2026 APEA PREDICTOR EXAM 2 LATEST VERSION 2026-2027
WITH ACTUAL 60 QUESTION AND ANSWERS RATED A GRADE.
UESTION
A nurse is providing education to a client who has been diagnosed with pityriasis rosea. Which of the
following statements accurately describes the recommended treatment approach for this condition?
CORRECT ANS: Nothing; it is a viral rash and can last up to two months before clearing on its own.
Expert Rationale
Pityriasis rosea is a common, self-limiting skin condition that is believed to be viral in origin, possibly
triggered by reactivation of human herpesviruses 6 and 7 (HHV-6 and HHV-7). The hallmark of the
condition is the initial appearance of a single, large "herald patch," followed by a generalized, symmetric,
papulosquamous rash that typically follows the lines of skin cleavage (often described as a "Christmas
tree" pattern on the back). Because the condition is benign and self-resolving, the recommended
treatment is primarily supportive, focusing on symptom management rather than a cure. Pruritus can be
managed with antihistamines or topical corticosteroids, but the rash itself will clear spontaneously,
usually within 6 to 12 weeks. Antibiotics, antifungals, and antiviral medications are not indicated, as they
have not been shown to alter the course of the disease. The nurse should reassure the client that the
condition is not contagious and will resolve without intervention.
DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Implementation MSC: NCLEX:
Physiological Integrity – Pharmacological and Parenteral Therapies
QUESTION
A nurse is reviewing a patient's medical record. The term that describes causing harm or damage to the
patient is which of the following?
CORRECT ANS: Deleterious
Expert Rationale
The term "deleterious" is an adjective used to describe something that is harmful, damaging, or injurious
to health or well-being. In a clinical context, a deleterious effect is an adverse outcome that results from
a disease process, a medical intervention, or an environmental exposure. For example, a medication may
have a deleterious effect on the liver (hepatotoxicity), or a disease may have a deleterious effect on
organ function. Understanding this term is important for nurses when documenting adverse effects,
communicating with the healthcare team, and educating patients about potential risks. The nurse should
be able to recognize and use this terminology to describe negative clinical outcomes accurately.
DIF: Cognitive Level: Remember (Knowledge) TOP: Nursing Process: Assessment MSC: NCLEX:
Physiological Integrity – Pharmacological and Parenteral Therapies
,QUESTION
A nurse is calculating the ideal body weight (IBW) for a male patient. Which of the following formulas
should the nurse use to determine the IBW for a male?
CORRECT ANS: Start at 106 pounds and then add 6 pounds for every inch above 5 feet.
Expert Rationale
Ideal body weight (IBW) is a clinical estimate of what a person should weigh based on their height, and it
is commonly used in medical calculations for drug dosing, nutritional assessments, and mechanical
ventilation settings. The most widely used formula for calculating IBW in males is the Devine formula: for
men, IBW is calculated as 106 pounds for the first 5 feet of height, plus 6 pounds for each additional inch
above 5 feet. For example, a man who is 5 feet 10 inches tall would have an IBW of 106 + (10 x 6) = 166
pounds. The formula for women is 100 pounds for the first 5 feet, plus 5 pounds for each additional inch
above 5 feet. The nurse should be aware that this is an estimate and that other factors, such as frame
size and muscle mass, may be considered in a comprehensive nutritional assessment. The calculation is
specifically for men, and the nurse should use the corresponding formula for women when applicable.
DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Assessment MSC: NCLEX:
Physiological Integrity – Pharmacological and Parenteral Therapies
QUESTION
A nurse is reviewing treatment options for a client diagnosed with lichen sclerosus. Which of the
following treatment modalities are considered appropriate for this condition?
CORRECT ANS: Topical steroids, topical calcineurin inhibitors to suppress the immune system, topical or
oral retinoids, phototherapy.
Expert Rationale
Lichen sclerosus is a chronic, inflammatory skin condition that most commonly affects the anogenital
area. It is thought to be an autoimmune disorder, and treatment focuses on managing symptoms and
preventing complications such as scarring and squamous cell carcinoma. The standard first-line
treatment is the application of ultrapotent topical corticosteroids (such as clobetasol propionate), which
are highly effective in reducing inflammation, pruritus, and skin thinning. Topical calcineurin inhibitors
(tacrolimus, pimecrolimus) are used as steroid-sparing agents to suppress the local immune response,
particularly in cases where long-term steroid use is a concern. Topical or oral retinoids (such as acitretin)
may be used in refractory cases to normalize keratinocyte differentiation. Phototherapy (narrowband
UVB or PUVA) is another option for resistant cases. The nurse should educate the client that treatment is
typically long-term and that regular follow-up is necessary to monitor for malignant transformation.
DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Implementation MSC: NCLEX:
Physiological Integrity – Pharmacological and Parenteral Therapies
, QUESTION
A nurse is assessing a patient with a severely elevated blood pressure. Which of the following clinical
findings is the tell-tale sign of malignant hypertension?
