APEA Pre-Predictor 2024/2025 Exam Test Bank Overview
questions and answers
Scarlet fever - ANSWER: A disease due to infection with Group A Beta-hemolytic
streptococcus, characterized by an acute onset of fever, pharyngitis, headache,
cervical lymphadenopathy, and a sandpaper textured rash.
Pastia lines - ANSWER: A deep, nonblanching rash on the flexor surfaces of the
skin associated with scarlet fever.
TSH check timing after thyroid hormone replacement - ANSWER: The nurse
practitioner should check the patient's TSH 6 weeks after starting thyroid hormone
replacement therapy.
Half-life of levothyroxine - ANSWER: The half-life of levothyroxine, the treatment of
choice for thyroid replacement, is 7 days.
Testicular self-examination - ANSWER: Essential for a patient with a history of
cryptorchidism to monitor for increased risk of testicular cancer.
Chronic bacterial prostatitis treatment - ANSWER: The treatment of choice is a
fluoroquinolone twice daily for 3 weeks to 4 months.
Candidal vaginitis underlying condition - ANSWER: Diabetes mellitus is a common
underlying cause of frequent candidal vaginal infections.
S3 heart sound characteristics - ANSWER: The S3 heart sound is low-pitched and
occurs just after the S2 heart sound, produced by rapid ventricular filling.
Normal PSA level - ANSWER: Normal PSA is 4 ng/ml or less; levels greater than 4
and less than 10 are associated with BPH.
,Prostate cancer PSA level - ANSWER: A PSA level of 10 or greater suggests
prostate cancer.
Positive serum acid phosphatase - ANSWER: Positive serum acid phosphatase is
associated with malignancy of the prostate gland with bone metastasis.
Acute onset symptoms in a child - ANSWER: Symptoms include fever, pharyngitis,
headache, cervical lymphadenopathy, and a sandpaper textured rash.
Fluoroquinolone cure rate for CBP - ANSWER: The cure rate with Bactrim-DS for
chronic bacterial prostatitis is only about 30-40%.
Risk factors for testicular cancer - ANSWER: Cryptorchidism is associated with an
increased risk for testicular cancer.
Incidence of candidiasis during pregnancy - ANSWER: Pregnancy increases the
incidence of candidiasis, but is unlikely a factor for a patient in a monogamous
relationship with an IUD.
Characteristics of S3 heart sound - ANSWER: It is a common finding with right-
sided heart failure, rapid growth, and the last trimester of pregnancy.
Timing for checking TSH after therapy - ANSWER: Meaningful changes in TSH levels
will be observed at 4-6 weeks after starting therapy.
Candidal vaginitis risk factors - ANSWER: Frequent infections can be caused by
underlying conditions such as diabetes mellitus.
Prostate gland abnormalities - ANSWER: Finding abnormalities on DRE
necessitates appropriate lab orders and review of PSA levels.
Fluoroquinolone dosage for prostatitis - ANSWER: Administered twice daily for a
duration of 3 weeks to 4 months.
,Cervical lymphadenopathy - ANSWER: Swelling of the cervical lymph nodes often
associated with infections such as scarlet fever.
Sandpaper textured rash - ANSWER: A characteristic rash associated with scarlet
fever that fades with pressure and ultimately desquamates.
Elevated Troponin I levels - ANSWER: Finding that most strongly correlates with
myocardial infarction.
Elevated creatinine kinase (CK) - ANSWER: Not diagnostic of a myocardial
infarction (MI); may be elevated from IM injection, surgery, or extensive skeletal
muscle trauma.
ST segment depression on EKG - ANSWER: Usually indicates ischemic myocardium,
but not necessarily post-MI.
Elevated ST segments - ANSWER: Reflect myocardial damage.
MB bands - ANSWER: Specific for myocardial smooth muscle; if elevated, the
patient may have had a very recent MI.
Troponin measurement - ANSWER: Most accurate marker of cardiac damage, more
specific and sensitive than CK MB.
