APEA Pre-Predictor Exam Review | Practice Questions & Verified Answers | 2026-2027
Prescriptive authority: may be exercised by giving a verbal medication order to a pharmacist.
An example of exercising prescriptive authority is giving a verbal order to a
pharmacist or writing an order for a prescription medication. Prescriptive authority
rules and regulations vary from state to state. Prescriptive authority is granted only
to those APRNs who meet the requirements of the governing body for the state in
which the APRN practices.
When examining a pregnant patient, where should the Above the umbilicus
fundal height be at 22 weeks?
Between 18 and 32 weeks, there is good correlation between fundal height and
gestational age of the fetus. The expected heights are: 10-12 weeks: fundus slightly
above the symphysis pubis 16 weeks: fundus midway between the symphysis pubis
and umbilicus 20 weeks: fundus at the level of umbilicus 28 weeks: fundus 3
fingerbreadths above the umbilicus 36 weeks: fundus just below the xiphoid process
What intervention does the American College of Exercise and weight loss
Rheumatology recommend as first-line therapy for
osteoarthritis? Exercise, weight loss, and rest are recommended by the American College of
Rheumatology guidelines for the initial management of osteoarthritis (OA). Given
the adverse effects of medications used to treat OA, it is best to minimize dosage
and delay use as long as possible. An extensive diagnostic workup is not
recommended unless the presentation is in question. Patients who have severe
degenerative joint disease (DJD), joint fusion, or whose pain severity is not relieved
by more conservative therapies may be candidates for joint replacement.
Acetaminophen is recommended as a first-line medication.
A 63-year-old male retired accountant complains of pain Osteoarthritis (OA)
and stiffness in his feet and hands of several years
duration. He reports that the pain and stiffness become Although his vocation involved sedentary activity, this patient is not at great risk for
worse with activity. On examination, he is noted to have osteoarthritis. Rheumatoid arthritis is characterized by several joint deformities,
Heberden's nodes but no other bony deformities. Which of usually bilaterally symmetrical. RA is characterized by inflammatory processes,
the following is the most probable diagnosis? while OA is not. RA and OA are chronic conditions. Gout is characterized by acute
exacerbations related to a defect in purine metabolism, increased uric acid
production, or decreased uric acid excretion.
The family of a 78-year-old man moved him into an ramipril (Altace®)
assisted living center because he can no longer be left at
home alone. He is unable to toilet when asked to do so Tricyclic antidepressants, like amitriptyline, have anticholinergic side effects which
and he has had several episodes of incontinence. He has are especially problematic in the elderly because they contribute to urinary
walked out of the facility twice and been unable to find his retention. Hydrochlorothiazide is a diuretic and may contribute to his incontinence.
way back from 3 blocks away. On examination, he is Cimetidine is well known to produce adverse reactions such as confusion in elders.
pleasant but mildly confused. Which of his medications is Ramipril, an ACE inhibitor, is unlikely to contribute to this patient's incontinence or
LEAST likely contributing to his behavior? confusion. Toileting may be a complicated by the anticholinergic medication and/or
the diuretic causing diuresis, urge incontinence, and inability to void at will.
A patient with no significant medical history has varicose elevate her legs periodically.
veins. She complains of "aching legs". The intervention
that will provide the greatest relief for her complaint is to: 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.
Stress urinary incontinence is: may be aggravated by caffeine or alcohol.
Stress urinary incontinence is not expected as a result of the normal aging process.
The primary problem is sphincter incompetence. The ingestion of caffeine or alcohol
decreases sphincter control. Anticholinergic and antidepressant medications are
causative factors related to overflow incontinence. Detrusor muscle instability is the
primary underlying problem causing urge incontinence.
Which commonly used herbal remedy is NOT associated Ginkgo biloba
with anxiety and/or depressive symptom relief?
Ginkgo biloba is a common herbal remedy associated with enhancement of
vascular and cerebral perfusion and memory. The nurse practitioner should be
aware when the patient is taking any herbal supplement to avoid risk of drug
interactions.