CORRECT ANS: Retinopathy and blurred vision; characterized by a diastolic BP of greater than 130
mmHg.
Expert Rationale
Malignant hypertension (also known as hypertensive emergency or accelerated-malignant hypertension)
is a severe, life-threatening form of hypertension characterized by a sudden and extreme elevation in
blood pressure, typically with a diastolic blood pressure exceeding 130 mmHg. It is associated with acute
end-organ damage. The hallmark clinical feature is hypertensive retinopathy, which includes retinal
hemorrhages, exudates, and papilledema (swelling of the optic disc). This results in blurred vision and
other visual disturbances. Other manifestations of end-organ damage include encephalopathy
(headache, confusion, seizures), acute renal failure, and myocardial ischemia. The presence of
retinopathy with papilledema in a patient with severely elevated blood pressure is pathognomonic for
malignant hypertension and requires immediate emergent treatment to prevent irreversible organ
damage. The nurse must recognize this sign as a critical finding and initiate emergency protocols.
DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Assessment MSC: NCLEX:
Physiological Integrity – Pharmacological and Parenteral Therapies
QUESTION
A nurse is assessing a patient with a tremor. What is the key clinical difference between a Parkinsonian
tremor and an essential tremor?
CORRECT ANS: A Parkinsonian tremor is also known as a resting tremor and is seen at rest, may look like
pill-rolling. An essential tremor is bilateral, symmetric, and seen when the hands are doing something.
Expert Rationale
Differentiating between a Parkinsonian tremor and an essential tremor is a critical diagnostic skill in
neurological assessment. A Parkinsonian tremor is a resting tremor, meaning it is most prominent when
the affected limb is at rest and supported, and it diminishes with voluntary movement. It is typically
unilateral in the early stages and is often described as a "pill-rolling" tremor, a slow, rhythmic movement
of the thumb against the index finger, resembling the action of rolling a pill. In contrast, an essential
tremor is an action tremor, which means it is most prominent when the patient is performing a voluntary
movement (such as writing, drinking, or eating) and is typically absent at rest. Essential tremors are
usually bilateral and symmetric, affecting both sides of the body equally. The nurse should observe the
tremor's characteristics and timing to help guide the differential diagnosis and appropriate referral.
DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Assessment MSC: NCLEX:
Physiological Integrity – Pharmacological and Parenteral Therapies
WITH ACTUAL 60 QUESTION AND ANSWERS RATED A GRADE.
UESTION
A nurse is providing education to a client who has been diagnosed with pityriasis rosea. Which of the
following statements accurately describes the recommended treatment approach for this condition?
CORRECT ANS: Nothing; it is a viral rash and can last up to two months before clearing on its own.
Expert Rationale
Pityriasis rosea is a common, self-limiting skin condition that is believed to be viral in origin, possibly
triggered by reactivation of human herpesviruses 6 and 7 (HHV-6 and HHV-7). The hallmark of the
condition is the initial appearance of a single, large "herald patch," followed by a generalized, symmetric,
papulosquamous rash that typically follows the lines of skin cleavage (often described as a "Christmas
tree" pattern on the back). Because the condition is benign and self-resolving, the recommended
treatment is primarily supportive, focusing on symptom management rather than a cure. Pruritus can be
managed with antihistamines or topical corticosteroids, but the rash itself will clear spontaneously,
usually within 6 to 12 weeks. Antibiotics, antifungals, and antiviral medications are not indicated, as they
have not been shown to alter the course of the disease. The nurse should reassure the client that the
condition is not contagious and will resolve without intervention.
DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Implementation MSC: NCLEX:
Physiological Integrity – Pharmacological and Parenteral Therapies
QUESTION
A nurse is reviewing a patient's medical record. The term that describes causing harm or damage to the
patient is which of the following?
CORRECT ANS: Deleterious
Expert Rationale
The term "deleterious" is an adjective used to describe something that is harmful, damaging, or injurious
to health or well-being. In a clinical context, a deleterious effect is an adverse outcome that results from
a disease process, a medical intervention, or an environmental exposure. For example, a medication may
have a deleterious effect on the liver (hepatotoxicity), or a disease may have a deleterious effect on
organ function. Understanding this term is important for nurses when documenting adverse effects,
communicating with the healthcare team, and educating patients about potential risks. The nurse should
be able to recognize and use this terminology to describe negative clinical outcomes accurately.
DIF: Cognitive Level: Remember (Knowledge) TOP: Nursing Process: Assessment MSC: NCLEX:
Physiological Integrity – Pharmacological and Parenteral Therapies
,QUESTION
A nurse is calculating the ideal body weight (IBW) for a male patient. Which of the following formulas
should the nurse use to determine the IBW for a male?
