APEA Predictor Exam
NSG 6440 Week 4 APEA Predictor Exam – Pre-
Predictor Test latest
1. A 15 years old high school student with a mild sore throat and low-grade fever that has
persisted for about 3 weeks. She reports general malaise, fatigue, and loss of appetite. The NP
suspects mononucleosis. Which of the following is the LEAST appropriate intervention?
a. Palpate the lymph nodes and spleen
b. Examine the posterior oropharynx for petechiae
c. Obtain a CBC, throat culture, and heterophil antibody test.
d. Obtain an urinalyses and serum for LFTs and amylase
Explanation: mononucleosis is a symptomatic infection caused by the Epstein-Bar virus.
Common is people 15-24 years of age. Common signs and symptoms following incubation
period (1-2 months) include fatigue, chills, malaise, anorexia, white tonsillar exudates and
lymphadenopathy or posterior cervical region. Splenomegaly can be present. A maculopapular or
occasionally a petechial rash occurs in less than 15% of patients. A diagnosis is usually made
using the Monospot. In addition, neutropenia and lymphocytosis are usually detected in the CBC.
2. A 32 years old male patient complaint of urinary frequency and burning on urination for 3
days. Urinalyses reveals bacteriuria and positive nitrites. He denies any past hx. Of urinary tract
infections. The initial treatment should be:
a. trimethoprim-sulfamethoxazole (Bactrim, Sulfatrim) for 7-10 day
b. ciprofloxacin (Cipro) for 3-5 days
c. Trimethoprim-Sulfamethoxazole for 3 days
d. 750 mg ciprofloxacin as a one-time dose
Explanation: trimethoprim-sulfamethoxazole (TMPS) is usually n appropriate medication to
treat urinary tract infections in most patients. In the case of community resistance to TMPS
>20%^, another medication should be substituted. In men, the appropriate length of time is 7-10
days. Women may be treated for 3 days for uncomplicated UTI
3. Which agent is most effective for the treatment of nodulocystic acne?
a. Benzoyl peroxide (Benzac)
b. Retinoic acid (Retin A)
c. Topical tetracycline
d. Isotretinoin)
Explanation: Isotretinoin (Accutane) is a systemic agent indicated for treatment with severe
inflammatory acne. Guidelines for its use must be clearly understood by the patient. A woman of
childbearing age must use an effective method of contraception because isotretinoin is
teratogenic. There are many restrictions in prescribing this medication because of the teratogenic
effects is given during pregnancy. Therefore, it is a pregnancy category X.
4. An 18 y/o woman is taking a combined hormonal oral contraceptive. She should be
instructed to use a backup method for the prevention of pregnancy
1
, APEA Predictor Exam
a. Throughout the week of placebo pills
b. If prescribed topiramate (Topamax) for the treatment of migraines.
2
, APEA Predictor Exam
c. If prescribed amoxicillin/clavulanate (Augmentin) for a sinus infection
d. if she forgets to take a single dose of the contraceptive
Explanation: Anticonvulsant including phenytoin (Dilantin), carbamazepine (Tegretol),
primidone (Mysoline), topiramate (Topamax) and oxcarbazepine (Trileptal) reduce the
effectiveness of contraceptives. Depo-medroxyprogesterone acetate injections or levonorgestrel-
releasing intrauterine devices would be a better method of contraceptive for patients taking
anticonvulsants. Most commonly used antibiotics have not been proven to reduce the
effectiveness of contraceptives. Rifampin is an exception, and additional …. Be used by women
taking this drug and using oral contraceptives, transdermal, or vaginal ring preparations.
Additional backup contraception should be used if taking antifungal agents. No additional
protection is needed thought the week of placebo pills. Missing one single dose of contraceptive
does not require additional protection, missing more than one doses does.
5. A 44 years old female patient has diabetes. Her total cholesterol (TC) is 250 mg/dl (6.5
mmol/L), LDL= 190 mg/dL (4.94 mmol/L), HDL= 25 mg/dL (65 mmol/L), and triglycerides=
344 mg/dL (8.94 mmol/L). What agent have the greatest effect on improving her lipid profile and
reducing morbidity and mortality associates with dyslipidemia?
a. Niacin (Niaspan)
b. Atorvastatin
c. Omega 3 fatty acids
d. Fenofibrates
Explanation: First and foremost, it is essential to educate individuals on a heart-healthy
lifestyle. LDL-C is one of the major culprits in the development of atherosclerotic heart disease.
