Pre-Predictor exam review EXAM 2025 QUESTIONS AND ANSWERS GRADED A+

Pre-Predictor exam review EXAM
2025 QUESTIONS AND ANSWERS
GRADED A+



1. Prescriptiveauthority: p
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kp Ans:maybeexercisedbygivingaverbalmedicationorderto a pharmacist.
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Rationale Anexampleofexercisingprescriptiveauthorityisgivingaverbalordertoa
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pharma- cistorwritinganorderforaprescriptionmedication.Prescriptiveauthorityrules
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and regulations vary from state to state.Prescriptive authority is granted only to those
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APRNswhomeettherequirementsofthegoverningbodyforthestateinwhichthe APRN
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practices.
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2. When examining a pregnant patient,where should the fundal height be at 22
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weeks?
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Ans : Above the umbilicus
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Rationale Between 18 and 32 weeks, there is good correlation between fundal height
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and gestationalageofthefetus.Theexpectedheightsare:10-12weeks:fundusslightly
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, abovethesymphysispubis16weeks:fundusmidwaybetweenthesymphysispubis and
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umbilicus 20 weeks:fundus at the level of umbilicus 28 weeks:fundus 3 fingerbreadths
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abovetheumbilicus36weeks:fundusjustbelowthexiphoidprocess
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3. WhatinterventiondoestheAmericanCollegeofRheumatologyrecommend as p
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first-line therapy for osteoarthritis?
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Ans: Exercise and weight loss kp kp kp kp




Rationale Exercise, weight loss, and rest are recommended by the American College kp kp kp kp kp kp kp kp kp kp kp




of Rheumatologyguidelinesfortheinitialmanagementofosteoarthritis(OA).Giventhe
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adverse effects of medications used to treat OA, it is best to minimize dosage and delay
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useaslongaspossible.Anextensivediagnosticworkupisnotrecommended unless the
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presentation is in question.Patients who have severe degenerative
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joint disease (DJD), joint fusion, or whose pain severity is not relieved by more
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conservativetherapiesmaybecandidatesforjointreplacement.Acetaminophenis
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recommended as a first-line medication.
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4. A 63-year-old male retired accountant complains of pain and stiffness in his
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feet and hands of several years duration. He reports that the pain and stiffness
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become worse with activity.On examination, he is noted to have Heberden's
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nodesbutnootherbonydeformities.Whichofthefollowingisthe most probable
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diagnosis?
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Ans: Osteoarthritis (OA) kp kp




Rationale Although his vocation involved sedentary activity, this patient is not at great kp kp kp kp kp kp kp kp kp kp kp kp




risk forosteoarthritis.Rheumatoidarthritisischaracterizedbyseveraljointdeformities,
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usually bilaterally symmetrical. RA is characterized by inflammatory processes, while
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OA is not.RA and OA are chronic conditions.Gout is characterized by
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acute exacerbationsrelated to a defect in purine metabolism, increased uricacid
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production, or decreased uric acid excretion.
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mailto:https://www.stuvia.com/user/Wisdoms 2/61 kp kp

, 5. The family of a 78-year-old man moved him into an assisted living center
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because he can no longer be left at home alone. He is unable to toilet when asked
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to do so and he has had several episodes of incontinence. He has walked out of
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the facility twice and been unable to find his way back from 3 blocksaway.On
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examination,heispleasantbutmildlyconfused.Whichofhis medications is
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LEAST likely contributing to his behavior?
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Ans: ramipril (Altace®) kp kp




Rationale Tricyclic antidepressants, like amitriptyline, have anticholinergic side kp kp kp kp kp kp kp




effects which areespeciallyproblematicintheelderlybecausetheycontributetourinary
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retention. Hydrochlorothiazideisadiureticandmaycontributetohisincontinence.
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Cimetidine is well known to produce adverse reactions such as confusion in elders.
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Ramipril, anACEinhibitor,isunlikelytocontributetothispatient'sincontinenceor
kp kp kp kp kp kp kp kp kp kp kp kp kp




confusion. Toiletingmaybeacomplicatedbytheanticholinergicmedicationand/orthe
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diuretic causing diuresis, urge incontinence, and inability to void at will.
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6. A patient with no significant medical history has varicose veins. She com-
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plains of "aching legs". The intervention that will provide the greatest relief for her
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complaint is to:
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Ans: elevate her legs periodically.
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Rationale The intervention that will provide the greatest relief for this patient is elevating
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her legs periodically.This will facilitate venous return.Use of support stockings will
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prolong the length of time she is able to stand in place, but will not provide relief afterher
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legsbeginaching.Supportstockingsshouldbeappliedpriortogettingout of bed.
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7. Stress urinary incontinence is: kp kp kp




Ans:maybe aggravated by caffeineor alcohol. p
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Rationale Stressurinaryincontinenceisnotexpectedasaresultofthenormalaging kp kp kp kp kp kp kp kp kp kp kp kp kp




process. Theprimaryproblemissphincterincompetence.Theingestionofcaffeineor
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alcohol decreases sphincter control. Anticholinergic and antidepressant medications
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are causativefactorsrelatedtooverflowincontinence.Detrusormuscleinstabilityisthe
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primary underlying problem causing urge incontinence.
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8. Which commonly used herbal remedy is NOT associated with anxiety and/or p
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depressive symptom relief?
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kp kp

, Ans: Ginkgo biloba
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Rationale Ginkgobilobaisacommonherbalremedyassociatedwithenhancementof
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vascular and cerebral perfusion and memory.The nurse practitioner should be aware
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when the patient is taking any herbal supplement to avoid risk of drug interactions.
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9. Upon ophthalmoscopic examination of a 78-year-old patient, the nurse
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practitionerobserves dark spots against a red retina.What diagnosis is this
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finding most consistent with?: Cataract
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