CORRECT ANS: Start at 106 pounds and then add 6 pounds for every inch above 5 feet.
Expert Rationale
Ideal body weight (IBW) is a clinical estimate of what a person should weigh based on their height, and it
is commonly used in medical calculations for drug dosing, nutritional assessments, and mechanical
ventilation settings. The most widely used formula for calculating IBW in males is the Devine formula: for
men, IBW is calculated as 106 pounds for the first 5 feet of height, plus 6 pounds for each additional inch
above 5 feet. For example, a man who is 5 feet 10 inches tall would have an IBW of 106 + (10 x 6) = 166
pounds. The formula for women is 100 pounds for the first 5 feet, plus 5 pounds for each additional inch
above 5 feet. The nurse should be aware that this is an estimate and that other factors, such as frame
size and muscle mass, may be considered in a comprehensive nutritional assessment. The calculation is
specifically for men, and the nurse should use the corresponding formula for women when applicable.
DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Assessment MSC: NCLEX:
Physiological Integrity – Pharmacological and Parenteral Therapies
QUESTION
A nurse is reviewing treatment options for a client diagnosed with lichen sclerosus. Which of the
following treatment modalities are considered appropriate for this condition?
CORRECT ANS: Topical steroids, topical calcineurin inhibitors to suppress the immune system, topical or
oral retinoids, phototherapy.
Expert Rationale
Lichen sclerosus is a chronic, inflammatory skin condition that most commonly affects the anogenital
area. It is thought to be an autoimmune disorder, and treatment focuses on managing symptoms and
preventing complications such as scarring and squamous cell carcinoma. The standard first-line
treatment is the application of ultrapotent topical corticosteroids (such as clobetasol propionate), which
are highly effective in reducing inflammation, pruritus, and skin thinning. Topical calcineurin inhibitors
(tacrolimus, pimecrolimus) are used as steroid-sparing agents to suppress the local immune response,
particularly in cases where long-term steroid use is a concern. Topical or oral retinoids (such as acitretin)
may be used in refractory cases to normalize keratinocyte differentiation. Phototherapy (narrowband
UVB or PUVA) is another option for resistant cases. The nurse should educate the client that treatment is
typically long-term and that regular follow-up is necessary to monitor for malignant transformation.
DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Implementation MSC: NCLEX:
Physiological Integrity – Pharmacological and Parenteral Therapies
, QUESTION
A nurse is assessing a patient with a severely elevated blood pressure. Which of the following clinical
findings is the tell-tale sign of malignant hypertension?
CORRECT ANS: Retinopathy and blurred vision; characterized by a diastolic BP of greater than 130
mmHg.
Expert Rationale
Malignant hypertension (also known as hypertensive emergency or accelerated-malignant hypertension)
is a severe, life-threatening form of hypertension characterized by a sudden and extreme elevation in
blood pressure, typically with a diastolic blood pressure exceeding 130 mmHg. It is associated with acute
end-organ damage. The hallmark clinical feature is hypertensive retinopathy, which includes retinal
hemorrhages, exudates, and papilledema (swelling of the optic disc). This results in blurred vision and
other visual disturbances. Other manifestations of end-organ damage include encephalopathy
(headache, confusion, seizures), acute renal failure, and myocardial ischemia. The presence of
retinopathy with papilledema in a patient with severely elevated blood pressure is pathognomonic for
malignant hypertension and requires immediate emergent treatment to prevent irreversible organ
damage. The nurse must recognize this sign as a critical finding and initiate emergency protocols.
DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Assessment MSC: NCLEX:
Physiological Integrity – Pharmacological and Parenteral Therapies
QUESTION
A nurse is assessing a patient with a tremor. What is the key clinical difference between a Parkinsonian
tremor and an essential tremor?
CORRECT ANS: A Parkinsonian tremor is also known as a resting tremor and is seen at rest, may look like
pill-rolling. An essential tremor is bilateral, symmetric, and seen when the hands are doing something.
Expert Rationale
Differentiating between a Parkinsonian tremor and an essential tremor is a critical diagnostic skill in
neurological assessment. A Parkinsonian tremor is a resting tremor, meaning it is most prominent when
the affected limb is at rest and supported, and it diminishes with voluntary movement. It is typically
unilateral in the early stages and is often described as a "pill-rolling" tremor, a slow, rhythmic movement
of the thumb against the index finger, resembling the action of rolling a pill. In contrast, an essential
tremor is an action tremor, which means it is most prominent when the patient is performing a voluntary
movement (such as writing, drinking, or eating) and is typically absent at rest. Essential tremors are
usually bilateral and symmetric, affecting both sides of the body equally. The nurse should observe the
tremor's characteristics and timing to help guide the differential diagnosis and appropriate referral.
DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Assessment MSC: NCLEX:
Physiological Integrity – Pharmacological and Parenteral Therapies