, APEA Pre-Predictor Exam Review | Practice Questions & Verified Answers | 2026-2027
Upon ophthalmoscopic examination of a 78-year-old Cataract
patient, the nurse practitioner observes dark spots against
a red retina. What diagnosis is this finding most consistent A cataract opacity is seen as a dark disruption of the red reflex on ophthalmoscopic
with? exam.
A 72 year old female patient reports a 6 month history of Osteoarthritis
progressively more swollen and painful distal
interphalangeal (DIP) joints of one hand. There are no When osteoarthritis affects the hands, the distal interphalangeal (DIP) joints are
systemic symptoms but the erythrocyte sedimentation rate usually involved. Rheumatoid arthritis is usually symmetrical, and the proximal
(ESR), antinuclear antibody (ANA), and rheumatoid factor interphalangeal (PIP) joints are more often affected. Inflammation often develops
(RF) are all minimally elevated. What is the most likely quickly, not gradually. This patient is elderly; therefore, it is expected that the ESR,
diagnosis? ANA, and RF will be only somewhat elevated. Over-interpretation of laboratory tests
without evidence of systemic inflammation can lead to misdiagnosis.
The nurse practitioner is evaluating a 35-year-old female chronic hepatitis B infection.
nurse. She has a history of hospitalization for hepatitis B
infection 2 years ago. Her laboratory tests demonstrate Presence of hepatitis B surface antigen at this time indicates chronic infection with
positive HBsAg. The nurse practitioner would most likely hepatitis B. Lab studies indicating a positive surface antigen on 2 separate
diagnose: occasions at least 6 months apart indicate chronic infection. Immunization produces
positive hepatitis B antibodies in most instances. Hepatitis B surface antigen would
not be present in a person who has recovered from hepatitis B infection. This case
would not be an acute episode because of the history of hepatitis B infection 2
years prior.
One exception to the recommendation to limit dietary fat children under 2 years-of-age.
intake is:
In order for myelinization of the nervous system to occur, children under 2 years-of-
age require > 30% daily dietary fat.
The most effective primary prevention of skin cancer is to limiting exposure to natural solar radiation.
educate the public about:
Primary prevention of skin cancer includes limiting sun exposure, avoiding tanning
facilities, and applying sunscreen. Examining the skin and recognizing melanoma
are both secondary prevention measures.
A patient has experienced nausea and vomiting, Offer an anti-emetic medication such as prochlorperazine (Compazine®) and
headache, malaise, low-grade fever, abdominal cramps, provide oral fluid and electrolyte replacement instruction.
and diarrhea for 32 hours. The white count is slightly
elevated with a shift to the left. He is requesting medication Enterocolitis is the most common clinical presentation of salmonellosis. Diagnosis is
for diarrhea. What is the most appropriate response? made by clinical presentation, and can be confirmed only with stool or blood
cultures. Most healthy adults have a course that is self-limiting to 72 hours.
Antibiotics should be used very discriminantly as resistance approaches 50%. Anti-
diarrheal agents potentially increase complications and predispose the patient to
bacteremia.
A child with Type 1 diabetes mellitus brings in a glucose Instruct the parent to monitor the blood glucose at 3:00 am.
diary indicating consistent morning hyperglycemia. How
can the nurse practitioner differentiate the Somogyi effect Dawn phenomenon is an early morning rise in plasma glucose. It indicates a need
from dawn phenomenon? for increased insulin. The Somogyi effect is a rise in plasma glucose in response to
hypoglycemia. It is usually accompanied by weight gain and hunger and is
corrected by decreasing the evening insulin dose. A series of 3 early morning
measurements of blood glucose will help differentiate between the 2 conditions.
Of the following signs and symptoms of heart failure (HF), weight gain.
the earliest clinical manifestation is:
The earliest and most sensitive clinical indicator of HF is weight gain. A patient with
HF should be instructed to weigh himself daily to note changes in his weight. The
best time of day to weigh is early morning. The other clinical manifestations listed
will present after the weight gain. Another early, clinical manifestation of CHF not
listed above is fatigue.
The mother of a 6-month-old infant asks about the use of discourage the use of walkers and encourage parental holding and floor play.
an infant walker. The most appropriate response is to:
Baby walkers are a significant cause of injuries in young children. Their use should
be discouraged and parental holding and floor play should be encouraged instead.
