lOM oA R CY cP S D|
CY18 211 88 4
lOM oA R CY cP S D| CY18 21 188 4
APEA 3P PRE PREDICTOR EXAM WITH RATIONALE
2023-2024 |VERIFIED EXAM|100% ACCURATE
1) A 15 years old high school student with a mild sore throat and low-grade fever that has
CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY
persisted for about 3 weeks. She reports general malaise, fatigue, and loss of appetite. The
CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY
NPsuspects mononucleosis. Which of the following is the LEAST appropriate intervention?
CY C
Y CY CY CY CY CY CY CY CY CY CY
a. Palpate the lymph nodes and spleen CY CY CY CY CY
b. Examine the posterior oropharynx for petechiae CY CY CY CY CY
c. Obtain a CBC, throat culture, and heterophil antibody test.d. CY CY CY CY CY CY CY CY C
Y
Obtain an urinalyses and serum for LFTs and amylase CY CY CY CY CY CY CY CY
Explanation: mononucleosis is a symptomatic infection caused by the Epstein-Bar virus. Common CY CY CY CY CY CY CY CY CY CY CY
is people 15-24 years of age. Common signs and symptoms following incubation period (1-2
CY CY CY CY CY CY CY CY CY CY CY CY CY CY
months) include fatigue, chills, malaise, anorexia, white tonsillar exudates and lymphadenopathyor
CY CY CY CY CY CY CY CY CY CY CY C
Y
posterior cervical region. Splenomegaly can be present. A maculopapular oroccasionally a petechial
CY CY CY CY CY CY CY CY CY CY C
Y CY CY
rash occurs in less than 15% of patients. A diagnosis is usually made using the Monospot. In addition,
CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY
neutropenia and lymphocytosis are usually detected in the CBC.
CY CY CY CY CY CY CY CY CY
2) A 32 years old male patient complaint of urinary frequency and burning on urination for
CY CY CY CY CY CY CY CY CY CY CY CY CY CY
3 days. Urinalyses reveals bacteriuria and positive nitrites. He denies any past hx. Of urinary
CY C
Y CY CY CY CY CY CY CY CY CY CY CY CY CY
tractinfections. The initial treatment should be:
CY C
Y CY CY CY CY CY
a. trimethoprim-sulfamethoxazole (Bactrim, Sulfatrim) for 7-10 day CY CY CY CY CY
b. ciprofloxacin (Cipro) for 3-5 days CY CY CY CY
c. Trimethoprim-Sulfamethoxazole for 3 days CY CY CY
d. 750 mg ciprofloxacin as a one-time dose CY CY CY CY CY CY
Explanation: trimethoprim-sulfamethoxazole (TMPS) is usuallyn appropriate medication CY CY CY CY C
Y CY CY
totreat urinary tract infections in most patients. In the case of community resistance to TMPS
CY C
Y CY CY CY CY CY CY C Y CY CY CY CY CY CY CY
>20%^, another medication should be substituted. In men, the appropriate length of time is 7-
CY CY CY CY CY CY CY CY CY CY CY CY CY CY
10days. Women may be treated for 3 days for uncomplicated UTI
C
Y CY CY CY CY CY CY CY CY CY CY
3) Which agent is most effective for the treatment of nodulocystic acne? CY CY CY CY CY CY CY CY CY CY
a. Benzoyl peroxide (Benzac) CY CY
b. Retinoic acid (RetinA) CY CY C
Y
c. Topical
tetracyclined.
CY C
Y
Isotretinoin)
Explanation: Isotretinoin (Accutane) is a systemic agent indicated for treatment with severe CY CY CY CY CY CY CY CY CY CY CY
inflammatoryacne. Guidelines for its use must be clearly understood by the patient.Awoman
CY CY CY CY CY CY CY CY CY CY CY CY CY C
Y C
Y
ofchildbearing age must use an effective method of contraception because isotretinoin is
CY C
Y CY CY CY CY CY CY CY CY CY CY CY
teratogenic. There are many restrictions in prescribing this medication because of the
CY CY CY CY CY CY CY CY CY CY CY CY
teratogeniceffects is given during pregnancy. Therefore, it is a pregnancy category X.
CY C
Y CY CY CY CY CY CY CY CY CY CY CY
, lOM oA R CY cP S D|
CY18 211 88 4
4) An 18 y/o woman is taking a combined hormonal oral contraceptive. She should be
CY CY CY CY CY CY CY CY CY CY CY CY CY
, lOM oA R CY cP S D|
CY18 211 88 4
instructed to use a backup method for the prevention of pregnancy
CY CY CY CY CY CY CY CY CY CY
a. Throughout the week of placebo pills
CY CY CY CY CY
b. If prescribed topiramate (Topamax) for the treatment of migraines.
