APEA Predictor exam
Cranial Nerve VIII - answer Acoustic (Hearing and balance)
Cranial nerve IX - answer Glossopharyngeal- swallowing and rise of the palate, gag
reflex
Cranial Nerve XI - answer Spinal Accessory (upper trapezius)
Deep tendon reflex – answer Ankle- S1 primarily
Knee- Lumbar 2,3,4
Supinator(brachioradialis)-C5,6
BicepTriceps-C6,7
Stroke risk scale - answerCHADS2
C-Congestive heart failure
H-Hypertension
A-Age >75 years
D- Diabetes
S-prior Stroke/TIA
In the majority of children, the first permanent teeth start to erupt at the age of 6 years.
Which of the following are the first permanent teeth to erupt in this time period?
A. First Molars
B. Second Molars
C. Lower or upper incisors
D. Canines - answerA. First Molars
All of the following are classified as activities of daily living (ADLs) except:
A. ability to feed self
B. Ability to manage bladder and bowel elimination
C. Personal hygiene and grooming
D. Grocery Shopping - answerD. Grocery shopping
You note the following result on a routine urinalysis of a 37-year old primigravida who is
at 30 weeks gestation. Leukocyte=trace, nitrite=negative, protein=2+, blood=negative.
Her weight has increased by 5 lbs during the past week. Which of the following is most
likely?
A.HELLP syndrome
B. Pregnancy-induced hypertension (pre-eclampsia)
C. Eclampsia of pregnancy
,D. Primary hypertension - answerB. Pregnancy-induced hypertension (pre-eclampsia).
Classic triad of symptoms of preeclampsia include hypertension, edema (weight gain),
and proteinuria.
The mother of a 12 month old infant reports to the nurse practitioner that her child had a
high fever for several days, which spontaneously resolved. After the fever resolved, the
child developed a maculopapular rash. Which of the following is the most likely
diagnosis?
A. Fifth Disease (erythema infectiosum)
B. Roseola infantum (exanthema subitum)
C. Varicella
D. Infantile maculopapular rashes - answerB. Roseola Infantum (Exanthema subitum)
A 70-year old male patient complains of a bright red-colored spot in his left eye for 2
days. He denies eye pain, visual changes, or headaches. He has a new onset of cough
from a recent viral upper respiratory infection. The only medicine he is on Bayer aspirin,
1 tablet a day. Which of the following is most likely?
A. Corneal abrasion
B. Acute bacterial conjunctivitis
C. Acute uveitis
D. Subconjunctival hemorrhage - answerD. Subconjunctival hemorrhage. Bright red
blood in a sharply defined area surrounded by normal-appearing conjunctiva indicates
subconjunctival hemorrhage.
A woman is being evaluated by the nurse practitioner for complaints of dyspareunia. A
microscopy slide reveals a large number of atrophic squamous epithelial cells. The
vaginal pH is 4.0. There are very few leukocytes and no RBCs are seen on the wet
smear. Which of the following is most likely?
A. Atrophic vaginitis
B. Bacterial Vaginosis
C. Trichomoniasis
D. This is a normal finding. - answerA. Atrophic vaginitis. Symptoms of atrophic vaginitis
include painful intercourse, atrophic squamous epithelial cells, and a decrease in pH.
Vaginal atrophy is caused by lack of or imbalance of estrogen. Normal pH of the vagina
is 4.0-5.0 (acidic)
The most common type of skin malignancy is:
A. Squamous cell cancer
B. Basal skin cancer
C. Melanoma
D. Dysplastic nevi - answerB. Basal skin cancer. It is several times more common that
squamous cell skin cancer according to the NIH.
Koplik's spots are associated with:
A. Poxvirius infections
B. Measles
,C. Kawasaki's disease
D. Reye's syndrome - answerB. Measles. S/S include fever over 101, coryza, cough,
conjunctivitis, rash, and koplik's spots on buccal mucosa
At what level of prevention would you classify for lung cancer?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Primordial prevention - answerD. primordial prevention. Screening for lung cancer is
not currently recommended in the general population, but it is secondary prevention.
