlyconfused.Whichofhis medications is
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
LEAST likely contributing to his behavior?
,/ ,/ ,/ ,/ ,/ ,/
Ans: ramipril (Altace®) ,/ ,/
Rationale Tricyclic antidepressants, like amitriptyline, have anticholinergic side ,/ ,/ ,/ ,/ ,/ ,/ ,/
effects which areespeciallyproblematicintheelderlybecausetheycontributetourinary
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
retention. Hydrochlorothiazideisadiureticandmaycontributetohisincontinence.
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
Cimetidine is well known to produce adverse reactions such as confusion in elders.
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
Ramipril, an ACEinhibitor,isunlikelytocontributetothispatient'sincontinenceor
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
confusion. Toiletingmaybeacomplicatedbytheanticholinergicmedicationand/orthe
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
diuretic causing diuresis, urge incontinence, and inability to void at will.
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
6. A patient with no significant medical history has varicose veins. She com-
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
plains of "aching legs". The intervention that will provide the greatest relief for her
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
complaint is to:
,/ ,/ ,/
Ans: elevate her legs periodically.
,/ ,/ ,/ ,/
Rationale 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, but will not provide
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
relief afterherlegsbeginaching.Supportstockingsshouldbeappliedpriortogettingout
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
of bed.
,/ ,/
7. Stress urinary incontinence is: ,/ ,/ ,/
Ans:may be aggravated by caffeine or alcohol. ,/ ,/ ,/ ,/ ,/ ,/ ,/
Rationale Stressurinaryincontinenceisnotexpectedasaresultofthenormalaging ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
process. Theprimaryproblemissphincterincompetence.Theingestionofcaffeineor
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
alcohol decreases sphincter control. Anticholinergic and antidepressant medications
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
are causativefactorsrelatedtooverflowincontinence.Detrusormuscleinstabilityisthe
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
primary underlying problem causing urge incontinence.
,/ ,/ ,/ ,/ ,/ ,/
8. Which commonly used herbal remedy is NOT associated with anxiety and/or ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
mailto:https://www.stuvia.com/user/Wisdoms
,/ ,/
, ,/ depressive symptom relief? ,/ ,/
Ans: Ginkgo biloba
,/ ,/
Rationale Ginkgobilobaisacommonherbalremedyassociatedwithenhancementof
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
vascular and cerebral perfusion and memory.The nurse practitioner should be aware
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
when the patient is taking any herbal supplement to avoid risk of drug interactions.
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
9. Upon ophthalmoscopic examination of a 78-year-old patient, the nurse
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
practitioner observes dark spots against a red retina.What diagnosis is this
,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/ ,/
finding most consistent with?: Cataract
,/ ,/ ,/ ,/ ,/
mailto:https://www.stuvia.com/user/Wisdoms
,/ ,/
