APEA Predictor/Pre-Predictor Test
(NSG 6440 Week 4)
1. According to Erickson, the developmental task of the elderly adult is:
a. Intimacy VS isolation
b. Ego integrity VS despair
c. Industry VS self-doubt
d. Trust Vs mistrust
explanation:
2. Moderate weight loss, particularly of visceral adipose tissue in patients with type 2 diabetes
mellitus may have all of the following beneficial effects EXCEPT:
a. Improved insulin sensitivity
b. Increased glucose uptake and utilization by the cells
c. Increase lean muscle mass’
d. Improved lipid profile
Explanation: Regular, consistent exercise is an essential part of diabetes and prediabetes
management. The ADA recommends that people with diabetes perform at least 30 minutes, 5
1 APEA PREDICTOR/PRE-PREDICTO R TEST
(NSG 6440 WEEK 4)!@*_________ ______ ______ ___
,days/wk of a moderate-intensity aerobic physical activity. The ADA also encourages people with
type 2 diabetes to perform resistance training 3Xwk in the absence of contraindications. Exercise
contributes to weight loss, which further decreases insulin resistance. The therapeutic benefits of
regular physical activity may result in a decreased need for diabetes medications to reach target
blood glucose goals. Regular exercise may also help reduce triglyceride and low-density
lipoprotein (LDL) cholesterol levels, increase high-density lipoprotein (HDL), reduce BP, and
improve circulation. Patients who use insulin, sulfonylureas, or meglitinides are at increased risk
for hypoglycemia when they increase physical activity.
3. A 12 y/o presents with eat pain or 36 hours duration. The NP diagnoses acute otitis media
because the
a. Tympanic membrane is bulging and glossy with tiny bubbles visible posteriorly
b. Tympanic membrane is retracted against boy landmarks
c. Bony landmarks are obscured, and the tympanic membrane is mildly erythematous, dulls
and immobile.
d. Canal is narrowed, erythematous, and exquisitely tender with speculum contact
Explanation: Serous otitis media typically presents with a flat or bulging and tympanic
membrane with a fluid line and/or tiny bubbles visible posteriorly. The tympanic membrane may
be immobile and retracted against the bony landmarks when the eustachian tube is swollen or
congested as with the common cold or allergies. Narrowing of the external canal with erythema
and extreme tenderness of the canal wall is indicative of otitis externa.
4. The NP should instruct the mother of an infant with thrush to:
a. Take oral nystatin since she is breastfeeding
b. Stop breast feeding until the thrush has resolved
c. administer antifungal medication to the infant prior to feeding
d. sterilized pacifiers and bottle nipples
explanation: Most bouts of oral thrush occur for no apparent reason. However, regularly
sterilization of pacifiers, bottles-feed and other mouth toys used by the baby may help to prevent
some bouts.
5. A 26 y/o patient, 18 weeks pregnant with twins, has been healthy and has followed
recommendations of her nurse midwife. She is in the office to discuss results of her maternal
serum alpha-fetoprotein (MSAFP) test. which show elevation in this particular pregnancy?
a. Elevated MSAFPO is an indicator of Down Syndrome
b. Low MSAFP is expected at 18 weeks’ gestation
c. Neural tube defects are highly probable
d. Elevated MSAFP is an expected finding
Explanation: elevated maternal serum alfa Protein is expected when a woman is pregnant with
twins. An elevation can also be an indication of a miscalculated due date. Low levels can indicate
Down Syndrome
2 APEA PREDICTOR/PRE-PREDICTO R TEST
(NSG 6440 WEEK 4)!@*_________ ______ ______ ___
,6. The hallmark of neurofibromatosis (von Recklinghousen disease) present in almost 100%
of patients is:
a. Acoustic neuroma
b. Astrocytoma of the retina
c. Distinctive osseous lesion
d. Café au lait spots
Explanation: Von Recklinghausen disease is also known as neurofibromatosis. It is
characterized by multiple neurofibromas, or tumors, forming that vary in shape, size, and
location. Neurofibromatosis type 1 and neurofibromatosis are differentiated by clinical features.
They both include benign tumors of the nerve tissue (neurofibromas). Only neurofibromatosis
type 1 (90%) has prominent clinical features, such as cafe-au-lait pigmentation.
