APEA Predictor Exam 250 High-Yield Nursing Questions &
Answers with Rationales – 2025/2026 Edition
1. A 5-year-old child is brought to the clinic with fever, cough, and difficulty breathing. On
assessment, the nurse notes nasal flaring and intercostal retractions. What is the
priority nursing action?
A. Administer antipyretics
B. Encourage oral fluids
C. Assess oxygen saturation and provide oxygen as needed
D. Start IV antibiotics immediately
Answer: C
Rationale: The child shows signs of respiratory distress (nasal flaring, intercostal
retractions). The priority is to ensure adequate oxygenation. Administering oxygen and
monitoring saturation is critical before other interventions.
2. A patient with a history of hypertension is prescribed hydrochlorothiazide. Which lab
result should the nurse monitor closely?
A. Blood glucose
B. Potassium levels
C. Calcium levels
D. Hemoglobin
Answer: B
Rationale: Hydrochlorothiazide is a thiazide diuretic that can cause hypokalemia.
Monitoring potassium levels helps prevent complications like cardiac arrhythmias.
3. A nurse is caring for a patient with diabetes mellitus who has a blood glucose of 320
mg/dL and ketones in urine. Which complication is the patient most likely experiencing?
,A. Hypoglycemia
B. Diabetic ketoacidosis
C. Hyperosmolar hyperglycemic state
D. Metabolic alkalosis
Answer: B
Rationale: Blood glucose >300 mg/dL with ketonuria suggests diabetic ketoacidosis
(DKA), an acute complication of diabetes requiring prompt intervention.
4. A postpartum patient reports heavy vaginal bleeding and dizziness 2 hours after
delivery. What is the immediate nursing action?
A. Monitor vital signs
B. Massage the fundus
C. Notify the physician
D. Start IV fluids
Answer: B
Rationale: Fundal massage helps stimulate uterine contraction to control postpartum
hemorrhage, which is a priority before other interventions.
5. A patient is prescribed warfarin. Which dietary instruction should the nurse provide?
A. Increase vitamin C intake
B. Limit vitamin K-rich foods
C. Avoid all protein
D. Take calcium supplements
Answer: B
Rationale: Vitamin K can counteract warfarin’s anticoagulant effect. Patients should
maintain a consistent intake of vitamin K to prevent fluctuations in INR.
,6. A 7-year-old child presents with a sudden rash and a history of fever and sore throat.
Which complication should the nurse monitor for if the child has scarlet fever?
A. Glomerulonephritis
B. Hepatitis
C. Pneumonia
D. Diabetes
Answer: A
Rationale: Scarlet fever, caused by group A Streptococcus, can lead to post-
streptococcal glomerulonephritis as a complication. Monitoring kidney function is
important.
7. A nurse is caring for a patient receiving IV morphine. Which assessment finding
requires immediate action?
A. Nausea
B. Respiratory rate of 8 breaths/min
C. Mild drowsiness
D. Itching at the IV site
Answer: B
Rationale: Morphine can cause respiratory depression. A respiratory rate below 10
breaths/min is dangerous and requires immediate intervention.
8. A patient with chronic kidney disease is on a low-potassium diet. Which food should
the nurse advise the patient to avoid?
A. Apples
B. Bananas
, C. Rice
D. Carrots
Answer: B
Rationale: Bananas are high in potassium, which can be dangerous for patients with
impaired kidney function.
9. A 10-year-old child presents with sudden onset of right lower quadrant abdominal
pain, nausea, and vomiting. What is the priority nursing action?
A. Administer analgesics
B. Prepare for appendectomy
C. Encourage oral fluids
D. Monitor vital signs
Answer: B
Rationale: Classic signs of appendicitis require surgical intervention. Analgesics may
mask symptoms, and oral intake can increase risk of complications.
10. A nurse is caring for a patient with heart failure who has bilateral lower limb edema
and shortness of breath. Which assessment finding is most concerning?
A. Mild ankle swelling
B. Crackles in the lungs
C. Weight gain of 0.5 kg in one week
D. Fatigue on exertion
Answer: B
Rationale: Pulmonary crackles indicate fluid accumulation in the lungs, suggesting
worsening heart failure, which is urgent.
11. A patient is prescribed metformin for type 2 diabetes. Which teaching point is most
important?
