APEA PRE-PREDICTOR 2025/2026 (ACTUAL EXAM) TEST BANK 850+ QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES ALREADY GRADED A+
A 6 yo had an acute onset of fever, pharyngitis, and headache 2 days ago. Today, he presents with cervical
lymphadenopathy and sandpaper textured rash everywhere except on his face. A rapid streptococcal antigen test is
positive. The remainder of the assessment in unremarkable. What is the most likely diagnosis and the most
appropriate action? - answer-Scarlet fever; treat with antibiotics.
This disease is due to infection with Group A Beta-hemolytic streptococcus. The rash is thought to be due to a
systemic reaction to the toxin produced by the microorganism. The rash fades with pressure and ultimately
desquamates. A deep, nonblanching rash on the flexor surfaces of the skin is referred to as pastia lines.
A patient has been diagnosed with hypothyroidism and thyroid hormone replacement therapy is prescribed.
When should the nurse practitioner check the patient's TSH? - answer-6 weeks.
The half-life of levothyroxine, the treatment of choice for thyroid replacement, is 7 days. The earliest that
meaningful changes will be observed is at 4-6 weeks. Therefore, the NP should wait a minimum of 4-6 weeks
before checking the patient's TSH.
A 15 yo malue has a history of cryptorchidism which was surgically repaired. Because of this information, it is
essential for the nurse practitioner to teach him about: - answer-testicular self- examination.
Cryptorchidism, even with surgical repair, is associated with increased risk for testicular cancer.
The treatment of choice for chronic bacterial prostatitis (CBP) is: - answer-a flouroquinolone twice daily for 3
weeks to 4 months.
The treatment of chice is a flouroquinolone twice daily for 3 weeks to 4 months. The cure rate with Bactrim-
DS is only about 30-40%.
A 25 yo female has a history of frequent candidal vaginal infections in the past year. She is in a monogamous
sexual relationship and uses and IUD for contraception. Of the following, which is the most likely underlying
conidition predisposing her to recurring candidal vaginitis? - answer-Diabetes.
A common underlying cause of frequent infections is diabetes mellitus. Pregnancy increases the incidence of
candidiasis, but is unlikely a factor with this patient.
Page 1 of 134
,APEA PRE-PREDICTOR 2025/2026 (ACTUAL EXAM) TEST BANK 850+ QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES ALREADY GRADED A+
Which of the following is NOT a characteristic of the S3 heart sound? - answer-The sound is high-pitched and
occurs just prior to the S1 heart sound.
The S3 heart sound is low-pitched and occurs just after the S2 heart sound. It is produced by rapid ventricular
filling and is best auscultated in the mitral area. It is a common finding with right-sided heart failure, rapid
growth, and the last trimester of pregnancy.
Following the finding of prostate gland abnormalities on DRE, the NP orders the appropriate labs. Whem
preparing to review lab reports with the patient, the nurse practitioner knows all of the following are true
EXCEPT: - answer-normal PSA is 10ng/ml or less.
Normal PSA is 4ng/ml or less. PSA levels greater the 4 and less than 10 are associated with BPH. A 10 or greater
PSA level suggests prostate cancer. Positive serum acid phosphatase is associated with malignancy of the prostate
gland with bone metasasis.
A 66 yo female presents to your clinic. She states that yesterday evening she had chest pain for 20-30 minutes.
Which finding most strongly correlates with myocardial infarction? - answer-Elevated Troponin I levels
An elevated creatinine kinase (CK) is not diagnostic of a myocardial infarction (MI). CK may be elevated from an
IM injection, surgery, ot any type of extensive skeletal muscle trauma or prolonged, strenuous physical exertion.
ST segment depression on EKG usually indicates an ischemic myocardium, but, not necessarily, one post-MI.
Elevated ST seghments reflect mycardial damage. MB bands are specific for myocardial smooth muscle. If these
are elevated, the patient MAY HAVE had a very recent MI. The most accurate marker of cardiac damage, because
it is more specific and sensitive than CK MB, is a troponin measurement.
