Pre-Predictor Exam Review. Questions
with Correct Verified Answers. Latest
Edition 2025-2026. Graded A
A 12-year-old presents with ear pain of 36 hours duration. The nurse
practitioner diagnoses acute otitis media because the: - ANS bony
landmarks are obscured and the tympanic membrane is mildly
erythematous, dull, and immobile.
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.
A 15-year-old high school student presents with a mild sore throat and low-
grade fever that has persisted for about 3 weeks. She reports general
malaise, fatigue, and loss of appetite. The nurse practitioner suspects
mononucleosis. Which of the following is the LEAST appropriate
intervention? - ANSObtain a urinalysis and serum for LFTs and amylase.
The clinical presentation of this patient is typical of mononucleosis.
Lymphadenopathy, splenomegaly, pharyngeal petechiae, and leukocytosis
are common additional findings. Urinalysis, serum amylase, and LFTs
1
,would not yield information regarding the diagnosis. The confirmatory tests
are throat culture and the heterophil antibody test.
A 16 year old sexually active student presents with complaints of a
greenish-gray frothy vaginal discharge and vaginal itching. The nurse
practitioner should suspect: - ANStrichomoniasis.
The cardinal symptoms of infection with Trichomonas vaginalis (a
flagellated protozoan) is a frothy, greenish-gray discharge with a fishy odor.
The vagina may be very edematous and red. The cervix may be friable with
petechiae ("strawberry cervix").
A 16 year-old has been diagnosed with Lyme disease. Which drug should
be used to treat him? - ANSDoxycycline
Doxycycline is frequently chosen first line to treat Lyme Disease. However,
numerous studies have demonstrated that amoxicillin and cefuroxime have
equal efficacy as doxycycline in treatment of early Lyme Disease. These
drugs are recommended in patients who exhibit erythema migrans.
Doxycycline is not recommended in children less than 9 years of age.
A 17-year-old female presents with painful vesicular lesions on her vulva.
Which of the following would be the most definitive diagnostic test? -
ANSTzanck prep
Tzanck prep is the only test in this list which is diagnostic for herpes
simplex. KOH prep is used to diagnose candidal and bacterial vaginosis.
2
,Gram stain is used to help distinguish Gram positive and Gram negative
organisms. The Papanicolaou (Pap) smear is used to screen for cervical
dysplasia and cancer.
A 2-year-old female presents with a 3 day history of high fever, followed by
abrupt resolution and development of a pink, maculopapular rash today.
What pharmacological intervention(s) should the nurse practitioner
consider? - ANSNo pharmacologic intervention is needed, but fluids should
be encouraged
This 2 year old has roseola, a human herpes virus. Since the fever has
resolved and the rash will last another day or 2, no pharmacologic
intervention is needed. Fluids should be encouraged because there may be
some residual dehydration from the 3 days of fever.
A 28 year-old has a Grade 3 murmur. Which characteristic indicates a need
for referral? - ANSA fixed split
A split is created because of closure of valves. For example, an S2 is
created by closure of the aortic and pulmonic valves. Normally these split
with inspiration and almost never with expiration. Splits should never be
fixed. This indicates some pathology like an atrial septal defect, pulmonic
stenosis, or possibly mitral regurgitation. In any event, this patient needs
initial evaluation with an echocardiogram because fixed splits are always
considered abnormal.
3
, A 3 year-old female had a fever of 102 degrees F for 3 days. Today she
woke up from a nap and is afebrile. She has a maculopapular rash. Which
statement is true? - ANSThe rash will blanch.
This describes a patient with roseola or exanthem subitum. This is a
common viral exanthem found in young children caused by the Human
Herpes Virus 6B. It is characterized by high fever for 3 days followed by the
abrupt cessation of fever and the appearance of a maculopapular rash.
This usually resolves in a few days. The child may return to school or
daycare when he has been fever free for 24 hours.
A 32 year-old patient is a newly diagnosed diabetic. She has developed a
sinus infection. Her symptoms have persisted for 10 days. Six weeks ago
she was treated with amoxicillin for an upper respiratory infection. It cleared
without incident. What should be recommended today? - ANSPrescribe
amoxicillin-clavulanate today.
Amoxicillin is no longer indicated for initial treatment in adults who have
acute bacterial sinusitis. A bacterial cause can be assumed since she's had
symptoms for 10 days. A viral infection likely would have run its course by
now. After 10 days of persistent symptoms, treatment is reasonable with an
antibiotic; especially since this patient is diabetic. She may be having blood
sugar elevations that facilitate growth of the causative organism of the
sinus infection. A decongestant could be added depending on her blood
pressure and personal history of using decongestants.