Neurofibromatosis type 2 consists of neurofibromas only without clinical features.
7. The NP correctly teaches an elderly patient with pernicious anemia that food sources of B12
include
a. Red meat, poultry, fish, eggs, dairy products
b. Canned and frozen fruit
c. Whole grain breads, cereals and pastas
d. Fresh vegetables
explanation: Pernicious anemia is a type of vitamin B12 anemia. VB12 can be found in foods
such as meat, poultry, shellfish, eggs, and dairy products. A special protein, called intrinsic factor
(IF), helps the intestines absorb vitamin B12. This protein is released by cells in the stomach.
When the stomach does not make enough intrinsic factor, the intestine cannot properly absorb
vitamin B12.
8. An 18-year-old female applying for college admission present to the health clinic because
evidence of rubella vaccination is required for admission. She says, “don’t remember ever
getting that shot” She has negative serologic evidence of rubella antibody. The NP should:
a. Tell her that her serologic evidence demonstrates that she is immune to the rubella and that
she probably has the disease as a child
b. Administer the vaccination after a negative pregnancy test and advise the patient that she
must not get pregnant for 28 days
c. Tell her that she needs the immunization and can get today if her pregnancy test is
negative
d. Administer the rubella vaccination after a negative pregnancy test and advise her not to get
pregnant for at least 6 months.
Explanation: Due to this very small chance of illness, the Centers for Disease Control and
Prevention (CDC) recommend waiting 28 days after getting the MMR vaccine before trying
to get pregnant.
9. A 45 y/o obese pre-menopausal female complains of indigestion, flatulence, RUQ pain and
epigastric “crampy pain”. Symptoms are exacerbated by high-fat meal. What is the most likely
diagnosis?
a. Hepatitis
3 APEA PREDICTOR/PRE-PREDICTO R TEST
(NSG 6440 WEEK 4)!@*_________ ______ ______ ___
, b. Chronic cholecystitis
c. Acute pancreatitis
d. Myocarditis
Explanation: The “typical” patient with chronic cholecystitis is “female, fat, fertile, and (over)
40” years of age. Myocarditis produces retrosternal pain that is not related to diet. The pain of
pancreatitis radiates to the back. The pain of hepatitis is non-specific upper quadrant pain.
10. A 16 y/o male presents w/ mild sore throat, fever, fatigue, posterior cervical adenopathy, and
palatine petechia. With for this patient, what drug would be the LEAST appropriate to
prescribe?
a. Ibuprofen
b. Erythromycin
c. Ampicillin
d. Doxycycline
Explanation: Mono can be managed with supportive care, including NSAIDs, and warm
sailing gargles. patients with strep throat should be prescribed penny ceiling or every
throw myosin instead of amoxicillin or ampicillin because amoxicillin and ampicillin
often cause a rash in mono patients.
11. A characteristic of delirium that is typically absent in dementia is
a. Acute onset of confusion in a previously alert and oriented patient
b. Gradual loss of short-term memory
c. Loss of language skills
d. Long term memory gaps filled in with confabulation
Explanation: Delirium is acute confusional state, is potentially a reversible cognitive
impairment that often has a physiological cause; physiological causes include electrolyte
imbalances, cerebral anoxia (an absence of oxygen); hypoglycemia; medication effects; tumors;
subdural hematoma; and cerebral infection, infarction, or hemorrhage. Dementia is a generalized
impairment of intellectual functioning that interferes with social and occupational functioning. It
is an umbrella term that includes Alzheimer's disease, Lewy body disease, frontal-temporal
dementia, and vascular dementia.
12. It is imperative that the NP teach patients taking oral contraceptives to report any of the
danger signs of complications. Which of the following would be the LEAST concern to the NP?
a. Lower leg pain
b. Upper abdominal pain
c. Chest pain
d. Weight gain
Explanation: Common side effects of OCP includes: bleeding between periods, nausea, breast
tenderness, headaches and weight gain. The symptoms often subside after a few months of use.
Lower Leg pain can be indicative of- DVT. Other major complication can include the liver,
gallbladder or the cardiac organ.