What is a secondary cause of hyperlipidemia? - answer-hypothyroidism
Hypothyroidism is a common secondary cause of hyperlipidemia. In the evaluation of a patient with
hyperlipidemia, a TSH should always be checked and corrected before attempting treatment for hyperlipidemia.
Other possible causes of seconday hyperlipidemia include pregnancy, excessive weight gain, excessive alcohol
intake, insulin resistance or deficiency, obstructive liver disease, and uremia.
Some medications can produce secondary hypothyroidism too: thiazide diuretics, some beta-blockers, oral
contraceptives, and corticosteroids.
A 35-yo male presents with a complaint of low pelvic pain, dysuria, hesitancy, urgency, and reduced for of stream.
The nurse practitioner suspects acute bacterial prostatitis. The NP would appropriately collect all of the following
specimens EXCEPT a: sterile in-and-out catheter urine specimen. - answer-A sterile
in-and-out catheter specimen would identify only organisms in the bladder and would not differentiate
Page 2 of 134
,APEA PRE-PREDICTOR 2025/2026 (ACTUAL EXAM) TEST BANK 850+ QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES ALREADY GRADED A+
between bladder, kidney, or prostate site infection. The sequence for obtaining specimens when prostat infection
is suspected is: 1. voided urethral urine, 2. Voided mid-stream bladder urine, and 3. voided post-prostate massage
urine.
A 24 yo female taking an oral contraceptive has missed her last 2 pills. What should the nurse practitioner advise
her to do to minimize her risk of pregnancy? - answer-Double today's dose and tomorrow's dose and use a barrier
method for the rest of the month.
If 2 mills are missed on consecutive days, the next 2 days' doseages should be doubled and a barrier method
recommended for the remainder of the cycle.
A 50yo, non-smoker, with no co-morbidity presents to the clinica and is diagnosed with pna. His vital signs are
normal except for temperature of 101.6 degrees. A sputum specimen is collected and sent for culture and
sensitivity. What action should the nurse practitioner take today? - answer-Start Clarithromycin (Biaxin) 500mg 2
times a day for 10 to 14 days.
Most treatment guidelines for outpatient pna in non-smokers without co-morbidity and 60 years of age or younger,
recommend erythromycin or another macrolide like Biaxin. Pcn s indicated for patient swith pneumococcal pna
and ciprofloxacin is recommended for Legionella species.
A 38 year old patient is being treated the by the NP for heavy vaginal bleeding secondary to multiple uterine
leiomyomas. Her uterus is greater than 12 weeks gestational size, her hematocrit is 28%, and she has not
responded to hormonal therapy. Which of the following would be the most appropriate intervention at this
time? - answer-Obtain a gynecological consultation
Gynecological consultation is recommended for a patient with a uterus greater that 12 weeks gestational size,
significant anemia (hct <30),. o a normal endometrial biopsy with failure to respond to hormonal therapy.
What maternal situation is considered an absolute contraindication to breastfeeding? - answer-Early HIV detection
There are few absolute contraindications to breastfeeding. HIV infection and IV drug abuse are 2
contraindications.
A 21 yo college student presents to the sudent health center with copious, markedly purulent discharge from her
left eye. The nurse practitioner should suspect: - answer-gonococcal conjunctivitis.
A purulent and copious discharge should alert the nurse practitioner to the likely possibility of gonococcal or
chlamydial conjunctivitis. Noth require systemic anitbiotic treatment and immediate referral to an
opthalmologist for evaluation.
Page 3 of 134
, APEA PRE-PREDICTOR 2025/2026 (ACTUAL EXAM) TEST BANK 850+ QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES ALREADY GRADED A+
Babies should begin oral iron supplementation: - answer-4-6 months of age.