A test called the visual fields by confrontation is used to evaluate for:
A. Peripheral vision
B. Central vision
C. Visual acuity
D. Accomodation - answerA. Peripheral vision
What is the most common cause of Cushing's syndrome? - answerAdministration of a
glucocorticoid or ACTH.
Iatrogenic Cushing's syndrome is the most common type. Exogenous glucocorticoid
administration produces a Cushing's Syndrome that is reversible by discontinuation of
the medication.
A patient with no significant medical history has vericose veins. She complains of
'"aching legs". The intervention that will provide the greatest relief for her complaint is to:
- answerElevate 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.
A 25-yo female patient presents for a routine well-women exam. On physical exam, the
NP notes a scant nipple discharge, absence of palpable mass, and absence of lymph
node enlargement. What is the most likely diagnosis? - answerItraductal papilloma.
Intraductal papilloma often presents as a non-tender mass with serous or bloody nipple
discharge located in the ductal system near the areola. Breast cancer, although usually
non-tender, may present with pain. Chest wall syndrome may present in some women
as breast pain. Fibrocystic breast disease often presents with bilateral breast pain.
According to the ANA, the role of the NP who provides primary health care is the: -
answerDirect nursing care role.
The NP with a traditional nursing care role is a primary health care provider. Increasing
numbers of nurse practitioners are assuming indirect roles such as educator,
administrator, researcher, and consultant.
, An 8-mo male presents with hemarthrosis of both knees and hematuria. The parents
give no history of trauma, but say " he has always bruised easily" The most likely
diagnosis is: - answerA type of hemophilia.
Hemophilia is usually diagnosed within the first year of life. It commonly presents with
hemarthrosis, bleeding into soft tissue, hematuria, and prolonged bleeding times.
The nurse practitioner is following a child with juvemile rheumatoid arthritis (JRA) who
has been previously diagnosed and is being managed for the disease by a pediatric
rheumatologist. The mother asks for information about the child's long-term prognosis.
The appropriate reply is that: - answermost children with JRA achieve complete
remission by adulthood, but its effects might cause lifelong limitations.
Although the active disease does not continue into adulthood, the contractures, growth
retardation, bone deformities, and visual impairment associated with JRA may lead to
lifelong functional impairments. A comprehensive treatment program involving physical
therapy, occupational therapy, nutrition, education, and regular opthalmologic care can
limit residual functional limitations.
Approximately 70% of the organisms found in canine oral and nasal fluids, and
consequently in fresh dog bite wounds, are: - answerStaphylococcus and Pasteurella
multocida.
All of these organisms are found in canine oral and nasal fluids, and cultured from fresh
dog bite wounds, but the most common (70%) are Staph and Pasteurella multocida.
Education of women with fibrocystic breast disease should include which of the
following statements? - answerCaffeine may trigger breast pain.
Avoidance of all methylxanthines (eg coffee, tea, chocolate) has been shown to reduce
breast pain in women with fibrocystic breast disease. It is usually a benign condition, not
a precursor of malignancy. Mammography is recommended once at age 35 years, at
least every 1-2 years after age 40, and then annually beginning at age 50 years. Oral
contraceptives may help reduce cyclical pain and swelling.
Congenital heart disorders present with symptoms at: - answerbirth, infancy, or in
childhood.
A common misconception is that congenital disorders always present symptomatically
at birth. They can present at various times throughout childhood and are classified as
cyanotic or acyanotic. Cardiac disorders in infants and children may be acquired from
rheumatic fever or kawasaki syndrome.
A 21-yo patient presents with abdominal guarding, rigid abdominal musculature,
rebound tenderness at McBurney's point, and leukocytosis. What is the most likely
diagnosis? - answerAppendicitis.
McBurney's point is the RLQ abdominal landmark for the appendix. Rigid abdominal
musculature, rebound tenderness, and positive psoas sign (inflamed psoas muscle),
indicates inflammation of the peritoneum. Cholecystitis presents with RUQ pain and
positive Murphy's inspriatory arrest. Ilcerative colitis presents with LLQ pain. Pain
associated with pancreatitis is typically in the epigastric region.