13. Which of the following oral medications should be avoided in a child under 8 years of age?
4 APEA PREDICTOR/PRE-PREDICTO R TEST
(NSG 6440 WEEK 4)!@*_________ ______ ______ ___
(NSG 6440 Week 4)
1. According to Erickson, the developmental task of the elderly adult is:
a. Intimacy VS isolation
b. Ego integrity VS despair
c. Industry VS self-doubt
d. Trust Vs mistrust
explanation:
2. Moderate weight loss, particularly of visceral adipose tissue in patients with type 2 diabetes
mellitus may have all of the following beneficial effects EXCEPT:
a. Improved insulin sensitivity
b. Increased glucose uptake and utilization by the cells
c. Increase lean muscle mass’
d. Improved lipid profile
Explanation: Regular, consistent exercise is an essential part of diabetes and prediabetes
management. The ADA recommends that people with diabetes perform at least 30 minutes, 5
1 APEA PREDICTOR/PRE-PREDICTO R TEST
(NSG 6440 WEEK 4)!@*_________ ______ ______ ___
,days/wk of a moderate-intensity aerobic physical activity. The ADA also encourages people with
type 2 diabetes to perform resistance training 3Xwk in the absence of contraindications. Exercise
contributes to weight loss, which further decreases insulin resistance. The therapeutic benefits of
regular physical activity may result in a decreased need for diabetes medications to reach target
blood glucose goals. Regular exercise may also help reduce triglyceride and low-density
lipoprotein (LDL) cholesterol levels, increase high-density lipoprotein (HDL), reduce BP, and
improve circulation. Patients who use insulin, sulfonylureas, or meglitinides are at increased risk
for hypoglycemia when they increase physical activity.
3. A 12 y/o presents with eat pain or 36 hours duration. The NP diagnoses acute otitis media
because the
a. Tympanic membrane is bulging and glossy with tiny bubbles visible posteriorly
b. Tympanic membrane is retracted against boy landmarks
c. Bony landmarks are obscured, and the tympanic membrane is mildly erythematous, dulls
and immobile.
d. Canal is narrowed, erythematous, and exquisitely tender with speculum contact
Explanation: Serous otitis media typically presents with a flat or bulging and tympanic
membrane with a fluid line and/or tiny bubbles visible posteriorly. The tympanic membrane may
be immobile and retracted against the bony landmarks when the eustachian tube is swollen or
congested as with the common cold or allergies. Narrowing of the external canal with erythema
and extreme tenderness of the canal wall is indicative of otitis externa.
4. The NP should instruct the mother of an infant with thrush to:
a. Take oral nystatin since she is breastfeeding
b. Stop breast feeding until the thrush has resolved
c. administer antifungal medication to the infant prior to feeding
d. sterilized pacifiers and bottle nipples
explanation: Most bouts of oral thrush occur for no apparent reason. However, regularly
sterilization of pacifiers, bottles-feed and other mouth toys used by the baby may help to prevent
some bouts.
5. A 26 y/o patient, 18 weeks pregnant with twins, has been healthy and has followed
recommendations of her nurse midwife. She is in the office to discuss results of her maternal
serum alpha-fetoprotein (MSAFP) test. which show elevation in this particular pregnancy?
a. Elevated MSAFPO is an indicator of Down Syndrome
b. Low MSAFP is expected at 18 weeks’ gestation
c. Neural tube defects are highly probable
d. Elevated MSAFP is an expected finding
Explanation: elevated maternal serum alfa Protein is expected when a woman is pregnant with
twins. An elevation can also be an indication of a miscalculated due date. Low levels can indicate
Down Syndrome
2 APEA PREDICTOR/PRE-PREDICTO R TEST
(NSG 6440 WEEK 4)!@*_________ ______ ______ ___
,6. The hallmark of neurofibromatosis (von Recklinghousen disease) present in almost 100%
of patients is:
a. Acoustic neuroma
b. Astrocytoma of the retina
c. Distinctive osseous lesion
d. Café au lait spots
Explanation: Von Recklinghausen disease is also known as neurofibromatosis. It is
characterized by multiple neurofibromas, or tumors, forming that vary in shape, size, and
location. Neurofibromatosis type 1 and neurofibromatosis are differentiated by clinical features.
They both include benign tumors of the nerve tissue (neurofibromas). Only neurofibromatosis
type 1 (90%) has prominent clinical features, such as cafe-au-lait pigmentation.