Generally, full term infants who are breadt-fed have sufficient stores of iron to last through the first 4-6 months of
life. Earlier supplementation may be m=necessary for premature infants, infants who are breastyfed exclusively
beyond the first 6 months of age, and infants who begin drinking cow's milk prior to 1 year of age.
Which item is NOT implicated in erectile dysfunction (ED)? - answer-Urinary tract infection (UTI)
Many systemic disease like diabetes, hypo/hyperthyroidism, Cushing's syndrome can result in ED> Many
medications can cause ED, particularly the antihypertensives (Vasotec) and the antidepressants (Paxil). Other
activities like heavy smoking, drug abuse, and alcoholism can also lead to ED.
Expected spriometry readings when the patient has chronic emphysema include: - answer-Increased total lung
capacity (TLC).
Residual volume is increased, Volume Capacity is decreased, FEV-1 in decreased, and total lung capacity is
increased with emphysema. RV, VC, and FEV-1 spirometry readings are the same whether COPD is due to
chronic emphysema or chronic bronchitis, however, TLC is normal or only slightly increased with chronic
bronchitis.
Physical exam findings consistent with emphysema include all of the following EXCEPT: - answer-pallor and
cyanosis of the mucosa and nailbeds.
Pallor and cyanosis is typical of chronic bronchitis (type B COPD, the "blue boater"_. Emphysema (Type A COPD,
the "pink puffer") is not associated with pallor or cyanosis. Increased AP dianeter produces a "barrel chest". The
normal chest is elliptical whereas the barrel chest is round. The muscles of the thorax appear thin and wasted while
the accessory muscles of respiration are hypertrophied. Breath sounds are minished and cough is weak and
ineffective.
Which laboratory test is useful in the diagnosis of spontaneous abortion? - answer-Serial quantitative beta-
huma chorionic gonadotropin levels.
Serial quantitative beta-human chorionic gonadotropin levels are the most useful for diagnosing spontaneous
abortion. The levels progressively decline.
The most acceoted recommendation regarding skin cancer prevention is: - answer-avoidance of excessive sun
exposure.
Page 4 of 134
AND CORRECT DETAILED ANSWERS WITH RATIONALES ALREADY GRADED A+
A 6 yo had an acute onset of fever, pharyngitis, and headache 2 days ago. Today, he presents with cervical
lymphadenopathy and sandpaper textured rash everywhere except on his face. A rapid streptococcal antigen test is
positive. The remainder of the assessment in unremarkable. What is the most likely diagnosis and the most
appropriate action? - answer-Scarlet fever; treat with antibiotics.
This disease is due to infection with Group A Beta-hemolytic streptococcus. The rash is thought to be due to a
systemic reaction to the toxin produced by the microorganism. The rash fades with pressure and ultimately
desquamates. A deep, nonblanching rash on the flexor surfaces of the skin is referred to as pastia lines.
A patient has been diagnosed with hypothyroidism and thyroid hormone replacement therapy is prescribed.
When should the nurse practitioner check the patient's TSH? - answer-6 weeks.
The half-life of levothyroxine, the treatment of choice for thyroid replacement, is 7 days. The earliest that
meaningful changes will be observed is at 4-6 weeks. Therefore, the NP should wait a minimum of 4-6 weeks
before checking the patient's TSH.
A 15 yo malue has a history of cryptorchidism which was surgically repaired. Because of this information, it is
essential for the nurse practitioner to teach him about: - answer-testicular self- examination.
Cryptorchidism, even with surgical repair, is associated with increased risk for testicular cancer.
The treatment of choice for chronic bacterial prostatitis (CBP) is: - answer-a flouroquinolone twice daily for 3
weeks to 4 months.
The treatment of chice is a flouroquinolone twice daily for 3 weeks to 4 months. The cure rate with Bactrim-
DS is only about 30-40%.
A 25 yo female has a history of frequent candidal vaginal infections in the past year. She is in a monogamous
sexual relationship and uses and IUD for contraception. Of the following, which is the most likely underlying
conidition predisposing her to recurring candidal vaginitis? - answer-Diabetes.