The target level of LDL-C is between 50 to 70mg/dl to prevent plaque formation in the blood
vessels. Guidelines strongly recommend statin therapy because they primarily lower LDL-C
levels, but they also have the secondary effects of lowering triglyceride and increasing HDL-C
levels.
6. A 30 years old female comes into a clinic with classic signs and symptoms of appendicitis.
The NP fails to refer the patient to a surgeon. The appendix ruptures and the woman die. This is
an example of
a. Failure of diligence
b. Professional liability
c. Negligence
d. Malpractice
Explanation: malpractice, a negligence tort, occurs when a health care professional’s actions fall
bellow the appropriate standard of care and hurts the patient. In this case the patient came with
sings and symptoms indicating appendicitis and the NP failed to refer the patient..
7. A NP has recently been hired to work in a fast track facility. The NP employer asked if
she has “a problem prescribing medications for emergency contraception.” The NP replies
affirmatively. This is:
a. Grounds for dismissal
b. An ethical dilemma for the NP
3
,q APEA qPredictor qExam
c. Illegal qaccording qto qthe qstandards qof
d. qnursing
Patient qabandonment.
Explanation: qin qthis qinstance, qthe qNP qhas qa qdifference qof qopinion qwith qher qemployer qbased
qon qher
religious qor qmoral qbelief qabout qproviding qemergency qcontraception. qThis qsituation qis qan
qexample
of qan qethical qdilemma. qFailure qto qparticipate qin qthe qprovision qof qcare qto qthe qpatient qbased qon
q8the
. A qpatient qpresents qwith qpruritic qlesions qon qboth qknees. qThere qare qvisible qsilver qscales.
NP’s q
Shouldqbeliefs qis qneitherqbe
qthis qcondition
How qagainst qthe qlaw qnor qa qviolation qof qthe qstandards qof qpractice
qmanaged?
a. Topical qantifungal qcream qor qointment
b. Oral qantibiotics
c. Topical qcorticosteroids qcream
d. Topical qanti-fungal/ qsteroid qcream
Explanation: qPsoriasis qis qcharacterized qby qerythematous qpapules, qas qwell qas qitchy, qred,
qprecisely
defined qplaques qwith qsilvery qscales. qAuspitz qsings qis qanother qcommon qfinding. qTopical qagents
containing qtar qand qsalicylic qacid qmay qbe qused. qTopical qsteroids, qsuch qas qbetamethasone, qmay
qalso
9. qordered.
be Antidepressant qdiscontinuation qsyndrome qis qless qlikely qif qthe
a. qIs qmale
patient
b. Is qless qthan q35 qy/o
c. Has qtaken qan qSSRI qwith qa qshort qhalf
d. qlife
Gradually qtapers qSSRI quse
Explanation: qAntidepressant qdiscontinuation qsyndrome qis qmost qoften qseen qin qthe qprimary qcare
office qin qassociation qwith qSSRI qdiscontinuation, qbecause qSSRIs qare qthe qmost qcommonly
prescribed qclass qof qantidepressant qmedications. qInterruption qof qtreatment qwith qan qanti-
depressant
medication qis qsometimes qassociated qwith qan qantidepressant qdiscontinuation qsyndrome; qin qearly
reports qit qwas qreferred qto qas qa q“withdrawal qreaction. qSymptoms qof qantidepressant
qdiscontinuation
syndrome qcan qinclude qflu-like qsymptoms, qinsomnia, qnausea, qimbalance, qsensory qdisturbances,
10. qhyperarousal.
and q Patient qwith qTapering qis qrecommended
qbenign qprostatic qby qexperts.
qhyperplasia (BPH) qshould qbe qtaught qto qavoid qwhich qone
qof qthe qdrug qclasses?
following
a. Alpha qadrenergic qantagonist
b. Anti-androgen qagents
c. Tricyclic qantidepressant q(TCA)
d. Sulfonamides
Explanation: qtricyclic qantidepressant qshould qnot qbe qused qby qmen qwith qbenign qprostatic
hyperplasia qbecause qof qthe qincreased qrisk qof qurinary qretention qsecondary qto qthe
qanticholigergic
effects qof qTCAs.
11. q Which qof qthe qfollowing qis qthe qbest qresponse qto qa qwoman qwho qhas qjust qadmitted
qshe qis
victim qaqspousal qabuse?
qof
a. What qwas qif qyou qdid qto qmake qhim
qangry?
