APEA PRE-PREDICTOR 2025-2026 ACTUAL EXAM
TEST BANK 850+ QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
(VERIFIED ANSWERS) |ALREADY GRADED A+
A 6 year had an acute onset ofifever, pharyngitis, and headache 2idays ago. Today,
h e presents with cervical lymphadenopathy and sandpaperitextured rash
everywhe re except on his face. A rapid streptococcal antigen test is positive. The
remainder of the assessment in unremarkable. What is the most likely diagnosis
and the mo st appropriate action? - answer-Scarlet fever; treatiwith antibiotics.
This disease is due to infection with Group A Beta-
hemolytic streptococcus. The rash is thought to be due to a systemic reaction to t
he toxin produced by the microorganism. The rash fades with pressure and ultim
ately desquamates. A deep, nonblanchingirash on the flexor surfaces of the skin i
s referred to as pastia lines.
A patient has been diagnosed with hypothyroidism and thyroid hormone replace
ment therapy is prescribed. When should the nurse practitioner check the patien
t's TSH? - answer-6 weeks.
The half-
life of levothyroxine, the treatment ofichoice for thyroid replacement, is 7 days.
The earliest that meaningful changes will be observed is at 4-
6 weeks. Therefore, the NP should wait a minimum ofi4-
6 weeks before checking the patient's TSH.
A 15 year malue has a history of cryptorchidism which was surgically repaired.
Bec ause of this information, it is essential forithe nurse practitionerito teach him
abo ut: - answer-testicular self- examination.
Cryptorchidism, even with surgical repair, is associated with increased risk for testic
ular cancer.
The treatment of choice forichronic bacterial prostatitis (CBP) is: - answer-
a flouroquinolone twice daily fori3 weeks to 4 months.
The treatmentiof chice is aiflouroquinolone twice dailyifor 3 weeks to 4 month
s. The cure rate with Bactrim-DS is onlyiabout 30-40%.
,A 25 year female has a history of frequent candidal vaginal infections in the past
ye ar. She is in a monogamous sexual relationship and uses and IUD
foricontracepti on. Ofithe following, which is the most likely
underlyingiconidition predisposing herito recurring candidal vaginitis? -
answer-Diabetes.
A common underlying cause ofifrequent infections is diabetes mellitus. Pregnan
cyiincreases the incidence of candidiasis, but is unlikely a factoriwith this patient
.
Which ofithe followingiis NOT a characteristic of the S3 heart sound? - answer-
The sound is high-pitched and occurs just prior to the S1 heart sound.
The S3 heartisound is low-
pitched and occurs just afterithe S2 heart sound. It is produced by rapid ventricul
arifillingiand is best auscultated in the mitral area. It is a common finding with rig
ht-sided heart failure, rapid growth, and the last trimester of pregnancy.
Following the findingiof prostate gland abnormalities on DRE, the NP orders the
appropriate labs. Whem preparing to review lab reports withithe patient, the nurs
e practitioner knows all of the following are true EXCEPT: - answer-
normal PSAiis 10ng/ml oriless.
Normal PSAiis 4ng/ml oriless. PSAilevels greater the 4 and less than 10 are associ
ated withiBPH. Ai10 origreater PSAilevel suggests prostate cancer. Positive seru
m acid phosphatase is associated with malignancy of the prostate gland with bon
e metasasis.
Ai66 year female presents to your clinic. She states that yesterday evening she had
c hest pain fori20-
30 minutes. Whichifinding most strongly correlates with myocardial infarction? -
answer-Elevated Troponin I levels
An elevated creatinine kinase (CK) is not diagnostic of a myocardial infarction (
MI). CKimay be elevated from an IM injection, surgery, ot anyitype of extensive s
keletal muscle trauma oriprolonged, strenuous physical exertion. ST segment de
pression on EKG usually indicates an ischemic myocardium, but, not necessaril
y, one post-
MI. Elevated ST seghments reflect mycardial damage. MB bands are specific for
myocardial smoothimuscle. Ifithese are elevated, the patientiMAY HAVE had a v
,ery recent MI. The most accurate marker of cardiac damage, because it is more s
pecific and sensitive than CK MB, is a troponin measurement.