Cranial Nerve VIII - answer Acoustic (Hearing and balance)
Cranial nerve IX - answer Glossopharyngeal- swallowing and rise of the palate, gag
reflex
Cranial Nerve XI - answer Spinal Accessory (upper trapezius)
Deep tendon reflex – answer Ankle- S1 primarily
Knee- Lumbar 2,3,4
Supinator(brachioradialis)-C5,6
BicepTriceps-C6,7
Stroke risk scale - answerCHADS2
C-Congestive heart failure
H-Hypertension
A-Age >75 years
D- Diabetes
S-prior Stroke/TIA
In the majority of children, the first permanent teeth start to erupt at the age of 6 years.
Which of the following are the first permanent teeth to erupt in this time period?
A. First Molars
B. Second Molars
C. Lower or upper incisors
D. Canines - answerA. First Molars
All of the following are classified as activities of daily living (ADLs) except:
A. ability to feed self
B. Ability to manage bladder and bowel elimination
C. Personal hygiene and grooming
D. Grocery Shopping - answerD. Grocery shopping
You note the following result on a routine urinalysis of a 37-year old primigravida who is
at 30 weeks gestation. Leukocyte=trace, nitrite=negative, protein=2+, blood=negative.
Her weight has increased by 5 lbs during the past week. Which of the following is most
likely?
A.HELLP syndrome
B. Pregnancy-induced hypertension (pre-eclampsia)
C. Eclampsia of pregnancy
,D. Primary hypertension - answerB. Pregnancy-induced hypertension (pre-eclampsia).
Classic triad of symptoms of preeclampsia include hypertension, edema (weight gain),
and proteinuria.
The mother of a 12 month old infant reports to the nurse practitioner that her child had a
high fever for several days, which spontaneously resolved. After the fever resolved, the
child developed a maculopapular rash. Which of the following is the most likely
diagnosis?
A. Fifth Disease (erythema infectiosum)
B. Roseola infantum (exanthema subitum)
C. Varicella
D. Infantile maculopapular rashes - answerB. Roseola Infantum (Exanthema subitum)
A 70-year old male patient complains of a bright red-colored spot in his left eye for 2
days. He denies eye pain, visual changes, or headaches. He has a new onset of cough
from a recent viral upper respiratory infection. The only medicine he is on Bayer aspirin,
1 tablet a day. Which of the following is most likely?
A. Corneal abrasion
B. Acute bacterial conjunctivitis
C. Acute uveitis
D. Subconjunctival hemorrhage - answerD. Subconjunctival hemorrhage. Bright red
blood in a sharply defined area surrounded by normal-appearing conjunctiva indicates
subconjunctival hemorrhage.
A woman is being evaluated by the nurse practitioner for complaints of dyspareunia. A
microscopy slide reveals a large number of atrophic squamous epithelial cells. The
vaginal pH is 4.0. There are very few leukocytes and no RBCs are seen on the wet
smear. Which of the following is most likely?
A. Atrophic vaginitis
B. Bacterial Vaginosis
C. Trichomoniasis
D. This is a normal finding. - answerA. Atrophic vaginitis. Symptoms of atrophic vaginitis
include painful intercourse, atrophic squamous epithelial cells, and a decrease in pH.
Vaginal atrophy is caused by lack of or imbalance of estrogen. Normal pH of the vagina
is 4.0-5.0 (acidic)
The most common type of skin malignancy is:
A. Squamous cell cancer
B. Basal skin cancer
C. Melanoma
D. Dysplastic nevi - answerB. Basal skin cancer. It is several times more common that
squamous cell skin cancer according to the NIH.
Koplik's spots are associated with:
A. Poxvirius infections
B. Measles
,C. Kawasaki's disease
D. Reye's syndrome - answerB. Measles. S/S include fever over 101, coryza, cough,
conjunctivitis, rash, and koplik's spots on buccal mucosa
At what level of prevention would you classify for lung cancer?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Primordial prevention - answerD. primordial prevention. Screening for lung cancer is
not currently recommended in the general population, but it is secondary prevention.