CY CY CY CY CY CY CY CY
1
, lOM oA R CY cP S D|
CY18 211 88 4
c. If prescribed amoxicillin/clavulanate (Augmentin) for a sinus infection
CY CY CY CY CY CY CY
d. if she forgets to take a single dose of the contraceptive
CY CY CY CY CY CY CY CY CY CY
Explanation: Anticonvulsant including phenytoin (Dilantin), carbamazepine (Tegretol), CY CY CY CY CY CY
primidone (Mysoline), topiramate (Topamax) and oxcarbazepine (Trileptal) reduce the
CY CY CY CY CY CY CY CY CY
effectiveness of contraceptives. Depo-medroxyprogesterone acetate injections or levonorgestrel-
CY CY CY CY CY C Y CY CY
releasing intrauterine devices would be a better method of contraceptive for patients taking
C
Y CY CY CY CY CY CY CY CY CY CY CY CY
anticonvulsants. Most commonly used antibiotics have not been proven to reduce the effectiveness
CY CY CY CY CY CY CY CY CY CY CY CY CY
of contraceptives. Rifampin is an exception, and additional …. Be used by women taking this drug
CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY
and using oral contraceptives, transdermal, or vaginal ring preparations.
CY CY CY CY CY CY CY CY CY
Additional backup contraception should be used if taking antifungal agents. No additional
CY CY CY CY CY CY CY CY CY CY CY
protection is needed thought the week of placebo pills. Missing one single dose of contraceptivedoes
CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY C
Y
not require additional protection, missing more than one doses does.
CY CY CY CY CY CY CY CY CY CY
5) A 44 years old female patient has diabetes. Her total cholesterol (TC) is 250 mg/dl (6.5
CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY
mmol/L), LDL= 190 mg/dL (4.94 mmol/L), HDL= 25 mg/dL (65 mmol/L), and triglycerides= 344
CY CY CY CY CY CY CY CY CY CY CY CY CY CY
mg/dL(8.94 mmol/L). What agent have the greatest effect on improving her lipid profile andreducing
CY C
Y CY CY CY CY CY CY CY CY CY CY CY CY CY C
Y
morbidity and mortality associates with dyslipidemia?
CY CY CY CY CY CY
a. Niacin
(Niaspan)b.
CY C
Y
Atorvastatin
c. Omega 3 fatty acids CY CY CY
d. Fenofibrates
Explanation: First and foremost, it is essential to educate individuals on a heart-healthy lifestyle. CY CY CY CY CY CY CY CY CY CY CY CY CY
LDL-C is one of the major culprits in the development of atherosclerotic heart disease.The target
CY CY CY CY CY CY CY CY CY CY CY CY CY CY C
Y CY
level of LDL-C is between 50 to 70mg/dl to prevent plaque formation in the blood vessels.
CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY
Guidelines strongly recommend statin therapy because they primarily lower LDL-C levels, but
CY CY CY CY CY CY CY CY CY CY CY CY
they also have the secondary effects of lowering triglyceride and increasing HDL-C levels.
CY CY CY CY CY CY CY CY CY CY CY CY CY
6) A 30 years old female comes into a clinic with classic signs and symptoms of appendicitis.The
CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY C
Y
NP fails to refer the patient to a surgeon. The appendix ruptures and the woman die. This is an
CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY C
Y
example of
CY CY
a. Failure of diligence CY CY
b. Professional liability C
Y
c. Negligence C
Y
d. Malpractice
C Y
Explanation: malpractice, a negligence tort, occurs when a health care professional’s actions CY CY CY CY CY CY CY CY CY CY CY
fallbellow the appropriate standard of care and hurts the patient. In this case the patient came with
CY C
Y CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY
sings and symptoms indicating appendicitis and the NP failed to refer the patient..
CY CY CY CY CY CY CY CY C
Y CY CY CY CY
7) A NP has recentlybeen hired to work in a fast track facility. The NP employer asked ifshe
CY CY CY C
Y CY CY CY CY CY CY CY CY CY CY CY CY CY C
Y
has ―a problem prescribing medications for emergency contraception.‖ The NP replies
CY CY CY CY CY CY CY CY CY CY CY
affirmatively. This is:
CY C
Y CY
a. Grounds for dismissal CY CY
b. An ethical dilemma for the NP CY CY CY CY CY
2
CY18 211 88 4
lOM oA R CY cP S D| CY18 21 188 4
APEA 3P PRE PREDICTOR EXAM WITH RATIONALE
2023-2024 |VERIFIED EXAM|100% ACCURATE
1) A 15 years old high school student with a mild sore throat and low-grade fever that has
CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY
persisted for about 3 weeks. She reports general malaise, fatigue, and loss of appetite. The
CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY
NPsuspects mononucleosis. Which of the following is the LEAST appropriate intervention?