Whatiis a secondary cause ofihyperlipidemia? - answer-hypothyroidism
Hypothyroidism is a common secondary cause of hyperlipidemia. In the evaluat
ion of a patientiwith hyperlipidemia, a TSH should always be checked and correc
ted before attempting treatment for hyperlipidemia. Other possible causes of sec
onday hyperlipidemia include pregnancy, excessive weight gain, excessive alcoh
ol intake, insulin resistance or deficiency, obstructive liver disease, and uremia.
Some medications can produce secondary hypothyroidism too: thiazide diuretic
s, some beta-blockers, oral contraceptives, and corticosteroids.
A 35-
yo male presents with a complaint of low pelvic pain, dysuria, hesitancy, urgency,
and reduced for of stream. The nurse practitionerisuspects acute bacterial prostat
itis. The NP would appropriately collect all of the followingispecimens EXCEPT
a: sterile in-and-out catheteriurine specimen. - answer-Aisterile
in-and-
out catheterispecimen would identify onlyiorganisms in the bladder and would not di
fferentiate
between bladder, kidney, or prostate site infection. The sequence for obtaining s
pecimens when prostat infection is suspected is: 1. voided urethral urine, 2. Voide
d mid-stream bladderiurine, and 3. voided post-prostate massage urine.
A 24 yo female taking an oral contraceptive has missed her last 2 pills. What shoul
d the nurse practitioner advise herito do to minimize her risk of pregnancy? -
answer-
Double today's dose and tomorrow's dose and use a barrier method forithe rest of
the month.
If 2imills are missed on consecutive days, the next 2 days' doseages should be dou
bled and a barrierimethod recommended forithe remainder of the cycle.
A 50yo, non-smoker, withino co-
morbidity presents to the clinica and is diagnosed with pna. His vital signs are no
rmal except foritemperature of 101.6 degrees. A sputum specimen is collected and
sent foriculture and sensitivity. What action should the nurse practitioneritake tod
, ay? - answer-Start Clarithromycin (Biaxin) 500mg 2 times a day fori10 to 14 days.
Mostitreatment guidelines for outpatient pna in non-smokers without co-
morbidity and 60 years ofiage oriyounger, recommend erythromycin or anotherim
acrolide like Biaxin. Pcn s indicated for patient swith pneumococcal pna and cipr
ofloxacin is recommended foriLegionella species.
Ai38 yeariold patient is being treated the by the NP foriheavy vaginal bleedingise
condaryito multiple uterine leiomyomas. Her uterus is greater than 12 weeks ges
tational size, her hematocrit is 28%, and she has not responded to hormonal ther
apy. Whichiofithe following would be the most appropriate intervention at this ti
me? - answer-Obtain a gynecological consultation
Gynecological consultation is recommended for a patient with a uterus greater t
hat 12 weeks gestational size, significant anemia (hct <30),. o a normal endometr
ial biopsyiwithifailure to respond to hormonal therapy.
Whatimaternal situation is considered an absolute contraindication to breastfeedi
ng? - answer-Early HIV detection
There are fewiabsolute contraindications to breastfeeding. HIV infection and IV
drug abuse are 2 contraindications.
Ai21 yo college student presents to the sudent health center with copious, marked
ly purulent discharge from herileft eye. The nurse practitioner should suspect: -
answer-gonococcal conjunctivitis.
A purulent and copious discharge should alert the nurse practitioner to the likely
possibility of gonococcal orichlamydial conjunctivitis. Noth require systemic ani
tbiotic treatment and immediate referral to an opthalmologist for evaluation.
Babies should begin oral iron supplementation: - answer-4-6 months of age.
Generally, full term infants who are breadt-
fed have sufficient stores ofiiron to last through the first 4-
6 months ofilife. Earlierisupplementation may be m=necessary foripremature infa
nts, infants who are breastyfed exclusively beyond the first 6 months ofiage, and in
fants who begin drinking cow's milkiprior to 1 year ofiage.