Secondary cause of hyperlipidemia - ANSWER: Hypothyroidism is a common
secondary cause; TSH should always be checked and corrected before treatment.
Other causes of secondary hyperlipidemia - ANSWER: Include pregnancy, excessive
weight gain, excessive alcohol intake, insulin resistance or deficiency, obstructive
liver disease, and uremia.
Medications causing secondary hypothyroidism - ANSWER: Include thiazide
diuretics, some beta-blockers, oral contraceptives, and corticosteroids.
, Acute bacterial prostatitis - ANSWER: Suspected in a patient with low pelvic pain,
dysuria, hesitancy, urgency, and reduced flow of stream.
Sterile in-and-out catheter urine specimen - ANSWER: Would identify only
organisms in the bladder and would not differentiate between bladder, kidney, or
prostate site infection.
Sequence for obtaining specimens in prostatitis - ANSWER: 1. Voided urethral urine,
2. Voided mid-stream bladder urine, 3. Voided post-prostate massage urine.
Missed oral contraceptive pills - ANSWER: If 2 pills are missed on consecutive days,
double today's dose and tomorrow's dose and use a barrier method for the rest of
the month.
Outpatient pneumonia treatment for non-smokers - ANSWER: Start Clarithromycin
(Biaxin) 500mg 2 times a day for 10 to 14 days.
Recommended treatment for pneumococcal pneumonia - ANSWER: Penicillin is
indicated for patients with pneumococcal pneumonia.
Legionella species treatment - ANSWER: Ciprofloxacin is recommended.
Heavy vaginal bleeding secondary to uterine leiomyomas - ANSWER: Most
appropriate intervention is to obtain a gynecological consultation.
Criteria for gynecological consultation - ANSWER: Recommended for a uterus
greater than 12 weeks gestational size, significant anemia (hct <30), or failure to
respond to hormonal therapy.
Absolute contraindication to breastfeeding - ANSWER: Early HIV detection
Contraindications to breastfeeding - ANSWER: HIV infection and IV drug abuse
questions and answers
Scarlet fever - ANSWER: A disease due to infection with Group A Beta-hemolytic
streptococcus, characterized by an acute onset of fever, pharyngitis, headache,
cervical lymphadenopathy, and a sandpaper textured rash.
Pastia lines - ANSWER: A deep, nonblanching rash on the flexor surfaces of the
skin associated with scarlet fever.
TSH check timing after thyroid hormone replacement - ANSWER: The nurse
practitioner should check the patient's TSH 6 weeks after starting thyroid hormone
replacement therapy.
Half-life of levothyroxine - ANSWER: The half-life of levothyroxine, the treatment of
choice for thyroid replacement, is 7 days.
Testicular self-examination - ANSWER: Essential for a patient with a history of
cryptorchidism to monitor for increased risk of testicular cancer.
Chronic bacterial prostatitis treatment - ANSWER: The treatment of choice is a
fluoroquinolone twice daily for 3 weeks to 4 months.
Candidal vaginitis underlying condition - ANSWER: Diabetes mellitus is a common
underlying cause of frequent candidal vaginal infections.
S3 heart sound characteristics - ANSWER: The S3 heart sound is low-pitched and
occurs just after the S2 heart sound, produced by rapid ventricular filling.
Normal PSA level - ANSWER: Normal PSA is 4 ng/ml or less; levels greater than 4
and less than 10 are associated with BPH.
,Prostate cancer PSA level - ANSWER: A PSA level of 10 or greater suggests
prostate cancer.
Positive serum acid phosphatase - ANSWER: Positive serum acid phosphatase is
associated with malignancy of the prostate gland with bone metastasis.
Acute onset symptoms in a child - ANSWER: Symptoms include fever, pharyngitis,
headache, cervical lymphadenopathy, and a sandpaper textured rash.
Fluoroquinolone cure rate for CBP - ANSWER: The cure rate with Bactrim-DS for
chronic bacterial prostatitis is only about 30-40%.
