APEA PRE PREDICTOR EXAM LATEST
2025/2026
QUESTIONS AND CORRECT ANSWERS
GRADED A+
C
When examining a pregnant patient, where should the fundal height be at 22
weeks? LE
Above the umbilicus
ST
Between 18 and 32 weeks, there is good correlation between fundal height and
gestational age of the fetus. The expected heights are: 10-12 weeks: fundus slightly
above the symphysis pubis 16 weeks: fundus midway between the symphysis pubis
BE
and umbilicus 20 weeks: fundus at the level of umbilicus 28 weeks: fundus 3
fingerbreadths above the umbilicus 36 weeks: fundus just below the xiphoid
process
What intervention does the American College of Rheumatology recommend as
first-line therapy for osteoarthritis?
Exercise and weight loss
Exercise, weight loss, and rest are recommended by the American College of
Rheumatology guidelines for the initial management of osteoarthritis (OA). Given
the adverse effects of medications used to treat OA, it is best to minimize dosage
,and delay use as long as possible. An extensive diagnostic workup is not
recommended unless the presentation is in question. Patients who have severe
degenerative joint disease (DJD), joint fusion, or whose pain severity is not
relieved by more conservative therapies may be candidates for joint replacement.
Acetaminophen is recommended as a first-line medication.
A 63-year-old male retired accountant complains of pain and stiffness in his feet
and hands of several years duration. He reports that the pain and stiffness become
worse with activity. On examination, he is noted to have Heberden's nodes but no
C
other bony deformities. Which of the following is the most probable diagnosis?
Osteoarthritis (OA)
LE
Although his vocation involved sedentary activity, this patient is not at great risk
ST
for osteoarthritis. Rheumatoid arthritis is characterized by several joint deformities,
usually bilaterally symmetrical. RA is characterized by inflammatory processes,
while OA is not. RA and OA are chronic conditions. Gout is characterized by acute
BE
exacerbations related to a defect in purine metabolism, increased uric acid
production, or decreased uric acid excretion.
The family of a 78-year-old man moved him into an assisted living center because
he can no longer be left at home alone. He is unable to toilet when asked to do so
and he has had several episodes of incontinence. He has walked out of the facility
twice and been unable to find his way back from 3 blocks away. On examination,
he is pleasant but mildly confused. Which of his medications is LEAST likely
contributing to his behavior?
ramipril (Altace®)
,Tricyclic antidepressants, like amitriptyline, have anticholinergic side effects
which are especially problematic in the elderly because they contribute to urinary
retention. Hydrochlorothiazide is a diuretic and may contribute to his incontinence.
Cimetidine is well known to produce adverse reactions such as confusion in elders.
Ramipril, an ACE inhibitor, is unlikely to contribute to this patient's incontinence
or confusion. Toileting may be a complicated by the anticholinergic medication
and/or the diuretic causing diuresis, urge incontinence, and inability to void at will.
Prescriptive authority: may be exercised by giving a verbal medication order to a
pharmacist.
C
An example of exercising prescriptive authority is giving a verbal order to a
LE
pharmacist or writing an order for a prescription medication. Prescriptive authority
rules and regulations vary from state to state. Prescriptive authority is granted only
to those APRNs who meet the requirements of the governing body for the state in
ST
which the APRN practices.
BE
A patient with no significant medical history has varicose veins. She complains of
"aching legs". The intervention that will provide the greatest relief for her
complaint is to:
elevate her legs periodically.
The intervention that will provide the greatest relief for this patient is elevating her
legs periodically. This will facilitate venous return. Use of support stockings will
prolong the length of time she is able to stand in place, but will not provide relief
after her legs begin aching. Support stockings should be applied prior to getting out
of bed.
, Stress urinary incontinence is:
may be aggravated by caffeine or alcohol.
Stress urinary incontinence is not expected as a result of the normal aging process.
The primary problem is sphincter incompetence. The ingestion of caffeine or
alcohol decreases sphincter control. Anticholinergic and antidepressant
medications are causative factors related to overflow incontinence. Detrusor
C
muscle instability is the primary underlying problem causing urge incontinence.
LE
ST
Which commonly used herbal remedy is NOT associated with anxiety and/or
depressive symptom relief?
Ginkgo biloba
BE
Ginkgo biloba is a common herbal remedy associated with enhancement of
vascular and cerebral perfusion and memory. The nurse practitioner should be
aware when the patient is taking any herbal supplement to avoid risk of drug
interactions.
Upon ophthalmoscopic examination of a 78-year-old patient, the nurse practitioner
observes dark spots against a red retina. What diagnosis is this finding most
consistent with?
