Pre-Predictor exam review EXAM 2025 QUESTIONS AND ANSWERS GRADED A+

Pre-Predictor exam review EXAM
2025 QUESTIONS AND ANSWERS
GRADED A+



1. Prescriptive authority: X5




X5 Ans:maybe exercised bygiving a verbal medication order to a pharmacist.
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Rationale An example of exercising prescriptive authority is giving a verbal order to a
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pharma- cistor writing an order for a prescription medication.Prescriptive authority rules
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and regulations vary from state to state. Prescriptive authority is granted only to
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those APRNs who meet the requirements of the governing body for the state in which
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the APRN practices.
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2. When examining a pregnant patient, where should the fundal height be at 22
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weeks?
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Ans : Above the umbilicus
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Rationale Between 18 and 32 weeks, there is good correlation between fundal
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height and gestationalage of the fetus.The expected heights are:10-12 weeks:fundus
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, slightly abovethesymphysispubis16 weeks:fundusmidwaybetween the symphysis
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pubis and umbilicus 20 weeks: fundus at the level of umbilicus 28 weeks: fundus 3
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fingerbreadthsabovetheumbilicus36weeks:fundusjustbelowthexiphoidprocess
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3. What intervention does the American College of Rheumatology recommend as
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first-line therapy for osteoarthritis?
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Ans: Exercise and weight loss
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Rationale Exercise, weight loss, and rest are recommended by the American
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College of Rheumatology guidelines for the initial management of osteoarthritis (OA).
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Given the adverse effects of medications used to treat OA, it is best to minimize
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dosage and delayuse as long as possible.An extensive diagnostic workup is not
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recommended unless the presentation is in question. Patients who have severe
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degenerative
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joint disease (DJD), joint fusion, or whose pain severity is not relieved by more
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conservative therapies may be candidates for joint replacement.Acetaminophen is
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recommended as a first-line medication.
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4. A 63-year-old male retired accountant complains of pain and stiffness in his
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feet and hands of several years duration. He reports that the pain and stiffness
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become worse with activity. On examination, he is noted to have Heberden's
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nodesbutnootherbonydeformities.Which ofthe following is the most probable
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diagnosis?
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Ans: Osteoarthritis (OA)
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Rationale Although his vocation involved sedentary activity, this patient is not at
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great risk for osteoarthritis.Rheumatoid arthritis is characterized by several joint
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deformities, usually bilaterally symmetrical. RA is characterized by inflammatory
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processes, while OA is not. RA and OA are chronic conditions. Gout is characterized
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by
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acute exacerbations related to a defect in purine metabolism, increased uric acid
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production, or decreased uric acid excretion.
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mailto:https://www.stuvia.com/user/Wisdoms
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, 5. The family of a 78-year-old man moved him into an assisted living center
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because he can no longer be left at home alone. He is unable to toilet when
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asked to do so and he has had several episodes of incontinence. He has
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walked out of the facility twice and been unable to find his way back from 3
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blocksaway.Onexamination,heispleasantbutmildlyconfused.Whichofhis
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medications is LEAST likely contributing to his behavior?
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Ans: ramipril (Altace®)
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Rationale Tricyclic antidepressants, like amitriptyline, have anticholinergic side
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effects which are especially problematic in the elderly because they contribute to urinary
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retention. Hydrochlorothiazide is a diuretic and may contribute to his incontinence.
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Cimetidine is well known to produce adverse reactions such as confusion in elders.
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Ramipril, an ACE inhibitor, is unlikely to contribute to this patient's incontinence or
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confusion. Toileting may be a complicated by the anticholinergic medication and/or the
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diuretic causing diuresis, urge incontinence, and inability to void at will.
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6. A patient with no significant medical history has varicose veins. She com-
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plains of "aching legs". The intervention that will provide the greatest relief for her
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complaint is to:
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Ans: elevate her legs periodically.
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Rationale The intervention that will provide the greatest relief for this patient is
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elevating her legs periodically.This will facilitate venous return. Use of support
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stockings will prolong the length of time she is able to stand in place, but will not
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provide relief after her legs begin aching.Support stockings should be applied prior to
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getting out of bed.
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7. Stress urinary incontinence is: X5 X5 X5




Ans: may be aggravated by caffeine or alcohol.
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Rationale Stress urinary incontinence is not expected as a result of the normal aging
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process. The primaryproblem is sphincter incompetence.The ingestion of caffeine or
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alcohol decreases sphincter control. Anticholinergic and antidepressant
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medications are causative factors related to overflow incontinence.Detrusor muscle
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instability is the primary underlying problem causing urge incontinence.
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8. Which commonly used herbal remedy is NOT associated with anxiety and/or
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mailto:https://www.stuvia.com/user/Wisdoms X5 X5

, X5 depressive symptom relief? X5 X5




Ans: Ginkgo biloba
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Rationale Ginkgo biloba is a common herbal remedy associated with enhancement of
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vascular and cerebral perfusion and memory.The nurse practitioner should be aware
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when the patient is taking any herbal supplement to avoid risk of drug interactions.
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9. Upon ophthalmoscopic examination of a 78-year-old patient, the nurse
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practitioner observes dark spots against a red retina.What diagnosis is this
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finding most consistent with?: Cataract
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mailto:https://www.stuvia.com/user/Wisdoms
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