A common underlying cause of frequent infections is diabetes mellitus. Pregnancy increases the incidence of
candidiasis, but is unlikely a factor with this patient.
Page 1 of 134
,APEA PRE-PREDICTOR 2025/2026 (ACTUAL EXAM) TEST BANK 850+ QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES ALREADY GRADED A+
Which of the following is NOT a characteristic of the S3 heart sound? - answer-The sound is high-pitched and
occurs just prior to the S1 heart sound.
The S3 heart sound is low-pitched and occurs just after the S2 heart sound. It is produced by rapid ventricular
filling and is best auscultated in the mitral area. It is a common finding with right-sided heart failure, rapid
growth, and the last trimester of pregnancy.
Following the finding of prostate gland abnormalities on DRE, the NP orders the appropriate labs. Whem
preparing to review lab reports with the patient, the nurse practitioner knows all of the following are true
EXCEPT: - answer-normal PSA is 10ng/ml or less.
Normal PSA is 4ng/ml or less. PSA levels greater the 4 and less than 10 are associated with BPH. A 10 or greater
PSA level suggests prostate cancer. Positive serum acid phosphatase is associated with malignancy of the prostate
gland with bone metasasis.
A 66 yo female presents to your clinic. She states that yesterday evening she had chest pain for 20-30 minutes.
Which finding most strongly correlates with myocardial infarction? - answer-Elevated Troponin I levels
An elevated creatinine kinase (CK) is not diagnostic of a myocardial infarction (MI). CK may be elevated from an
IM injection, surgery, ot any type of extensive skeletal muscle trauma or prolonged, strenuous physical exertion.
ST segment depression on EKG usually indicates an ischemic myocardium, but, not necessarily, one post-MI.
Elevated ST seghments reflect mycardial damage. MB bands are specific for myocardial smooth muscle. If these
are elevated, the patient MAY HAVE had a very recent MI. The most accurate marker of cardiac damage, because
it is more specific and sensitive than CK MB, is a troponin measurement.
What is a secondary cause of hyperlipidemia? - answer-hypothyroidism
Hypothyroidism is a common secondary cause of hyperlipidemia. In the evaluation of a patient with
hyperlipidemia, a TSH should always be checked and corrected before attempting treatment for hyperlipidemia.
Other possible causes of seconday hyperlipidemia include pregnancy, excessive weight gain, excessive alcohol
intake, insulin resistance or deficiency, obstructive liver disease, and uremia.
Some medications can produce secondary hypothyroidism too: thiazide diuretics, some beta-blockers, oral
contraceptives, and corticosteroids.
A 35-yo male presents with a complaint of low pelvic pain, dysuria, hesitancy, urgency, and reduced for of stream.
The nurse practitioner suspects acute bacterial prostatitis. The NP would appropriately collect all of the following
specimens EXCEPT a: sterile in-and-out catheter urine specimen. - answer-A sterile
in-and-out catheter specimen would identify only organisms in the bladder and would not differentiate
Page 2 of 134
,APEA PRE-PREDICTOR 2025/2026 (ACTUAL EXAM) TEST BANK 850+ QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES ALREADY GRADED A+
between bladder, kidney, or prostate site infection. The sequence for obtaining specimens when prostat infection
is suspected is: 1. voided urethral urine, 2. Voided mid-stream bladder urine, and 3. voided post-prostate massage
urine.
A 24 yo female taking an oral contraceptive has missed her last 2 pills. What should the nurse practitioner advise
her to do to minimize her risk of pregnancy? - answer-Double today's dose and tomorrow's dose and use a barrier
method for the rest of the month.
If 2 mills are missed on consecutive days, the next 2 days' doseages should be doubled and a barrier method
recommended for the remainder of the cycle.