Which item is NOT implicated in erectile dysfunction (ED)? - answer-
Urinary tract infection (UTI)
TEST BANK 850+ QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
(VERIFIED ANSWERS) |ALREADY GRADED A+
A 6 year had an acute onset ofifever, pharyngitis, and headache 2idays ago. Today,
h e presents with cervical lymphadenopathy and sandpaperitextured rash
everywhe re except on his face. A rapid streptococcal antigen test is positive. The
remainder of the assessment in unremarkable. What is the most likely diagnosis
and the mo st appropriate action? - answer-Scarlet fever; treatiwith antibiotics.
This disease is due to infection with Group A Beta-
hemolytic streptococcus. The rash is thought to be due to a systemic reaction to t
he toxin produced by the microorganism. The rash fades with pressure and ultim
ately desquamates. A deep, nonblanchingirash on the flexor surfaces of the skin i
s referred to as pastia lines.
A patient has been diagnosed with hypothyroidism and thyroid hormone replace
ment therapy is prescribed. When should the nurse practitioner check the patien
t's TSH? - answer-6 weeks.
The half-
life of levothyroxine, the treatment ofichoice for thyroid replacement, is 7 days.
The earliest that meaningful changes will be observed is at 4-
6 weeks. Therefore, the NP should wait a minimum ofi4-
6 weeks before checking the patient's TSH.
A 15 year malue has a history of cryptorchidism which was surgically repaired.
Bec ause of this information, it is essential forithe nurse practitionerito teach him
abo ut: - answer-testicular self- examination.
Cryptorchidism, even with surgical repair, is associated with increased risk for testic
ular cancer.
The treatment of choice forichronic bacterial prostatitis (CBP) is: - answer-
a flouroquinolone twice daily fori3 weeks to 4 months.
The treatmentiof chice is aiflouroquinolone twice dailyifor 3 weeks to 4 month
s. The cure rate with Bactrim-DS is onlyiabout 30-40%.
,A 25 year female has a history of frequent candidal vaginal infections in the past
ye ar. She is in a monogamous sexual relationship and uses and IUD
foricontracepti on. Ofithe following, which is the most likely
underlyingiconidition predisposing herito recurring candidal vaginitis? -
answer-Diabetes.
A common underlying cause ofifrequent infections is diabetes mellitus. Pregnan
cyiincreases the incidence of candidiasis, but is unlikely a factoriwith this patient
.
Which ofithe followingiis NOT a characteristic of the S3 heart sound? - answer-
The sound is high-pitched and occurs just prior to the S1 heart sound.
The S3 heartisound is low-
pitched and occurs just afterithe S2 heart sound. It is produced by rapid ventricul
arifillingiand is best auscultated in the mitral area. It is a common finding with rig
ht-sided heart failure, rapid growth, and the last trimester of pregnancy.
Following the findingiof prostate gland abnormalities on DRE, the NP orders the
appropriate labs. Whem preparing to review lab reports withithe patient, the nurs
e practitioner knows all of the following are true EXCEPT: - answer-
normal PSAiis 10ng/ml oriless.
Normal PSAiis 4ng/ml oriless. PSAilevels greater the 4 and less than 10 are associ
ated withiBPH. Ai10 origreater PSAilevel suggests prostate cancer. Positive seru
m acid phosphatase is associated with malignancy of the prostate gland with bon
e metasasis.
Ai66 year female presents to your clinic. She states that yesterday evening she had
c hest pain fori20-
30 minutes. Whichifinding most strongly correlates with myocardial infarction? -
answer-Elevated Troponin I levels
An elevated creatinine kinase (CK) is not diagnostic of a myocardial infarction (
MI). CKimay be elevated from an IM injection, surgery, ot anyitype of extensive s
keletal muscle trauma oriprolonged, strenuous physical exertion. ST segment de
pression on EKG usually indicates an ischemic myocardium, but, not necessaril
y, one post-
MI. Elevated ST seghments reflect mycardial damage. MB bands are specific for
myocardial smoothimuscle. Ifithese are elevated, the patientiMAY HAVE had a v
,ery recent MI. The most accurate marker of cardiac damage, because it is more s
pecific and sensitive than CK MB, is a troponin measurement.