2025/2026
QUESTIONS AND CORRECT ANSWERS
GRADED A+
C
When examining a pregnant patient, where should the fundal height be at 22
weeks? LE
Above the umbilicus
ST
Between 18 and 32 weeks, there is good correlation between fundal height and
gestational age of the fetus. The expected heights are: 10-12 weeks: fundus slightly
above the symphysis pubis 16 weeks: fundus midway between the symphysis pubis
BE
and umbilicus 20 weeks: fundus at the level of umbilicus 28 weeks: fundus 3
fingerbreadths above the umbilicus 36 weeks: fundus just below the xiphoid
process
What intervention does the American College of Rheumatology recommend as
first-line therapy for osteoarthritis?
Exercise and weight loss
Exercise, weight loss, and rest are recommended by the American College of
Rheumatology guidelines for the initial management of osteoarthritis (OA). Given
the adverse effects of medications used to treat OA, it is best to minimize dosage
,and delay use as long as possible. An extensive diagnostic workup is not
recommended unless the presentation is in question. Patients who have severe
degenerative joint disease (DJD), joint fusion, or whose pain severity is not
relieved by more conservative therapies may be candidates for joint replacement.
Acetaminophen is recommended as a first-line medication.
A 63-year-old male retired accountant complains of pain and stiffness in his feet
and hands of several years duration. He reports that the pain and stiffness become
worse with activity. On examination, he is noted to have Heberden's nodes but no
C
other bony deformities. Which of the following is the most probable diagnosis?
Osteoarthritis (OA)
LE
Although his vocation involved sedentary activity, this patient is not at great risk
ST
for osteoarthritis. Rheumatoid arthritis is characterized by several joint deformities,
usually bilaterally symmetrical. RA is characterized by inflammatory processes,
while OA is not. RA and OA are chronic conditions. Gout is characterized by acute
BE
exacerbations related to a defect in purine metabolism, increased uric acid
production, or decreased uric acid excretion.
The family of a 78-year-old man moved him into an assisted living center because
he can no longer be left at home alone. He is unable to toilet when asked to do so
and he has had several episodes of incontinence. He has walked out of the facility
twice and been unable to find his way back from 3 blocks away. On examination,
he is pleasant but mildly confused. Which of his medications is LEAST likely
contributing to his behavior?
ramipril (Altace®)
,Tricyclic antidepressants, like amitriptyline, have anticholinergic side effects
which are especially problematic in the elderly because they contribute to urinary
retention. Hydrochlorothiazide is a diuretic and may contribute to his incontinence.
Cimetidine is well known to produce adverse reactions such as confusion in elders.
Ramipril, an ACE inhibitor, is unlikely to contribute to this patient's incontinence
or confusion. Toileting may be a complicated by the anticholinergic medication
and/or the diuretic causing diuresis, urge incontinence, and inability to void at will.
Prescriptive authority: may be exercised by giving a verbal medication order to a
pharmacist.
C
An example of exercising prescriptive authority is giving a verbal order to a
LE
pharmacist or writing an order for a prescription medication. Prescriptive authority
rules and regulations vary from state to state. Prescriptive authority is granted only
to those APRNs who meet the requirements of the governing body for the state in
ST
which the APRN practices.
BE
A patient with no significant medical history has varicose veins. She complains of
"aching legs". The intervention that will provide the greatest relief for her
complaint is to:
elevate her legs periodically.
The intervention that will provide the greatest relief for this patient is elevating her
legs periodically. This will facilitate venous return. Use of support stockings will
prolong the length of time she is able to stand in place, but will not provide relief
after her legs begin aching. Support stockings should be applied prior to getting out
of bed.
, Stress urinary incontinence is:
may be aggravated by caffeine or alcohol.
Stress urinary incontinence is not expected as a result of the normal aging process.
The primary problem is sphincter incompetence. The ingestion of caffeine or
alcohol decreases sphincter control. Anticholinergic and antidepressant
medications are causative factors related to overflow incontinence. Detrusor
C
muscle instability is the primary underlying problem causing urge incontinence.
LE
ST
Which commonly used herbal remedy is NOT associated with anxiety and/or
depressive symptom relief?
Ginkgo biloba
BE
Ginkgo biloba is a common herbal remedy associated with enhancement of
vascular and cerebral perfusion and memory. The nurse practitioner should be
aware when the patient is taking any herbal supplement to avoid risk of drug
interactions.
Upon ophthalmoscopic examination of a 78-year-old patient, the nurse practitioner
observes dark spots against a red retina. What diagnosis is this finding most
consistent with?