A test called the visual fields by confrontation is used to evaluate for:
A. Peripheral vision
B. Central vision
C. Visual acuity
D. Accomodation - answerA. Peripheral vision
What is the most common cause of Cushing's syndrome? - answerAdministration of a
glucocorticoid or ACTH.
Iatrogenic Cushing's syndrome is the most common type. Exogenous glucocorticoid
administration produces a Cushing's Syndrome that is reversible by discontinuation of
the medication.
A patient with no significant medical history has vericose veins. She complains of
'"aching legs". The intervention that will provide the greatest relief for her complaint is to:
- answerElevate 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.
A 25-yo female patient presents for a routine well-women exam. On physical exam, the
NP notes a scant nipple discharge, absence of palpable mass, and absence of lymph
node enlargement. What is the most likely diagnosis? - answerItraductal papilloma.
Intraductal papilloma often presents as a non-tender mass with serous or bloody nipple
discharge located in the ductal system near the areola. Breast cancer, although usually
non-tender, may present with pain. Chest wall syndrome may present in some women
as breast pain. Fibrocystic breast disease often presents with bilateral breast pain.
According to the ANA, the role of the NP who provides primary health care is the: -
answerDirect nursing care role.
The NP with a traditional nursing care role is a primary health care provider. Increasing
numbers of nurse practitioners are assuming indirect roles such as educator,
administrator, researcher, and consultant.
, An 8-mo male presents with hemarthrosis of both knees and hematuria. The parents
give no history of trauma, but say " he has always bruised easily" The most likely
diagnosis is: - answerA type of hemophilia.
Hemophilia is usually diagnosed within the first year of life. It commonly presents with
hemarthrosis, bleeding into soft tissue, hematuria, and prolonged bleeding times.
The nurse practitioner is following a child with juvemile rheumatoid arthritis (JRA) who
has been previously diagnosed and is being managed for the disease by a pediatric
rheumatologist. The mother asks for information about the child's long-term prognosis.
The appropriate reply is that: - answermost children with JRA achieve complete
remission by adulthood, but its effects might cause lifelong limitations.
Although the active disease does not continue into adulthood, the contractures, growth
retardation, bone deformities, and visual impairment associated with JRA may lead to
lifelong functional impairments. A comprehensive treatment program involving physical
therapy, occupational therapy, nutrition, education, and regular opthalmologic care can
limit residual functional limitations.
Approximately 70% of the organisms found in canine oral and nasal fluids, and
consequently in fresh dog bite wounds, are: - answerStaphylococcus and Pasteurella
multocida.
All of these organisms are found in canine oral and nasal fluids, and cultured from fresh
dog bite wounds, but the most common (70%) are Staph and Pasteurella multocida.
Education of women with fibrocystic breast disease should include which of the
following statements? - answerCaffeine may trigger breast pain.
Avoidance of all methylxanthines (eg coffee, tea, chocolate) has been shown to reduce
breast pain in women with fibrocystic breast disease. It is usually a benign condition, not
a precursor of malignancy. Mammography is recommended once at age 35 years, at
least every 1-2 years after age 40, and then annually beginning at age 50 years. Oral
contraceptives may help reduce cyclical pain and swelling.
Congenital heart disorders present with symptoms at: - answerbirth, infancy, or in
childhood.
A common misconception is that congenital disorders always present symptomatically
at birth. They can present at various times throughout childhood and are classified as
cyanotic or acyanotic. Cardiac disorders in infants and children may be acquired from
rheumatic fever or kawasaki syndrome.
A 21-yo patient presents with abdominal guarding, rigid abdominal musculature,
rebound tenderness at McBurney's point, and leukocytosis. What is the most likely
diagnosis? - answerAppendicitis.
McBurney's point is the RLQ abdominal landmark for the appendix. Rigid abdominal
musculature, rebound tenderness, and positive psoas sign (inflamed psoas muscle),
indicates inflammation of the peritoneum. Cholecystitis presents with RUQ pain and
positive Murphy's inspriatory arrest. Ilcerative colitis presents with LLQ pain. Pain
associated with pancreatitis is typically in the epigastric region.