Answers with Rationales – 2025/2026 Edition
1. A 5-year-old child is brought to the clinic with fever, cough, and difficulty breathing. On
assessment, the nurse notes nasal flaring and intercostal retractions. What is the
priority nursing action?
A. Administer antipyretics
B. Encourage oral fluids
C. Assess oxygen saturation and provide oxygen as needed
D. Start IV antibiotics immediately
Answer: C
Rationale: The child shows signs of respiratory distress (nasal flaring, intercostal
retractions). The priority is to ensure adequate oxygenation. Administering oxygen and
monitoring saturation is critical before other interventions.
2. A patient with a history of hypertension is prescribed hydrochlorothiazide. Which lab
result should the nurse monitor closely?
A. Blood glucose
B. Potassium levels
C. Calcium levels
D. Hemoglobin
Answer: B
Rationale: Hydrochlorothiazide is a thiazide diuretic that can cause hypokalemia.
Monitoring potassium levels helps prevent complications like cardiac arrhythmias.
3. A nurse is caring for a patient with diabetes mellitus who has a blood glucose of 320
mg/dL and ketones in urine. Which complication is the patient most likely experiencing?
,A. Hypoglycemia
B. Diabetic ketoacidosis
C. Hyperosmolar hyperglycemic state
D. Metabolic alkalosis
Answer: B
Rationale: Blood glucose >300 mg/dL with ketonuria suggests diabetic ketoacidosis
(DKA), an acute complication of diabetes requiring prompt intervention.
4. A postpartum patient reports heavy vaginal bleeding and dizziness 2 hours after
delivery. What is the immediate nursing action?
A. Monitor vital signs
B. Massage the fundus
C. Notify the physician
D. Start IV fluids
Answer: B
Rationale: Fundal massage helps stimulate uterine contraction to control postpartum
hemorrhage, which is a priority before other interventions.
5. A patient is prescribed warfarin. Which dietary instruction should the nurse provide?
A. Increase vitamin C intake
B. Limit vitamin K-rich foods
C. Avoid all protein
D. Take calcium supplements
Answer: B
Rationale: Vitamin K can counteract warfarin’s anticoagulant effect. Patients should
maintain a consistent intake of vitamin K to prevent fluctuations in INR.
,6. A 7-year-old child presents with a sudden rash and a history of fever and sore throat.
Which complication should the nurse monitor for if the child has scarlet fever?
A. Glomerulonephritis
B. Hepatitis
C. Pneumonia
D. Diabetes
Answer: A
Rationale: Scarlet fever, caused by group A Streptococcus, can lead to post-
streptococcal glomerulonephritis as a complication. Monitoring kidney function is
important.
7. A nurse is caring for a patient receiving IV morphine. Which assessment finding
requires immediate action?
A. Nausea
B. Respiratory rate of 8 breaths/min
C. Mild drowsiness
D. Itching at the IV site
Answer: B
Rationale: Morphine can cause respiratory depression. A respiratory rate below 10
breaths/min is dangerous and requires immediate intervention.
8. A patient with chronic kidney disease is on a low-potassium diet. Which food should
the nurse advise the patient to avoid?
A. Apples
B. Bananas
, C. Rice
D. Carrots
Answer: B
Rationale: Bananas are high in potassium, which can be dangerous for patients with
impaired kidney function.
9. A 10-year-old child presents with sudden onset of right lower quadrant abdominal
pain, nausea, and vomiting. What is the priority nursing action?
A. Administer analgesics
B. Prepare for appendectomy
C. Encourage oral fluids
D. Monitor vital signs
Answer: B
Rationale: Classic signs of appendicitis require surgical intervention. Analgesics may
mask symptoms, and oral intake can increase risk of complications.
10. A nurse is caring for a patient with heart failure who has bilateral lower limb edema
and shortness of breath. Which assessment finding is most concerning?
A. Mild ankle swelling
B. Crackles in the lungs
C. Weight gain of 0.5 kg in one week
D. Fatigue on exertion
Answer: B
Rationale: Pulmonary crackles indicate fluid accumulation in the lungs, suggesting
worsening heart failure, which is urgent.
11. A patient is prescribed metformin for type 2 diabetes. Which teaching point is most
important?