CY C
Y CY CY CY CY CY CY CY CY CY CY
a. Palpate the lymph nodes and spleen CY CY CY CY CY
b. Examine the posterior oropharynx for petechiae CY CY CY CY CY
c. Obtain a CBC, throat culture, and heterophil antibody test.d. CY CY CY CY CY CY CY CY C
Y
Obtain an urinalyses and serum for LFTs and amylase CY CY CY CY CY CY CY CY
Explanation: mononucleosis is a symptomatic infection caused by the Epstein-Bar virus. Common CY CY CY CY CY CY CY CY CY CY CY
is people 15-24 years of age. Common signs and symptoms following incubation period (1-2
CY CY CY CY CY CY CY CY CY CY CY CY CY CY
months) include fatigue, chills, malaise, anorexia, white tonsillar exudates and lymphadenopathyor
CY CY CY CY CY CY CY CY CY CY CY C
Y
posterior cervical region. Splenomegaly can be present. A maculopapular oroccasionally a petechial
CY CY CY CY CY CY CY CY CY CY C
Y CY CY
rash occurs in less than 15% of patients. A diagnosis is usually made using the Monospot. In addition,
CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY
neutropenia and lymphocytosis are usually detected in the CBC.
CY CY CY CY CY CY CY CY CY
2) A 32 years old male patient complaint of urinary frequency and burning on urination for
CY CY CY CY CY CY CY CY CY CY CY CY CY CY
3 days. Urinalyses reveals bacteriuria and positive nitrites. He denies any past hx. Of urinary
CY C
Y CY CY CY CY CY CY CY CY CY CY CY CY CY
tractinfections. The initial treatment should be:
CY C
Y CY CY CY CY CY
a. trimethoprim-sulfamethoxazole (Bactrim, Sulfatrim) for 7-10 day CY CY CY CY CY
b. ciprofloxacin (Cipro) for 3-5 days CY CY CY CY
c. Trimethoprim-Sulfamethoxazole for 3 days CY CY CY
d. 750 mg ciprofloxacin as a one-time dose CY CY CY CY CY CY
Explanation: trimethoprim-sulfamethoxazole (TMPS) is usuallyn appropriate medication CY CY CY CY C
Y CY CY
totreat urinary tract infections in most patients. In the case of community resistance to TMPS
CY C
Y CY CY CY CY CY CY C Y CY CY CY CY CY CY CY
>20%^, another medication should be substituted. In men, the appropriate length of time is 7-
CY CY CY CY CY CY CY CY CY CY CY CY CY CY
10days. Women may be treated for 3 days for uncomplicated UTI
C
Y CY CY CY CY CY CY CY CY CY CY
3) Which agent is most effective for the treatment of nodulocystic acne? CY CY CY CY CY CY CY CY CY CY
a. Benzoyl peroxide (Benzac) CY CY
b. Retinoic acid (RetinA) CY CY C
Y
c. Topical
tetracyclined.
CY C
Y
Isotretinoin)
Explanation: Isotretinoin (Accutane) is a systemic agent indicated for treatment with severe CY CY CY CY CY CY CY CY CY CY CY
inflammatoryacne. Guidelines for its use must be clearly understood by the patient.Awoman
CY CY CY CY CY CY CY CY CY CY CY CY CY C
Y C
Y
ofchildbearing age must use an effective method of contraception because isotretinoin is
CY C
Y CY CY CY CY CY CY CY CY CY CY CY
teratogenic. There are many restrictions in prescribing this medication because of the
CY CY CY CY CY CY CY CY CY CY CY CY
teratogeniceffects is given during pregnancy. Therefore, it is a pregnancy category X.
CY C
Y CY CY CY CY CY CY CY CY CY CY CY
, lOM oA R CY cP S D|
CY18 211 88 4
4) An 18 y/o woman is taking a combined hormonal oral contraceptive. She should be
CY CY CY CY CY CY CY CY CY CY CY CY CY
, lOM oA R CY cP S D|
CY18 211 88 4
instructed to use a backup method for the prevention of pregnancy
CY CY CY CY CY CY CY CY CY CY
a. Throughout the week of placebo pills
CY CY CY CY CY
b. If prescribed topiramate (Topamax) for the treatment of migraines.