A 50yo, non-smoker, with no co-morbidity presents to the clinica and is diagnosed with pna. His vital signs are
normal except for temperature of 101.6 degrees. A sputum specimen is collected and sent for culture and
sensitivity. What action should the nurse practitioner take today? - answer-Start Clarithromycin (Biaxin) 500mg 2
times a day for 10 to 14 days.
Most treatment guidelines for outpatient pna in non-smokers without co-morbidity and 60 years of age or younger,
recommend erythromycin or another macrolide like Biaxin. Pcn s indicated for patient swith pneumococcal pna
and ciprofloxacin is recommended for Legionella species.
A 38 year old patient is being treated the by the NP for heavy vaginal bleeding secondary to multiple uterine
leiomyomas. Her uterus is greater than 12 weeks gestational size, her hematocrit is 28%, and she has not
responded to hormonal therapy. Which of the following would be the most appropriate intervention at this
time? - answer-Obtain a gynecological consultation
Gynecological consultation is recommended for a patient with a uterus greater that 12 weeks gestational size,
significant anemia (hct <30),. o a normal endometrial biopsy with failure to respond to hormonal therapy.
What maternal situation is considered an absolute contraindication to breastfeeding? - answer-Early HIV detection
There are few absolute contraindications to breastfeeding. HIV infection and IV drug abuse are 2
contraindications.
A 21 yo college student presents to the sudent health center with copious, markedly purulent discharge from her
left eye. The nurse practitioner should suspect: - answer-gonococcal conjunctivitis.
A purulent and copious discharge should alert the nurse practitioner to the likely possibility of gonococcal or
chlamydial conjunctivitis. Noth require systemic anitbiotic treatment and immediate referral to an
opthalmologist for evaluation.
Page 3 of 134
, APEA PRE-PREDICTOR 2025/2026 (ACTUAL EXAM) TEST BANK 850+ QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES ALREADY GRADED A+
Babies should begin oral iron supplementation: - answer-4-6 months of age.
Generally, full term infants who are breadt-fed have sufficient stores of iron to last through the first 4-6 months of
life. Earlier supplementation may be m=necessary for premature infants, infants who are breastyfed exclusively
beyond the first 6 months of age, and infants who begin drinking cow's milk prior to 1 year of age.
Which item is NOT implicated in erectile dysfunction (ED)? - answer-Urinary tract infection (UTI)
Many systemic disease like diabetes, hypo/hyperthyroidism, Cushing's syndrome can result in ED> Many
medications can cause ED, particularly the antihypertensives (Vasotec) and the antidepressants (Paxil). Other
activities like heavy smoking, drug abuse, and alcoholism can also lead to ED.
Expected spriometry readings when the patient has chronic emphysema include: - answer-Increased total lung
capacity (TLC).
Residual volume is increased, Volume Capacity is decreased, FEV-1 in decreased, and total lung capacity is
increased with emphysema. RV, VC, and FEV-1 spirometry readings are the same whether COPD is due to
chronic emphysema or chronic bronchitis, however, TLC is normal or only slightly increased with chronic
bronchitis.
Physical exam findings consistent with emphysema include all of the following EXCEPT: - answer-pallor and
cyanosis of the mucosa and nailbeds.
Pallor and cyanosis is typical of chronic bronchitis (type B COPD, the "blue boater"_. Emphysema (Type A COPD,
the "pink puffer") is not associated with pallor or cyanosis. Increased AP dianeter produces a "barrel chest". The
normal chest is elliptical whereas the barrel chest is round. The muscles of the thorax appear thin and wasted while
the accessory muscles of respiration are hypertrophied. Breath sounds are minished and cough is weak and
ineffective.
Which laboratory test is useful in the diagnosis of spontaneous abortion? - answer-Serial quantitative beta-
huma chorionic gonadotropin levels.
Serial quantitative beta-human chorionic gonadotropin levels are the most useful for diagnosing spontaneous
abortion. The levels progressively decline.
The most acceoted recommendation regarding skin cancer prevention is: - answer-avoidance of excessive sun
exposure.
Page 4 of 134