Neurofibromatosis type 2 consists of neurofibromas only without clinical features.
7. The NP correctly teaches an elderly patient with pernicious anemia that food sources of B12
include
a. Red meat, poultry, fish, eggs, dairy products
b. Canned and frozen fruit
c. Whole grain breads, cereals and pastas
d. Fresh vegetables
explanation: Pernicious anemia is a type of vitamin B12 anemia. VB12 can be found in foods
such as meat, poultry, shellfish, eggs, and dairy products. A special protein, called intrinsic factor
(IF), helps the intestines absorb vitamin B12. This protein is released by cells in the stomach.
When the stomach does not make enough intrinsic factor, the intestine cannot properly absorb
vitamin B12.
8. An 18-year-old female applying for college admission present to the health clinic because
evidence of rubella vaccination is required for admission. She says, “don’t remember ever
getting that shot” She has negative serologic evidence of rubella antibody. The NP should:
a. Tell her that her serologic evidence demonstrates that she is immune to the rubella and that
she probably has the disease as a child
b. Administer the vaccination after a negative pregnancy test and advise the patient that she
must not get pregnant for 28 days
c. Tell her that she needs the immunization and can get today if her pregnancy test is
negative
d. Administer the rubella vaccination after a negative pregnancy test and advise her not to get
pregnant for at least 6 months.
Explanation: Due to this very small chance of illness, the Centers for Disease Control and
Prevention (CDC) recommend waiting 28 days after getting the MMR vaccine before trying
to get pregnant.
9. A 45 y/o obese pre-menopausal female complains of indigestion, flatulence, RUQ pain and
epigastric “crampy pain”. Symptoms are exacerbated by high-fat meal. What is the most likely
diagnosis?
a. Hepatitis
3 APEA PREDICTOR/PRE-PREDICTO R TEST
(NSG 6440 WEEK 4)!@*_________ ______ ______ ___
, b. Chronic cholecystitis
c. Acute pancreatitis
d. Myocarditis
Explanation: The “typical” patient with chronic cholecystitis is “female, fat, fertile, and (over)
40” years of age. Myocarditis produces retrosternal pain that is not related to diet. The pain of
pancreatitis radiates to the back. The pain of hepatitis is non-specific upper quadrant pain.
10. A 16 y/o male presents w/ mild sore throat, fever, fatigue, posterior cervical adenopathy, and
palatine petechia. With for this patient, what drug would be the LEAST appropriate to
prescribe?
a. Ibuprofen
b. Erythromycin
c. Ampicillin
d. Doxycycline
Explanation: Mono can be managed with supportive care, including NSAIDs, and warm
sailing gargles. patients with strep throat should be prescribed penny ceiling or every
throw myosin instead of amoxicillin or ampicillin because amoxicillin and ampicillin
often cause a rash in mono patients.
11. A characteristic of delirium that is typically absent in dementia is
a. Acute onset of confusion in a previously alert and oriented patient
b. Gradual loss of short-term memory
c. Loss of language skills
d. Long term memory gaps filled in with confabulation
Explanation: Delirium is acute confusional state, is potentially a reversible cognitive
impairment that often has a physiological cause; physiological causes include electrolyte
imbalances, cerebral anoxia (an absence of oxygen); hypoglycemia; medication effects; tumors;
subdural hematoma; and cerebral infection, infarction, or hemorrhage. Dementia is a generalized
impairment of intellectual functioning that interferes with social and occupational functioning. It
is an umbrella term that includes Alzheimer's disease, Lewy body disease, frontal-temporal
dementia, and vascular dementia.
12. It is imperative that the NP teach patients taking oral contraceptives to report any of the
danger signs of complications. Which of the following would be the LEAST concern to the NP?
a. Lower leg pain
b. Upper abdominal pain
c. Chest pain
d. Weight gain
Explanation: Common side effects of OCP includes: bleeding between periods, nausea, breast
tenderness, headaches and weight gain. The symptoms often subside after a few months of use.
Lower Leg pain can be indicative of- DVT. Other major complication can include the liver,
gallbladder or the cardiac organ.
13. Which of the following oral medications should be avoided in a child under 8 years of age?
4 APEA PREDICTOR/PRE-PREDICTO R TEST
(NSG 6440 WEEK 4)!@*_________ ______ ______ ___