CY CY CY CY CY CY CY CY
1
, lOM oA R CY cP S D|
CY18 211 88 4
c. If prescribed amoxicillin/clavulanate (Augmentin) for a sinus infection
CY CY CY CY CY CY CY
d. if she forgets to take a single dose of the contraceptive
CY CY CY CY CY CY CY CY CY CY
Explanation: Anticonvulsant including phenytoin (Dilantin), carbamazepine (Tegretol), CY CY CY CY CY CY
primidone (Mysoline), topiramate (Topamax) and oxcarbazepine (Trileptal) reduce the
CY CY CY CY CY CY CY CY CY
effectiveness of contraceptives. Depo-medroxyprogesterone acetate injections or levonorgestrel-
CY CY CY CY CY C Y CY CY
releasing intrauterine devices would be a better method of contraceptive for patients taking
C
Y CY CY CY CY CY CY CY CY CY CY CY CY
anticonvulsants. Most commonly used antibiotics have not been proven to reduce the effectiveness
CY CY CY CY CY CY CY CY CY CY CY CY CY
of contraceptives. Rifampin is an exception, and additional …. Be used by women taking this drug
CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY
and using oral contraceptives, transdermal, or vaginal ring preparations.
CY CY CY CY CY CY CY CY CY
Additional backup contraception should be used if taking antifungal agents. No additional
CY CY CY CY CY CY CY CY CY CY CY
protection is needed thought the week of placebo pills. Missing one single dose of contraceptivedoes
CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY C
Y
not require additional protection, missing more than one doses does.
CY CY CY CY CY CY CY CY CY CY
5) A 44 years old female patient has diabetes. Her total cholesterol (TC) is 250 mg/dl (6.5
CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY
mmol/L), LDL= 190 mg/dL (4.94 mmol/L), HDL= 25 mg/dL (65 mmol/L), and triglycerides= 344
CY CY CY CY CY CY CY CY CY CY CY CY CY CY
mg/dL(8.94 mmol/L). What agent have the greatest effect on improving her lipid profile andreducing
CY C
Y CY CY CY CY CY CY CY CY CY CY CY CY CY C
Y
morbidity and mortality associates with dyslipidemia?
CY CY CY CY CY CY
a. Niacin
(Niaspan)b.
CY C
Y
Atorvastatin
c. Omega 3 fatty acids CY CY CY
d. Fenofibrates
Explanation: First and foremost, it is essential to educate individuals on a heart-healthy lifestyle. CY CY CY CY CY CY CY CY CY CY CY CY CY
LDL-C is one of the major culprits in the development of atherosclerotic heart disease.The target
CY CY CY CY CY CY CY CY CY CY CY CY CY CY C
Y CY
level of LDL-C is between 50 to 70mg/dl to prevent plaque formation in the blood vessels.
CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY
Guidelines strongly recommend statin therapy because they primarily lower LDL-C levels, but
CY CY CY CY CY CY CY CY CY CY CY CY
they also have the secondary effects of lowering triglyceride and increasing HDL-C levels.
CY CY CY CY CY CY CY CY CY CY CY CY CY
6) A 30 years old female comes into a clinic with classic signs and symptoms of appendicitis.The
CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY C
Y
NP fails to refer the patient to a surgeon. The appendix ruptures and the woman die. This is an
CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY C
Y
example of
CY CY
a. Failure of diligence CY CY
b. Professional liability C
Y
c. Negligence C
Y
d. Malpractice
C Y
Explanation: malpractice, a negligence tort, occurs when a health care professional’s actions CY CY CY CY CY CY CY CY CY CY CY
fallbellow the appropriate standard of care and hurts the patient. In this case the patient came with
CY C
Y CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY CY
sings and symptoms indicating appendicitis and the NP failed to refer the patient..
CY CY CY CY CY CY CY CY C
Y CY CY CY CY
7) A NP has recentlybeen hired to work in a fast track facility. The NP employer asked ifshe
CY CY CY C
Y CY CY CY CY CY CY CY CY CY CY CY CY CY C
Y
has ―a problem prescribing medications for emergency contraception.‖ The NP replies
CY CY CY CY CY CY CY CY CY CY CY
affirmatively. This is:
CY C
Y CY
a. Grounds for dismissal CY CY
b. An ethical dilemma for the NP CY CY CY CY CY
2