Whatiis a secondary cause ofihyperlipidemia? - answer-hypothyroidism
Hypothyroidism is a common secondary cause of hyperlipidemia. In the evaluat
ion of a patientiwith hyperlipidemia, a TSH should always be checked and correc
ted before attempting treatment for hyperlipidemia. Other possible causes of sec
onday hyperlipidemia include pregnancy, excessive weight gain, excessive alcoh
ol intake, insulin resistance or deficiency, obstructive liver disease, and uremia.
Some medications can produce secondary hypothyroidism too: thiazide diuretic
s, some beta-blockers, oral contraceptives, and corticosteroids.
A 35-
yo male presents with a complaint of low pelvic pain, dysuria, hesitancy, urgency,
and reduced for of stream. The nurse practitionerisuspects acute bacterial prostat
itis. The NP would appropriately collect all of the followingispecimens EXCEPT
a: sterile in-and-out catheteriurine specimen. - answer-Aisterile
in-and-
out catheterispecimen would identify onlyiorganisms in the bladder and would not di
fferentiate
between bladder, kidney, or prostate site infection. The sequence for obtaining s
pecimens when prostat infection is suspected is: 1. voided urethral urine, 2. Voide
d mid-stream bladderiurine, and 3. voided post-prostate massage urine.
A 24 yo female taking an oral contraceptive has missed her last 2 pills. What shoul
d the nurse practitioner advise herito do to minimize her risk of pregnancy? -
answer-
Double today's dose and tomorrow's dose and use a barrier method forithe rest of
the month.
If 2imills are missed on consecutive days, the next 2 days' doseages should be dou
bled and a barrierimethod recommended forithe remainder of the cycle.
A 50yo, non-smoker, withino co-
morbidity presents to the clinica and is diagnosed with pna. His vital signs are no
rmal except foritemperature of 101.6 degrees. A sputum specimen is collected and
sent foriculture and sensitivity. What action should the nurse practitioneritake tod
, ay? - answer-Start Clarithromycin (Biaxin) 500mg 2 times a day fori10 to 14 days.
Mostitreatment guidelines for outpatient pna in non-smokers without co-
morbidity and 60 years ofiage oriyounger, recommend erythromycin or anotherim
acrolide like Biaxin. Pcn s indicated for patient swith pneumococcal pna and cipr
ofloxacin is recommended foriLegionella species.
Ai38 yeariold patient is being treated the by the NP foriheavy vaginal bleedingise
condaryito multiple uterine leiomyomas. Her uterus is greater than 12 weeks ges
tational size, her hematocrit is 28%, and she has not responded to hormonal ther
apy. Whichiofithe following would be the most appropriate intervention at this ti
me? - answer-Obtain a gynecological consultation
Gynecological consultation is recommended for a patient with a uterus greater t
hat 12 weeks gestational size, significant anemia (hct <30),. o a normal endometr
ial biopsyiwithifailure to respond to hormonal therapy.
Whatimaternal situation is considered an absolute contraindication to breastfeedi
ng? - answer-Early HIV detection
There are fewiabsolute contraindications to breastfeeding. HIV infection and IV
drug abuse are 2 contraindications.
Ai21 yo college student presents to the sudent health center with copious, marked
ly purulent discharge from herileft eye. The nurse practitioner should suspect: -
answer-gonococcal conjunctivitis.
A purulent and copious discharge should alert the nurse practitioner to the likely
possibility of gonococcal orichlamydial conjunctivitis. Noth require systemic ani
tbiotic treatment and immediate referral to an opthalmologist for evaluation.
Babies should begin oral iron supplementation: - answer-4-6 months of age.
Generally, full term infants who are breadt-
fed have sufficient stores ofiiron to last through the first 4-
6 months ofilife. Earlierisupplementation may be m=necessary foripremature infa
nts, infants who are breastyfed exclusively beyond the first 6 months ofiage, and in
fants who begin drinking cow's milkiprior to 1 year ofiage.
Which item is NOT implicated in erectile dysfunction (ED)? - answer-
Urinary tract infection (UTI)
