APEA PRE-PREDICTOR EXAM 100 Practice Questions with Answers & Detailed Rationales 2026
Updated Edition | Advanced Practice Education Associates
================================================================
HEALTH PROMOTION AND SCREENING (Questions 1-20)
QUESTION 1
A 58-year-old patient has an annual exam. A fecal occult blood test was used to screen for
colon cancer. Three were ordered on separate days. The first test was positive; the last two
were negative. How should the nurse practitioner proceed?
A) Rescreen in one year
B) Perform a fourth exam
C) Refer him for a colonoscopy
D) Examine him for hemorrhoids
ANSWER: C) Refer him for a colonoscopy
RATIONALE: A fecal occult blood test is performed multiple times because tumors don't
consistently excrete blood. The standard of practice is to refer all positive colon cancer
screens for colonoscopy regardless of subsequent negative results .
QUESTION 2
What is the recommendation from the American Cancer Society for assessment of the
prostate gland in a man who is 45 years old and of average risk for development of prostate
cancer?
A) Screening starting at 50 years of age
B) Prostate specific antigen (PSA) now
C) PSA and digital rectal exam now
D) Digital rectal exam only
,ANSWER: A) Screening starting at 50 years of age
RATIONALE: At age 50 years, males of average prostate cancer risk should have PSA
measurement with or without digital rectal exam. Those at high risk (family history, African
American) should have screening discussions at age 40-45 years .
QUESTION 3
A 75-year-old adult asks for the pneumonia vaccine. His immunization record indicates that he
had one at age 65 and another a year later. What is the recommendation of the CDC about
how the NP should handle his request?
A) Administer another pneumonia vaccine today
B) Do not administer another pneumonia vaccine
C) Administer Prevnar 13 today
D) Administer Pneumovax 23 today
ANSWER: B) Do not administer another pneumonia vaccine
RATIONALE: PCV13 is given first at age 65, followed by PPSV23 one year later. Routine
revaccination is not recommended after this schedule .
QUESTION 4
Screening for abdominal aortic aneurysm should take place:
A) Once for all males aged 65-75 who have ever smoked
B) Once for all men and women who have hypertension
C) Annually after age 75 years for males and females
D) Only if the patient has smoked and has hypertension
ANSWER: A) Once for all males aged 65-75 who have ever smoked
,RATIONALE: The USPSTF recommends one-time screening for abdominal aortic aneurysm in
men aged 65-75 who have ever smoked. Screening is not routinely recommended for women .
QUESTION 5
A 67-year-old patient presents an immunization record that reflects having received the
PCV13 immunization when she was 65 years old. She received the PPSV23 immunization one
year later. Which statement below reflects the current standard of practice recommended by
ACIP and CDC for this patient?
A) She should be revaccinated today
B) She should receive the immunization every 5 years
C) She can elect to receive it today if she has COPD
D) She does not need the immunization
ANSWER: D) She does not need the immunization
RATIONALE: Routine revaccination is not recommended for this patient because she has met
the ACIP/CDC standard with PCV13 at age 65 and PPSV23 one year later .
QUESTION 6
Which recommendation below reflects CDC's recommendation for administration of the
zoster vaccine?
A) It should be given to immunocompetent adults age 60 and older
B) It should be given to immunocompetent adults age 65 and older
C) It can be given regardless of immune status at age 50
D) It can be given regardless of immune status at age 60
ANSWER: A) It should be given to immunocompetent adults age 60 and older
RATIONALE: CDC recommends zoster vaccine for immunocompetent adults aged 60 and older.
It is FDA-approved for age 50 and older but should never be used to treat shingles .
, QUESTION 7
A mammogram in a healthy 50-year-old female patient is an example of:
A) Primary prevention
B) Secondary prevention
C) Tertiary prevention
D) Quaternary prevention
ANSWER: B) Secondary prevention
RATIONALE: Secondary prevention involves screenings intended to identify early course of
disease. Mammography identifies early breast cancer before symptoms develop .
QUESTION 8
A 67-year-old patient should receive which of the following immunizations if he has not
previously had them? (Select all that apply)
A) Influenza
B) Tdap
C) Zoster
D) Pneumococcal
E) Hepatitis B
ANSWER: A, B, C, D
RATIONALE: Adults 65 and older should receive influenza vaccine annually, Tdap once, zoster
vaccine, and pneumococcal vaccine series .