4
NSG 6440 Week 4 APEA Predictor Exam – Pre-
Predictor Test latest
1. A 15 years old high school student with a mild sore throat and low-grade fever that has
persisted for about 3 weeks. She reports general malaise, fatigue, and loss of appetite. The NP
suspects mononucleosis. Which of the following is the LEAST appropriate intervention?
a. Palpate the lymph nodes and spleen
b. Examine the posterior oropharynx for petechiae
c. Obtain a CBC, throat culture, and heterophil antibody test.
d. Obtain an urinalyses and serum for LFTs and amylase
Explanation: mononucleosis is a symptomatic infection caused by the Epstein-Bar virus.
Common is people 15-24 years of age. Common signs and symptoms following incubation
period (1-2 months) include fatigue, chills, malaise, anorexia, white tonsillar exudates and
lymphadenopathy or posterior cervical region. Splenomegaly can be present. A maculopapular or
occasionally a petechial rash occurs in less than 15% of patients. A diagnosis is usually made
using the Monospot. In addition, neutropenia and lymphocytosis are usually detected in the CBC.
2. A 32 years old male patient complaint of urinary frequency and burning on urination for 3
days. Urinalyses reveals bacteriuria and positive nitrites. He denies any past hx. Of urinary tract
infections. The initial treatment should be:
a. trimethoprim-sulfamethoxazole (Bactrim, Sulfatrim) for 7-10 day
b. ciprofloxacin (Cipro) for 3-5 days
c. Trimethoprim-Sulfamethoxazole for 3 days
d. 750 mg ciprofloxacin as a one-time dose
Explanation: trimethoprim-sulfamethoxazole (TMPS) is usually n appropriate medication to
treat urinary tract infections in most patients. In the case of community resistance to TMPS
>20%^, another medication should be substituted. In men, the appropriate length of time is 7-10
days. Women may be treated for 3 days for uncomplicated UTI
3. Which agent is most effective for the treatment of nodulocystic acne?
a. Benzoyl peroxide (Benzac)
b. Retinoic acid (Retin A)
c. Topical tetracycline
d. Isotretinoin)
Explanation: Isotretinoin (Accutane) is a systemic agent indicated for treatment with severe
inflammatory acne. Guidelines for its use must be clearly understood by the patient. A woman of
childbearing age must use an effective method of contraception because isotretinoin is
teratogenic. There are many restrictions in prescribing this medication because of the teratogenic
effects is given during pregnancy. Therefore, it is a pregnancy category X.
4. An 18 y/o woman is taking a combined hormonal oral contraceptive. She should be
instructed to use a backup method for the prevention of pregnancy
1
, APEA Predictor Exam
a. Throughout the week of placebo pills
b. If prescribed topiramate (Topamax) for the treatment of migraines.
2
, APEA Predictor Exam
c. If prescribed amoxicillin/clavulanate (Augmentin) for a sinus infection
d. if she forgets to take a single dose of the contraceptive
Explanation: Anticonvulsant including phenytoin (Dilantin), carbamazepine (Tegretol),
primidone (Mysoline), topiramate (Topamax) and oxcarbazepine (Trileptal) reduce the
effectiveness of contraceptives. Depo-medroxyprogesterone acetate injections or levonorgestrel-
releasing intrauterine devices would be a better method of contraceptive for patients taking
anticonvulsants. Most commonly used antibiotics have not been proven to reduce the
effectiveness of contraceptives. Rifampin is an exception, and additional …. Be used by women
taking this drug and using oral contraceptives, transdermal, or vaginal ring preparations.
Additional backup contraception should be used if taking antifungal agents. No additional
protection is needed thought the week of placebo pills. Missing one single dose of contraceptive
does not require additional protection, missing more than one doses does.
5. A 44 years old female patient has diabetes. Her total cholesterol (TC) is 250 mg/dl (6.5
mmol/L), LDL= 190 mg/dL (4.94 mmol/L), HDL= 25 mg/dL (65 mmol/L), and triglycerides=
344 mg/dL (8.94 mmol/L). What agent have the greatest effect on improving her lipid profile and
reducing morbidity and mortality associates with dyslipidemia?
a. Niacin (Niaspan)
b. Atorvastatin
c. Omega 3 fatty acids
d. Fenofibrates
Explanation: First and foremost, it is essential to educate individuals on a heart-healthy
lifestyle. LDL-C is one of the major culprits in the development of atherosclerotic heart disease.