, APEA Pre-Predictor Exam Review | Practice Questions & Verified Answers | 2026-2027
A mother complains that her 3-month-old infant becomes adding 1 to 2 teaspoons of corn syrup to the infant's bottle twice a day.
constipated easily. She states she has been using her 4-
year-old sibling's suppositories, but they make the baby Corn syrup acts as an osmotic agent to increase water concentration in fecal
"fussy" and have diarrhea stools. The nurse practitioner material, stimulating peristalsis and, thus, a bowel movement.
should recommend:
A patient presents with an inflamed upper eyelid margin. Blepharitis; treat with warm compresses and gentle debridement with a cotton swab
The conjunctiva is red and there is particulate matter along
the upper eyelid. The patient complains of a sensation that Blepharitis is an inflammation of the eyelid and can be caused by bacteria or a
"there is something in my eye." What is the diagnosis and seborrheic process. Treatment includes lid scrubs and a topical antibiotic if the
how should it be treated? cause is bacterial.
Initial treatment of a child presenting with a severe head aimed at resuscitation, then maintenance of oxygenation and blood flow.
injury is:
A head-injured patient requires that all related injuries be identified and treated, but
the most immediate need is airway resuscitation, maintenance of oxygenation, and
maintenance of blood flow. Cerebral edema, a major complication of head injury, is
managed with adequate oxygenation, elevation of the head and trunk to facilitate
venous return from the head, isotonic intravenous fluid administration maintaining
low central venous pressure, and maintenance of normal body temperature.
Eligibility requirements for the ANP or FNP exam include a masters degree in nursing or an area.
all of the following EXCEPT:
Today, NP students are prepared at the graduate level. There are nurse
practitioners who have completed an accredited or approved non-graduate level
educational program prior to implementation of graduate level education
requirements. Most states have "grandfathered" these NPs into practice.
A 12-year-old presents with ear pain of 36 hours duration. bony landmarks are obscured and the tympanic membrane is mildly erythematous,
The nurse practitioner diagnoses acute otitis media dull, and immobile.
because the:
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.
An appropriate initial treatment for external genital warts topical trichloroacetic acid (TCA).
caused by human papilloma virus (HPV) in a non-pregnant
patient is: Appropriate initial treatment of external genital warts caused by HPV includes
cryotherapy with liquid nitrogen or cryoprobe, self-treatment with podofilox 0.5%
solution, podophyllin 10%-25%, trichloroacetic acid (TCA), or electrodesiccation or
electrocautery. 5-fluorouracil cream has not been evaluated in controlled studies
and is not recommended for treatment of genital warts. Intralesional interferon is
used for treatment of persistent and recurrent genital warts, but is not
recommended by the CDC. Topical acyclovir is not indicated for treatment of genital
warts.
A 6-year-old presents with complaints of sore throat and Herpangina
fever for 2 days. He has multiple vesiculated ulcerations on
his tonsils and uvula. There are no other remarkable Herpangina is a viral infection common in toddlers and young children caused by
findings. What is the most likely diagnosis? Coxsackie virus. The clinical findings of numerous, small (1-2 mm) ulcerations on
the tonsils and uvula are typical of herpangina. The ulcerations can be very painful
but usually resolve in 7 to 10 days. Treatment is symptomatic.
The daughter of a 75-year-old patient reports that her doxepin (Sinequan)
mother roams the house at night saying she cannot fall
asleep. She has fallen twice. Of the following choices, Low dose doxepin (Sinequan) has been proven efficacious in the therapy of
which would be the most appropriate to treat her transient insomnia, producing improvements in wake after sleep onset, total sleep
insomnia? time and sleep-onset latency. Since this patient is having difficulty falling asleep,
she needs a drug which will produce drowsiness at bedtime (sleep-onset latency).
At low doses (<6mg/day), doxepin also has a good efficacy and safety profile in
elderly patients with chronic insomnia, with a safety profile comparable to placebo.
Elderly or debilitated patients may be especially sensitive to the effects of zolpidem
(Ambien). Ambien can increase the risk of falls, as well as cause confusion.
Although the other choices would provide sedation, they have longer half-lives and
would likely cause drowsiness the next morning/day. Additionally, use of the other
drugs listed for primary treatment of insomnia would be off-label.