QUESTION 9
The leading cause of injury death in the elderly is:
Updated Edition | Advanced Practice Education Associates
================================================================
HEALTH PROMOTION AND SCREENING (Questions 1-20)
QUESTION 1
A 58-year-old patient has an annual exam. A fecal occult blood test was used to screen for
colon cancer. Three were ordered on separate days. The first test was positive; the last two
were negative. How should the nurse practitioner proceed?
A) Rescreen in one year
B) Perform a fourth exam
C) Refer him for a colonoscopy
D) Examine him for hemorrhoids
ANSWER: C) Refer him for a colonoscopy
RATIONALE: A fecal occult blood test is performed multiple times because tumors don't
consistently excrete blood. The standard of practice is to refer all positive colon cancer
screens for colonoscopy regardless of subsequent negative results .
QUESTION 2
What is the recommendation from the American Cancer Society for assessment of the
prostate gland in a man who is 45 years old and of average risk for development of prostate
cancer?
A) Screening starting at 50 years of age
B) Prostate specific antigen (PSA) now
C) PSA and digital rectal exam now
D) Digital rectal exam only
,ANSWER: A) Screening starting at 50 years of age
RATIONALE: At age 50 years, males of average prostate cancer risk should have PSA
measurement with or without digital rectal exam. Those at high risk (family history, African
American) should have screening discussions at age 40-45 years .
QUESTION 3
A 75-year-old adult asks for the pneumonia vaccine. His immunization record indicates that he
had one at age 65 and another a year later. What is the recommendation of the CDC about
how the NP should handle his request?
A) Administer another pneumonia vaccine today
B) Do not administer another pneumonia vaccine
C) Administer Prevnar 13 today
D) Administer Pneumovax 23 today
ANSWER: B) Do not administer another pneumonia vaccine
RATIONALE: PCV13 is given first at age 65, followed by PPSV23 one year later. Routine
revaccination is not recommended after this schedule .
QUESTION 4
Screening for abdominal aortic aneurysm should take place:
A) Once for all males aged 65-75 who have ever smoked
B) Once for all men and women who have hypertension
C) Annually after age 75 years for males and females
D) Only if the patient has smoked and has hypertension
ANSWER: A) Once for all males aged 65-75 who have ever smoked
,RATIONALE: The USPSTF recommends one-time screening for abdominal aortic aneurysm in
men aged 65-75 who have ever smoked. Screening is not routinely recommended for women .
QUESTION 5
A 67-year-old patient presents an immunization record that reflects having received the
PCV13 immunization when she was 65 years old. She received the PPSV23 immunization one
year later. Which statement below reflects the current standard of practice recommended by
ACIP and CDC for this patient?
A) She should be revaccinated today
B) She should receive the immunization every 5 years
C) She can elect to receive it today if she has COPD
D) She does not need the immunization
ANSWER: D) She does not need the immunization
RATIONALE: Routine revaccination is not recommended for this patient because she has met
the ACIP/CDC standard with PCV13 at age 65 and PPSV23 one year later .
QUESTION 6
Which recommendation below reflects CDC's recommendation for administration of the
zoster vaccine?
A) It should be given to immunocompetent adults age 60 and older
B) It should be given to immunocompetent adults age 65 and older
C) It can be given regardless of immune status at age 50
D) It can be given regardless of immune status at age 60
ANSWER: A) It should be given to immunocompetent adults age 60 and older
RATIONALE: CDC recommends zoster vaccine for immunocompetent adults aged 60 and older.
It is FDA-approved for age 50 and older but should never be used to treat shingles .
, QUESTION 7
A mammogram in a healthy 50-year-old female patient is an example of:
A) Primary prevention
B) Secondary prevention
C) Tertiary prevention
D) Quaternary prevention
ANSWER: B) Secondary prevention
RATIONALE: Secondary prevention involves screenings intended to identify early course of
disease. Mammography identifies early breast cancer before symptoms develop .
QUESTION 8
A 67-year-old patient should receive which of the following immunizations if he has not
previously had them? (Select all that apply)
A) Influenza
B) Tdap
C) Zoster
D) Pneumococcal
E) Hepatitis B
ANSWER: A, B, C, D
RATIONALE: Adults 65 and older should receive influenza vaccine annually, Tdap once, zoster
vaccine, and pneumococcal vaccine series .
QUESTION 9
The leading cause of injury death in the elderly is:
