PRE-PREDICTOR EXAM STUDY
GUIDE. GRADED A+.
QUESTIONS AND 100%
VERIFIED ANSWERS. LATEST
2025/2026 UPDATE
Prescriptive authority: - Ans✔✔-may be exercised by giving a verbal medication
order to a pharmacist.
An example of exercising prescriptive authority is giving a verbal order to a
pharmacist or writing an order for a prescription medication. Prescriptive
authority rules and regulations vary from state to state. Prescriptive authority is
granted only to those APRNs who meet the requirements of the governing
body for the state in which the APRN practices.
When examining a pregnant patient, where should the fundal height be at 22
weeks? - Ans✔✔-Above the umbilicus
Between 18 and 32 weeks, there is good correlation between fundal height and
gestational age of the fetus. The expected heights are: 10-12 weeks: fundus
slightly above the symphysis pubis 16 weeks: fundus midway between the
symphysis pubis and umbilicus 20 weeks: fundus at the level of umbilicus 28
,weeks: fundus 3 fingerbreadths above the umbilicus 36 weeks: fundus just
below the xiphoid process
What intervention does the American College of Rheumatology recommend as
first-line therapy for osteoarthritis? - Ans✔✔-Exercise and weight loss
Exercise, weight loss, and rest are recommended by the American College of
Rheumatology guidelines for the initial management of osteoarthritis (OA).
Given the adverse effects of medications used to treat OA, it is best to minimize
dosage and delay use as long as possible. An extensive diagnostic workup is not
recommended 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 conservative therapies may be candidates for joint
replacement. Acetaminophen is recommended as a first-line medication.
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
nodes but no other bony deformities. Which of the following is the most
probable diagnosis? - Ans✔✔-Osteoarthritis (OA)
Although his vocation involved sedentary activity, this patient is not at great
risk for osteoarthritis. 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.
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 blocks
away. On examination, he is pleasant but mildly confused. Which of his
medications is LEAST likely contributing to his behavior? - Ans✔✔-ramipril
(Altace®)
Tricyclic antidepressants, like amitriptyline, have anticholinergic side effects
which are especially problematic in the elderly because they contribute to
urinary retention. Hydrochlorothiazide is a diuretic and may contribute to his
incontinence. Cimetidine is well known to produce adverse reactions such as
confusion in elders. Ramipril, an ACE inhibitor, is unlikely to contribute to this
patient's incontinence or confusion. Toileting may be a complicated by the
anticholinergic medication and/or the diuretic causing diuresis, urge
incontinence, and inability to void at will.
A patient with no significant medical history has varicose veins. She complains
of "aching legs". The intervention that will provide the greatest relief for her
complaint is to: - Ans✔✔-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, but will not provide
relief after her legs begin aching. Support stockings should be applied prior to
getting out of bed.
Stress urinary incontinence is: - Ans✔✔-may be aggravated by caffeine or
alcohol.
Stress urinary incontinence is not expected as a result of the normal aging
process. The primary problem is sphincter incompetence. The ingestion of
caffeine or alcohol decreases sphincter control. Anticholinergic and
antidepressant medications are causative factors related to overflow
, incontinence. Detrusor muscle instability is the primary underlying problem
causing urge incontinence.
Which commonly used herbal remedy is NOT associated with anxiety and/or
depressive symptom relief? - Ans✔✔-Ginkgo biloba
Ginkgo biloba is a common herbal remedy associated with enhancement of
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.
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? - Ans✔✔-Cataract
A cataract opacity is seen as a dark disruption of the red reflex on
ophthalmoscopic exam.
A 72 year old female patient reports a 6 month history of progressively more
swollen and painful distal interphalangeal (DIP) joints of one hand. There are
no systemic symptoms but the erythrocyte sedimentation rate (ESR),
antinuclear antibody (ANA), and rheumatoid factor (RF) are all minimally
elevated. What is the most likely diagnosis? - Ans✔✔-Osteoarthritis
When osteoarthritis affects the hands, the distal interphalangeal (DIP) joints
are usually involved. Rheumatoid arthritis is usually symmetrical, and the
proximal interphalangeal (PIP) joints are more often affected. Inflammation
often develops quickly, not gradually. This patient is elderly; therefore, it is
expected that the ESR, ANA, and RF will be only somewhat elevated. Over-
GUIDE. GRADED A+.
QUESTIONS AND 100%
VERIFIED ANSWERS. LATEST
2025/2026 UPDATE
Prescriptive authority: - Ans✔✔-may be exercised by giving a verbal medication
order to a pharmacist.
An example of exercising prescriptive authority is giving a verbal order to a
pharmacist or writing an order for a prescription medication. Prescriptive
authority rules and regulations vary from state to state. Prescriptive authority is
granted only to those APRNs who meet the requirements of the governing
body for the state in which the APRN practices.
When examining a pregnant patient, where should the fundal height be at 22
weeks? - Ans✔✔-Above the umbilicus
Between 18 and 32 weeks, there is good correlation between fundal height and
gestational age of the fetus. The expected heights are: 10-12 weeks: fundus
slightly above the symphysis pubis 16 weeks: fundus midway between the
symphysis pubis and umbilicus 20 weeks: fundus at the level of umbilicus 28
,weeks: fundus 3 fingerbreadths above the umbilicus 36 weeks: fundus just
below the xiphoid process
What intervention does the American College of Rheumatology recommend as
first-line therapy for osteoarthritis? - Ans✔✔-Exercise and weight loss
Exercise, weight loss, and rest are recommended by the American College of
Rheumatology guidelines for the initial management of osteoarthritis (OA).
Given the adverse effects of medications used to treat OA, it is best to minimize
dosage and delay use as long as possible. An extensive diagnostic workup is not
recommended 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 conservative therapies may be candidates for joint
replacement. Acetaminophen is recommended as a first-line medication.
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
nodes but no other bony deformities. Which of the following is the most
probable diagnosis? - Ans✔✔-Osteoarthritis (OA)
Although his vocation involved sedentary activity, this patient is not at great
risk for osteoarthritis. 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.
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 blocks
away. On examination, he is pleasant but mildly confused. Which of his
medications is LEAST likely contributing to his behavior? - Ans✔✔-ramipril
(Altace®)
Tricyclic antidepressants, like amitriptyline, have anticholinergic side effects
which are especially problematic in the elderly because they contribute to
urinary retention. Hydrochlorothiazide is a diuretic and may contribute to his
incontinence. Cimetidine is well known to produce adverse reactions such as
confusion in elders. Ramipril, an ACE inhibitor, is unlikely to contribute to this
patient's incontinence or confusion. Toileting may be a complicated by the
anticholinergic medication and/or the diuretic causing diuresis, urge
incontinence, and inability to void at will.
A patient with no significant medical history has varicose veins. She complains
of "aching legs". The intervention that will provide the greatest relief for her
complaint is to: - Ans✔✔-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, but will not provide
relief after her legs begin aching. Support stockings should be applied prior to
getting out of bed.
Stress urinary incontinence is: - Ans✔✔-may be aggravated by caffeine or
alcohol.
Stress urinary incontinence is not expected as a result of the normal aging
process. The primary problem is sphincter incompetence. The ingestion of
caffeine or alcohol decreases sphincter control. Anticholinergic and
antidepressant medications are causative factors related to overflow
, incontinence. Detrusor muscle instability is the primary underlying problem
causing urge incontinence.
Which commonly used herbal remedy is NOT associated with anxiety and/or
depressive symptom relief? - Ans✔✔-Ginkgo biloba
Ginkgo biloba is a common herbal remedy associated with enhancement of
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.
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? - Ans✔✔-Cataract
A cataract opacity is seen as a dark disruption of the red reflex on
ophthalmoscopic exam.
A 72 year old female patient reports a 6 month history of progressively more
swollen and painful distal interphalangeal (DIP) joints of one hand. There are
no systemic symptoms but the erythrocyte sedimentation rate (ESR),
antinuclear antibody (ANA), and rheumatoid factor (RF) are all minimally
elevated. What is the most likely diagnosis? - Ans✔✔-Osteoarthritis
When osteoarthritis affects the hands, the distal interphalangeal (DIP) joints
are usually involved. Rheumatoid arthritis is usually symmetrical, and the
proximal interphalangeal (PIP) joints are more often affected. Inflammation
often develops quickly, not gradually. This patient is elderly; therefore, it is
expected that the ESR, ANA, and RF will be only somewhat elevated. Over-