Prescriptive authority: may be exercised by giving a verbal medication order to a pharmacist.
An example of exercising prescriptive authority is giving a verbal order to a
pharmacist or writing an order for a prescription medication. Prescriptive authority
rules and regulations vary from state to state. Prescriptive authority is granted only
to those APRNs who meet the requirements of the governing body for the state in
which the APRN practices.
When examining a pregnant patient, where should the Above the umbilicus
fundal height be at 22 weeks?
Between 18 and 32 weeks, there is good correlation between fundal height and
gestational age of the fetus. The expected heights are: 10-12 weeks: fundus slightly
above the symphysis pubis 16 weeks: fundus midway between the symphysis pubis
and umbilicus 20 weeks: fundus at the level of umbilicus 28 weeks: fundus 3
fingerbreadths above the umbilicus 36 weeks: fundus just below the xiphoid process
What intervention does the American College of Exercise and weight loss
Rheumatology recommend as first-line therapy for
osteoarthritis? Exercise, weight loss, and rest are recommended by the American College of
Rheumatology guidelines for the initial management of osteoarthritis (OA). Given
the adverse effects of medications used to treat OA, it is best to minimize dosage
and delay use as long as possible. An extensive diagnostic workup is not
recommended unless the presentation is in question. Patients who have severe
degenerative joint disease (DJD), joint fusion, or whose pain severity is not relieved
by more conservative therapies may be candidates for joint replacement.
Acetaminophen is recommended as a first-line medication.
A 63-year-old male retired accountant complains of pain Osteoarthritis (OA)
and stiffness in his feet and hands of several years
duration. He reports that the pain and stiffness become Although his vocation involved sedentary activity, this patient is not at great risk for
worse with activity. On examination, he is noted to have osteoarthritis. Rheumatoid arthritis is characterized by several joint deformities,
Heberden's nodes but no other bony deformities. Which of usually bilaterally symmetrical. RA is characterized by inflammatory processes,
the following is the most probable diagnosis? while OA is not. RA and OA are chronic conditions. Gout is characterized by acute
exacerbations related to a defect in purine metabolism, increased uric acid
production, or decreased uric acid excretion.
The family of a 78-year-old man moved him into an ramipril (Altace®)
assisted living center because he can no longer be left at
home alone. He is unable to toilet when asked to do so Tricyclic antidepressants, like amitriptyline, have anticholinergic side effects which
and he has had several episodes of incontinence. He has are especially problematic in the elderly because they contribute to urinary
walked out of the facility twice and been unable to find his retention. Hydrochlorothiazide is a diuretic and may contribute to his incontinence.
way back from 3 blocks away. On examination, he is Cimetidine is well known to produce adverse reactions such as confusion in elders.
pleasant but mildly confused. Which of his medications is Ramipril, an ACE inhibitor, is unlikely to contribute to this patient's incontinence or
LEAST likely contributing to his behavior? confusion. Toileting may be a complicated by the anticholinergic medication and/or
the diuretic causing diuresis, urge incontinence, and inability to void at will.
A patient with no significant medical history has varicose elevate her legs periodically.
veins. She complains of "aching legs". The intervention
that will provide the greatest relief for her complaint is to: 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.
Stress urinary incontinence is: may be aggravated by caffeine or alcohol.
Stress urinary incontinence is not expected as a result of the normal aging process.
The primary problem is sphincter incompetence. The ingestion of caffeine or alcohol
decreases sphincter control. Anticholinergic and antidepressant medications are
causative factors related to overflow incontinence. Detrusor muscle instability is the
primary underlying problem causing urge incontinence.
Which commonly used herbal remedy is NOT associated Ginkgo biloba
with anxiety and/or depressive symptom relief?
Ginkgo biloba is a common herbal remedy associated with enhancement of
vascular and cerebral perfusion and memory. The nurse practitioner should be
aware when the patient is taking any herbal supplement to avoid risk of drug
interactions.
, APEA Pre-Predictor Exam Review | Practice Questions & Verified Answers | 2026-2027
Upon ophthalmoscopic examination of a 78-year-old Cataract
patient, the nurse practitioner observes dark spots against
a red retina. What diagnosis is this finding most consistent A cataract opacity is seen as a dark disruption of the red reflex on ophthalmoscopic
with? exam.