4
with Correct Verified Answers. Latest
Edition 2025-2026. Graded A
A 12-year-old presents with ear pain of 36 hours duration. The nurse
practitioner diagnoses acute otitis media because the: - ANS bony
landmarks are obscured and the tympanic membrane is mildly
erythematous, dull, and immobile.
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.
A 15-year-old high school student presents with a mild sore throat and low-
grade fever that has persisted for about 3 weeks. She reports general
malaise, fatigue, and loss of appetite. The nurse practitioner suspects
mononucleosis. Which of the following is the LEAST appropriate
intervention? - ANSObtain a urinalysis and serum for LFTs and amylase.
The clinical presentation of this patient is typical of mononucleosis.
Lymphadenopathy, splenomegaly, pharyngeal petechiae, and leukocytosis
are common additional findings. Urinalysis, serum amylase, and LFTs
1
,would not yield information regarding the diagnosis. The confirmatory tests
are throat culture and the heterophil antibody test.
A 16 year old sexually active student presents with complaints of a
greenish-gray frothy vaginal discharge and vaginal itching. The nurse
practitioner should suspect: - ANStrichomoniasis.
The cardinal symptoms of infection with Trichomonas vaginalis (a
flagellated protozoan) is a frothy, greenish-gray discharge with a fishy odor.
The vagina may be very edematous and red. The cervix may be friable with
petechiae ("strawberry cervix").
A 16 year-old has been diagnosed with Lyme disease. Which drug should
be used to treat him? - ANSDoxycycline
Doxycycline is frequently chosen first line to treat Lyme Disease. However,
numerous studies have demonstrated that amoxicillin and cefuroxime have
equal efficacy as doxycycline in treatment of early Lyme Disease. These
drugs are recommended in patients who exhibit erythema migrans.
Doxycycline is not recommended in children less than 9 years of age.
A 17-year-old female presents with painful vesicular lesions on her vulva.
Which of the following would be the most definitive diagnostic test? -
ANSTzanck prep
Tzanck prep is the only test in this list which is diagnostic for herpes
simplex. KOH prep is used to diagnose candidal and bacterial vaginosis.
2
,Gram stain is used to help distinguish Gram positive and Gram negative
organisms. The Papanicolaou (Pap) smear is used to screen for cervical
dysplasia and cancer.
A 2-year-old female presents with a 3 day history of high fever, followed by
abrupt resolution and development of a pink, maculopapular rash today.
What pharmacological intervention(s) should the nurse practitioner
consider? - ANSNo pharmacologic intervention is needed, but fluids should
be encouraged
This 2 year old has roseola, a human herpes virus. Since the fever has
resolved and the rash will last another day or 2, no pharmacologic
intervention is needed. Fluids should be encouraged because there may be
some residual dehydration from the 3 days of fever.
A 28 year-old has a Grade 3 murmur. Which characteristic indicates a need
for referral? - ANSA fixed split
A split is created because of closure of valves. For example, an S2 is
created by closure of the aortic and pulmonic valves. Normally these split
with inspiration and almost never with expiration. Splits should never be
fixed. This indicates some pathology like an atrial septal defect, pulmonic
stenosis, or possibly mitral regurgitation. In any event, this patient needs
initial evaluation with an echocardiogram because fixed splits are always
considered abnormal.
3
, A 3 year-old female had a fever of 102 degrees F for 3 days. Today she
woke up from a nap and is afebrile. She has a maculopapular rash. Which
statement is true? - ANSThe rash will blanch.
This describes a patient with roseola or exanthem subitum. This is a
common viral exanthem found in young children caused by the Human
Herpes Virus 6B. It is characterized by high fever for 3 days followed by the
abrupt cessation of fever and the appearance of a maculopapular rash.
This usually resolves in a few days. The child may return to school or
daycare when he has been fever free for 24 hours.
A 32 year-old patient is a newly diagnosed diabetic. She has developed a
sinus infection. Her symptoms have persisted for 10 days. Six weeks ago
she was treated with amoxicillin for an upper respiratory infection. It cleared
without incident. What should be recommended today? - ANSPrescribe
amoxicillin-clavulanate today.
Amoxicillin is no longer indicated for initial treatment in adults who have
acute bacterial sinusitis. A bacterial cause can be assumed since she's had
symptoms for 10 days. A viral infection likely would have run its course by
now. After 10 days of persistent symptoms, treatment is reasonable with an
antibiotic; especially since this patient is diabetic. She may be having blood
sugar elevations that facilitate growth of the causative organism of the
sinus infection. A decongestant could be added depending on her blood
pressure and personal history of using decongestants.
4
