3P APEA EXAM QUESTIONS AND ANSWERS 100% ACCURATE(GRADED A+)

A 43 year old Hispanic male has an audible diastolic murmur best heard in the mitral listening point. There is no audible click. His status has been monitored for the past two years. This murmur is probably - ANSWER mitral stenosis A patient who has diabetes presents with pain in his lower legs when he walks and pain resolution with rest. When specifically asked about his pain in his lower leg, he likely will report pain - ANSWER in the calf muscle A patient with hypertension describes a previous allergic reaction to a sulfa antibiotic as "sloughing of skin" and hospitalization. Which medication is contraindicated in this patient? - ANSWER hydrochlorothiazide A 75 year old patient who has aortic stenosis wants to know what symptoms indicate worsening of his stenosis. the NP replies: - ANSWER shortness of breath and syncope A 74 year old patient has PAD. Which item listed below is an important nonmodifiable risk factor for PAD? - ANSWER diabetes Benazepril should be d/c immediately if - ANSWER pregnancy occurs aortic regurgitation characteristics - ANSWER long asymptomatic period follow by exercise intolerance, then dyspnea at rest DVT classic symptoms - ANSWER swelling, pain, and discoloration of lower extremity Characteristic of ACE-induced cough is that? - ANSWER usually begins two weeks of starting therapy Valve most commonly involved in chronic rheumatic heart disease - ANSWER mitral Medication that can exacerbate HF - ANSWER naproxen Patient taking ACE inhibitors should avoid? - ANSWER potassium supplements good drug to reduce morbidity and mortality in mild HF - ANSWER metoprolol A pt. taking atorvastatin newly diagnosed with dyslipidemia complaints of fatigue, weakness, and muscle aches in his lower back, arms, legs for the past 3 days. it is not improved with rest How should this be evaluated? - ANSWER Stop the atorvastatin immediately symptom not indicative of HF - ANSWER headache What class of meds is preferred to normalized lipid levels and reduce risk of cardiac events - ANSWER HMG CoA reductase inhibitors Highest sensitivity in diagnosing HF - ANSWER BNP The NP is caring for a 74-year-old who had an acute coronary syndrome 6 weeks ago. What medications should be part of his regimen unless contraindicated - ANSWER ACE, ASA, beta blockers, and statin patient with the highest systolic B/P - ANSWER 75-year-old male test that is most cost effective to screen for abdominal aortic aneurysm - ANSWER abdominal ultrasound a 74-year-old patient has had an increase in b/p since the last exam. his b/p has increased from 144/90 to reading in the upper 160's/upper 80's. If medication is to be started on this patient, what would be a good first choice? - ANSWER Calcium channel blocker Factor contributing to the development of AAA - ANSWER cigarette smoking A 40-year-old African-American pt. has a b/p of 175/100 and 170/102. What is a reasonable plan of care for this pt today? - ANSWER initiate amlodipine 5mg daily Usual course of treatment for mitral valve prolapse - ANSWER is benign A 50-year-old patient with hypertension has taken HCTZ 25mg daily for the past 4 weeks. Her b/p has decreased from 155/95 to 145/90. How should the NP proceed? - ANSWER add another drug from another class to the daily 25mg HCTZ A patient with mitral valve prolapse reports chest pain and frequent arrhythmias. In the absence of other cardiac anomalies, the drug of choice to treat her symptoms is: - ANSWER metoprolol which hypertensive pt. is most likely to have adverse b/p effects from excessive sodium consumption? - ANSWER a 70-year-old African American where would the murmur associated w/mitral regurgitation best be auscultated? - ANSWER mitral listening point A pt. with a positive hx of a tick bite 2 weeks ago and erythema migrans has a positive ELISA for borrelia burgdorferi. The Western blot is positive. How should he be managed? - ANSWER he should receive Doxycycline for Lyme disease a pt. has/seborrheic dermatitis. Which vehicle would be most appropriate to use in the hairline area to treat this? - ANSWER foam A microscopic exam of the sample taken from a skin lesion indicates hyphae. What type of infection might this indicate? - ANSWER fungal A pt. has been dx w/MRSA. she is allergic to sulfa. Which medication could be used to treat her? - ANSWER doxycycline A 15-year-old male has worked this summer as a lifeguard at a local swimming pool. He complains of itching in the groin area. He is dx with tinea cruris. The NP is likely to identify - ANSWER well marginated half moon shape macules on the inner thigh A pt. exhibits petechiae on both lower legs w/o other complaints. How should the NP proceed? - ANSWER order a CBC A pt. has been dx w/scabies. What is the medication of choice to treat this? - ANSWER permethrin and good hand hygiene A pt. has been in the sun for the past few weeks and has developed darkened skin and numerous 3-6 mm light-colored, flat lesions on his trunk. What is the likely etiology? - ANSWER tinea vesicolor Which vehicle is least appropriate in a pt. w/atopic dermatitis? - ANSWER lotions a pt. presents w/small vesicles on the lateral edges of his fingers and intense itching. there are small vesicles on the palmar surface of the hand. What is this called? - ANSWER dyshidrotic dermatitis a low-potency topical hydrocortisone cream would be most appropriate in a pt. who has been dx with? - ANSWER atopic dermatitis most common form of skin cancer - ANSWER basal cell carcinoma greatest percutaneous absorption areas in the body - ANSWER genitalia most common place for basal cell carcinoma - ANSWER face A 74-year-old is dx w/shingles. The NP is deciding how to best manage her care. What should be prescribed? - ANSWER an oral antiviral agent the American Cancer Society uses an ABCDE Mneumonic to help pt.'s develop awareness of suspicious skin lesions what do they represent? - ANSWER A= asymetry B=border C=color D=diameter E=enlarging or elevated characteristic of shingles - ANSWER single dermatome affected Grade 3 murmur indication for a referral - ANSWER a fixed split Group of meds used to treat HF - ANSWER fosinopril, HCTZ, verapamil Mr. Smith is a 72-year-old patient who takes warfarin for chronic A-fib. INR today is 4.0. the NP should: - ANSWER stop the warfarin today and repeat INR tomorrow According to the NHLBI, which characteristic is a coronary heart disease risk equivalent, that is, which risk factor places the pt. as a CHD risk similar to a hx of CHD - ANSWER diabetes mellitus An adolescent has acne. The NP prescribed a benzoyl peroxide product for him. What important teaching point should be given to this adolescent regarding the benzoyl peroxide. - ANSWER photosensitivity of the skin can occur A 76-year-old obese pt. has fatigue, thirst, and frequent urination. She was asked to measure AM fasting glucose values for 1 week. The values range from 142-175 this pt: - ANSWER can be dx w/DMT2 The most appropriate time to begin screening for renal nephropathy in a pt w/ T2DM - ANSWER at diagnosis In order to determine how much T4 replacement a pt. needs to reestablish a euthyroid state, the NP considers: - ANSWER the pt.'s body weight A pt. has been dx w/T2DM. A criterion for dx is: - ANSWER a fasting glucose > or equal to 126 and confirmed on a previous day.