A 72 year old female patient reports a 6 month history of Osteoarthritis
progressively more swollen and painful distal
interphalangeal (DIP) joints of one hand. There are no When osteoarthritis affects the hands, the distal interphalangeal (DIP) joints are
systemic symptoms but the erythrocyte sedimentation rate usually involved. Rheumatoid arthritis is usually symmetrical, and the proximal
(ESR), antinuclear antibody (ANA), and rheumatoid factor interphalangeal (PIP) joints are more often affected. Inflammation often develops
(RF) are all minimally elevated. What is the most likely quickly, not gradually. This patient is elderly; therefore, it is expected that the ESR,
diagnosis? ANA, and RF will be only somewhat elevated. Over-interpretation of laboratory tests
without evidence of systemic inflammation can lead to misdiagnosis.
The nurse practitioner is evaluating a 35-year-old female chronic hepatitis B infection.
nurse. She has a history of hospitalization for hepatitis B
infection 2 years ago. Her laboratory tests demonstrate Presence of hepatitis B surface antigen at this time indicates chronic infection with
positive HBsAg. The nurse practitioner would most likely hepatitis B. Lab studies indicating a positive surface antigen on 2 separate
diagnose: occasions at least 6 months apart indicate chronic infection. Immunization produces
positive hepatitis B antibodies in most instances. Hepatitis B surface antigen would
not be present in a person who has recovered from hepatitis B infection. This case
would not be an acute episode because of the history of hepatitis B infection 2
years prior.
One exception to the recommendation to limit dietary fat children under 2 years-of-age.
intake is:
In order for myelinization of the nervous system to occur, children under 2 years-of-
age require > 30% daily dietary fat.
The most effective primary prevention of skin cancer is to limiting exposure to natural solar radiation.
educate the public about:
Primary prevention of skin cancer includes limiting sun exposure, avoiding tanning
facilities, and applying sunscreen. Examining the skin and recognizing melanoma
are both secondary prevention measures.
A patient has experienced nausea and vomiting, Offer an anti-emetic medication such as prochlorperazine (Compazine®) and
headache, malaise, low-grade fever, abdominal cramps, provide oral fluid and electrolyte replacement instruction.
and diarrhea for 32 hours. The white count is slightly
elevated with a shift to the left. He is requesting medication Enterocolitis is the most common clinical presentation of salmonellosis. Diagnosis is
for diarrhea. What is the most appropriate response? made by clinical presentation, and can be confirmed only with stool or blood
cultures. Most healthy adults have a course that is self-limiting to 72 hours.
Antibiotics should be used very discriminantly as resistance approaches 50%. Anti-
diarrheal agents potentially increase complications and predispose the patient to
bacteremia.
A child with Type 1 diabetes mellitus brings in a glucose Instruct the parent to monitor the blood glucose at 3:00 am.
diary indicating consistent morning hyperglycemia. How
can the nurse practitioner differentiate the Somogyi effect Dawn phenomenon is an early morning rise in plasma glucose. It indicates a need
from dawn phenomenon? for increased insulin. The Somogyi effect is a rise in plasma glucose in response to
hypoglycemia. It is usually accompanied by weight gain and hunger and is
corrected by decreasing the evening insulin dose. A series of 3 early morning
measurements of blood glucose will help differentiate between the 2 conditions.
Of the following signs and symptoms of heart failure (HF), weight gain.
the earliest clinical manifestation is:
The earliest and most sensitive clinical indicator of HF is weight gain. A patient with
HF should be instructed to weigh himself daily to note changes in his weight. The
best time of day to weigh is early morning. The other clinical manifestations listed
will present after the weight gain. Another early, clinical manifestation of CHF not
listed above is fatigue.
The mother of a 6-month-old infant asks about the use of discourage the use of walkers and encourage parental holding and floor play.
an infant walker. The most appropriate response is to:
Baby walkers are a significant cause of injuries in young children. Their use should
be discouraged and parental holding and floor play should be encouraged instead.