Risk factors for testicular cancer - ANSWER: Cryptorchidism is associated with an
increased risk for testicular cancer.
Incidence of candidiasis during pregnancy - ANSWER: Pregnancy increases the
incidence of candidiasis, but is unlikely a factor for a patient in a monogamous
relationship with an IUD.
Characteristics of S3 heart sound - ANSWER: It is a common finding with right-
sided heart failure, rapid growth, and the last trimester of pregnancy.
Timing for checking TSH after therapy - ANSWER: Meaningful changes in TSH levels
will be observed at 4-6 weeks after starting therapy.
Candidal vaginitis risk factors - ANSWER: Frequent infections can be caused by
underlying conditions such as diabetes mellitus.
Prostate gland abnormalities - ANSWER: Finding abnormalities on DRE
necessitates appropriate lab orders and review of PSA levels.
Fluoroquinolone dosage for prostatitis - ANSWER: Administered twice daily for a
duration of 3 weeks to 4 months.
,Cervical lymphadenopathy - ANSWER: Swelling of the cervical lymph nodes often
associated with infections such as scarlet fever.
Sandpaper textured rash - ANSWER: A characteristic rash associated with scarlet
fever that fades with pressure and ultimately desquamates.
Elevated Troponin I levels - ANSWER: Finding that most strongly correlates with
myocardial infarction.
Elevated creatinine kinase (CK) - ANSWER: Not diagnostic of a myocardial
infarction (MI); may be elevated from IM injection, surgery, or extensive skeletal
muscle trauma.
ST segment depression on EKG - ANSWER: Usually indicates ischemic myocardium,
but not necessarily post-MI.
Elevated ST segments - ANSWER: Reflect myocardial damage.
MB bands - ANSWER: Specific for myocardial smooth muscle; if elevated, the
patient may have had a very recent MI.
Troponin measurement - ANSWER: Most accurate marker of cardiac damage, more
specific and sensitive than CK MB.
Secondary cause of hyperlipidemia - ANSWER: Hypothyroidism is a common
secondary cause; TSH should always be checked and corrected before treatment.
Other causes of secondary hyperlipidemia - ANSWER: Include pregnancy, excessive
weight gain, excessive alcohol intake, insulin resistance or deficiency, obstructive
liver disease, and uremia.
Medications causing secondary hypothyroidism - ANSWER: Include thiazide
diuretics, some beta-blockers, oral contraceptives, and corticosteroids.
, Acute bacterial prostatitis - ANSWER: Suspected in a patient with low pelvic pain,
dysuria, hesitancy, urgency, and reduced flow of stream.
Sterile in-and-out catheter urine specimen - ANSWER: Would identify only
organisms in the bladder and would not differentiate between bladder, kidney, or
prostate site infection.
Sequence for obtaining specimens in prostatitis - ANSWER: 1. Voided urethral urine,
2. Voided mid-stream bladder urine, 3. Voided post-prostate massage urine.
Missed oral contraceptive pills - ANSWER: If 2 pills are missed on consecutive days,
double today's dose and tomorrow's dose and use a barrier method for the rest of
the month.
Outpatient pneumonia treatment for non-smokers - ANSWER: Start Clarithromycin
(Biaxin) 500mg 2 times a day for 10 to 14 days.
Recommended treatment for pneumococcal pneumonia - ANSWER: Penicillin is
indicated for patients with pneumococcal pneumonia.
Legionella species treatment - ANSWER: Ciprofloxacin is recommended.
Heavy vaginal bleeding secondary to uterine leiomyomas - ANSWER: Most
appropriate intervention is to obtain a gynecological consultation.
Criteria for gynecological consultation - ANSWER: Recommended for a uterus
greater than 12 weeks gestational size, significant anemia (hct <30), or failure to
respond to hormonal therapy.
Absolute contraindication to breastfeeding - ANSWER: Early HIV detection
Contraindications to breastfeeding - ANSWER: HIV infection and IV drug abuse