The target level of LDL-C is between 50 to 70mg/dl to prevent plaque formation in the blood
vessels. Guidelines strongly recommend statin therapy because they primarily lower LDL-C
levels, but they also have the secondary effects of lowering triglyceride and increasing HDL-C
levels.
6. A 30 years old female comes into a clinic with classic signs and symptoms of appendicitis.
The NP fails to refer the patient to a surgeon. The appendix ruptures and the woman die. This is
an example of
a. Failure of diligence
b. Professional liability
c. Negligence
d. Malpractice
Explanation: malpractice, a negligence tort, occurs when a health care professional’s actions fall
bellow the appropriate standard of care and hurts the patient. In this case the patient came with
sings and symptoms indicating appendicitis and the NP failed to refer the patient..
7. A NP has recently been hired to work in a fast track facility. The NP employer asked if
she has “a problem prescribing medications for emergency contraception.” The NP replies
affirmatively. This is:
a. Grounds for dismissal
b. An ethical dilemma for the NP
3
,q APEA qPredictor qExam
c. Illegal qaccording qto qthe qstandards qof
d. qnursing
Patient qabandonment.
Explanation: qin qthis qinstance, qthe qNP qhas qa qdifference qof qopinion qwith qher qemployer qbased
qon qher
religious qor qmoral qbelief qabout qproviding qemergency qcontraception. qThis qsituation qis qan
qexample
of qan qethical qdilemma. qFailure qto qparticipate qin qthe qprovision qof qcare qto qthe qpatient qbased qon
q8the
. A qpatient qpresents qwith qpruritic qlesions qon qboth qknees. qThere qare qvisible qsilver qscales.
NP’s q
Shouldqbeliefs qis qneitherqbe
qthis qcondition
How qagainst qthe qlaw qnor qa qviolation qof qthe qstandards qof qpractice
qmanaged?
a. Topical qantifungal qcream qor qointment
b. Oral qantibiotics
c. Topical qcorticosteroids qcream
d. Topical qanti-fungal/ qsteroid qcream
Explanation: qPsoriasis qis qcharacterized qby qerythematous qpapules, qas qwell qas qitchy, qred,
qprecisely
defined qplaques qwith qsilvery qscales. qAuspitz qsings qis qanother qcommon qfinding. qTopical qagents
containing qtar qand qsalicylic qacid qmay qbe qused. qTopical qsteroids, qsuch qas qbetamethasone, qmay
qalso
9. qordered.
be Antidepressant qdiscontinuation qsyndrome qis qless qlikely qif qthe
a. qIs qmale
patient
b. Is qless qthan q35 qy/o
c. Has qtaken qan qSSRI qwith qa qshort qhalf
d. qlife
Gradually qtapers qSSRI quse
Explanation: qAntidepressant qdiscontinuation qsyndrome qis qmost qoften qseen qin qthe qprimary qcare
office qin qassociation qwith qSSRI qdiscontinuation, qbecause qSSRIs qare qthe qmost qcommonly
prescribed qclass qof qantidepressant qmedications. qInterruption qof qtreatment qwith qan qanti-
depressant
medication qis qsometimes qassociated qwith qan qantidepressant qdiscontinuation qsyndrome; qin qearly
reports qit qwas qreferred qto qas qa q“withdrawal qreaction. qSymptoms qof qantidepressant
qdiscontinuation
syndrome qcan qinclude qflu-like qsymptoms, qinsomnia, qnausea, qimbalance, qsensory qdisturbances,
10. qhyperarousal.
and q Patient qwith qTapering qis qrecommended
qbenign qprostatic qby qexperts.
qhyperplasia (BPH) qshould qbe qtaught qto qavoid qwhich qone
qof qthe qdrug qclasses?
following
a. Alpha qadrenergic qantagonist
b. Anti-androgen qagents
c. Tricyclic qantidepressant q(TCA)
d. Sulfonamides
Explanation: qtricyclic qantidepressant qshould qnot qbe qused qby qmen qwith qbenign qprostatic
hyperplasia qbecause qof qthe qincreased qrisk qof qurinary qretention qsecondary qto qthe
qanticholigergic
effects qof qTCAs.
11. q Which qof qthe qfollowing qis qthe qbest qresponse qto qa qwoman qwho qhas qjust qadmitted
qshe qis
victim qaqspousal qabuse?
qof
a. What qwas qif qyou qdid qto qmake qhim
qangry?
4