, APEA Pre-Predictor Exam Review | Practice Questions & Verified Answers | 2026-2027
A mother complains that her 3-month-old infant becomes adding 1 to 2 teaspoons of corn syrup to the infant's bottle twice a day.
constipated easily. She states she has been using her 4-
year-old sibling's suppositories, but they make the baby Corn syrup acts as an osmotic agent to increase water concentration in fecal
"fussy" and have diarrhea stools. The nurse practitioner material, stimulating peristalsis and, thus, a bowel movement.
should recommend:
A patient presents with an inflamed upper eyelid margin. Blepharitis; treat with warm compresses and gentle debridement with a cotton swab
The conjunctiva is red and there is particulate matter along
the upper eyelid. The patient complains of a sensation that Blepharitis is an inflammation of the eyelid and can be caused by bacteria or a
"there is something in my eye." What is the diagnosis and seborrheic process. Treatment includes lid scrubs and a topical antibiotic if the
how should it be treated? cause is bacterial.
Initial treatment of a child presenting with a severe head aimed at resuscitation, then maintenance of oxygenation and blood flow.
injury is:
A head-injured patient requires that all related injuries be identified and treated, but
the most immediate need is airway resuscitation, maintenance of oxygenation, and
maintenance of blood flow. Cerebral edema, a major complication of head injury, is
managed with adequate oxygenation, elevation of the head and trunk to facilitate
venous return from the head, isotonic intravenous fluid administration maintaining
low central venous pressure, and maintenance of normal body temperature.
Eligibility requirements for the ANP or FNP exam include a masters degree in nursing or an area.
all of the following EXCEPT:
Today, NP students are prepared at the graduate level. There are nurse
practitioners who have completed an accredited or approved non-graduate level
educational program prior to implementation of graduate level education
requirements. Most states have "grandfathered" these NPs into practice.
A 12-year-old presents with ear pain of 36 hours duration. bony landmarks are obscured and the tympanic membrane is mildly erythematous,
The nurse practitioner diagnoses acute otitis media dull, and immobile.
because the:
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.
An appropriate initial treatment for external genital warts topical trichloroacetic acid (TCA).
caused by human papilloma virus (HPV) in a non-pregnant
patient is: Appropriate initial treatment of external genital warts caused by HPV includes
cryotherapy with liquid nitrogen or cryoprobe, self-treatment with podofilox 0.5%
solution, podophyllin 10%-25%, trichloroacetic acid (TCA), or electrodesiccation or
electrocautery. 5-fluorouracil cream has not been evaluated in controlled studies
and is not recommended for treatment of genital warts. Intralesional interferon is
used for treatment of persistent and recurrent genital warts, but is not
recommended by the CDC. Topical acyclovir is not indicated for treatment of genital
warts.
A 6-year-old presents with complaints of sore throat and Herpangina
fever for 2 days. He has multiple vesiculated ulcerations on
his tonsils and uvula. There are no other remarkable Herpangina is a viral infection common in toddlers and young children caused by
findings. What is the most likely diagnosis? Coxsackie virus. The clinical findings of numerous, small (1-2 mm) ulcerations on
the tonsils and uvula are typical of herpangina. The ulcerations can be very painful
but usually resolve in 7 to 10 days. Treatment is symptomatic.
The daughter of a 75-year-old patient reports that her doxepin (Sinequan)
mother roams the house at night saying she cannot fall
asleep. She has fallen twice. Of the following choices, Low dose doxepin (Sinequan) has been proven efficacious in the therapy of
which would be the most appropriate to treat her transient insomnia, producing improvements in wake after sleep onset, total sleep
insomnia? time and sleep-onset latency. Since this patient is having difficulty falling asleep,
she needs a drug which will produce drowsiness at bedtime (sleep-onset latency).
At low doses (<6mg/day), doxepin also has a good efficacy and safety profile in
elderly patients with chronic insomnia, with a safety profile comparable to placebo.
Elderly or debilitated patients may be especially sensitive to the effects of zolpidem
(Ambien). Ambien can increase the risk of falls, as well as cause confusion.
Although the other choices would provide sedation, they have longer half-lives and
would likely cause drowsiness the next morning/day. Additionally, use of the other
drugs listed for primary treatment of insomnia would be off-label.
