1
APEA PREDICTOR EXAM
The diagnosis of Meniere's disease is based on: - ANSWER The exclusion of other
pathologies.
Most cases of Meniere's disease are idiopathic and the diagnosis is based on the
exclusion of other pathologies. Central vertigo is present with many vestibular
problems. Low frequency hearing loss is more commonly associated with
Meniere's disease. MRI is helpful to rule out acoustic neurome, but not to
diagnose Meniere's disease.
The reason beta-adrenergic blockers should be avoided in patients with diabetes
is because they may: - ANSWER Mask symptoms of hypoglycemia.
Beta blockers may mask the peripheral signs of hypoglycemia like jitteriness and
tachycardia. However, beta blockers will not mask diaphoresis. Therefore diabetics
on betablockers should be taught to look for this specific symptom as a possible
indication of hypoglycemia.
An adult female patient is seeking information about her ideal weight. She is 5
feet 7 inches tall. Using the "height-weight formula" what is her ideal body
weight? - ANSWER 135 lbs
The height-weight formula is a quick method of determining ideal weight. Females
allow 100 lbs for the first 5 feet of height plus 5 lbs for each additional inch. Males
allow 106 lbs for the first 5 feet plus 6 lbs for each additional inch. This method
can only be used as an estimate because it does not account for body composition
or age.
,2
The nurs practitioner is caring for a 19 year old female college student with iron
deficiency anemia secondary to heavy menstrual bleeding. An appropriate INITIAL
treatment for this patient is: - ANSWER Oral ferrous sulfate.
With iron deficiency anemia, iron stores of the body must be replenished as well
as the underlying cause corrected. A daily iron supplement is used initially. The
most common form is ferrous sulfate. Intramuscular iron dextran is usually not
needed, but may be required in the presence of a malabsorption disorder,
inflammatory bowel disease, intolerance to oral iron, or blood loss too great to be
compensated by oral iron.
A male patient with chronic atrial fibrillation takes a generic brand of Coumadin
(warfarin). He should report all of these to his health care provider EXCEPT: -
ANSWER one missed dose of warfarin.
This patient takes warfarin for prevention of emboli secondary to chronic atrial
fibrillation. According to the NHLBI and ACCP, warfarin is the standard of care
when anticoagulation is required for this condition. Warfarin is a drug with a
narrow therapeutic index. This means that fluctuation in its level (increased or
decreased) can potentiall cause big changes in its therapeutic effect.
Consequently, warfarin levels are checked frequently to maintain therapeutic
levels. If changes such as medication substitutions occur, warfarin levels should be
checked in 3-7 days. Levels should be checked minimally every 4-6 weeks once
regulation has occurred. While it is important NOT to omit doses of warfarin, this
is the least important of all the choices because the effect of warfarin lasts beyond
24 hours.
Which of the following medication or medication class that does NOT have
dizziness or vertigo as potential adverse side effects? - ANSWER Meclizine
(Antivert)
Dizziness is associated with a sensation of body movement when there is no body
movement occurring. (The person is spinning and the room is not). Vertigo is the
,3
sensation that the person is still and the room is spinning. There is no associated
muscle weakeness or visual disturbance with either of these conditions. The most
common causes are related to drug ingestion, hypotension, inner or middle ear
pathology, and positional vertigo. Dizziness is an adverse reaction associated with
certain antibiotics (gentomycin and strptomycin) and high-dose salicylates. Vertigo
is associated with certain inner ear pathology such as labyrinthitis and Meniere's
disease. Meclizine is a long-acting antihistamine which is used to treat chronic
vertigo.
A PPD is considered positive at 5 millimeters or more for which population? -
ANSWER Confirmed or suspected HIV infection, injecting drug users, close
contacts of a TB case, persons with a chest X-ray suggestive of TB
A PPD greater than or equal to 10 mm is considered positive for injecting drug
users known to be HIV negative, occupants of long-term care facilities, age less
than 4 years, groups with a high prevalance for TB, the medically underserved,
and healthcare workers. A PPD is considered positive at 15mm or more in those
with no known risk factors.
Considering mortality statistics for the adolescent age group. education targeted
toward this group should first focus on: - ANSWER alcohol abuse.
Alcohol is the most commonly used psychoactive substance in the United States
today. It has been used by about 90% of adolescents by 16 years of age. Motor
vehicle accidents related to driving under the influence of alcohol are the leading
cause of death in the 15-24 year old age group.
A patient with moderate persistent asthma will probably be most effectively
managed with daily: - ANSWER inhaled steroids and long acting bronchodilators.
, 4
A patient with moderate persistent asthma has symptoms daily. He is best
managed with daily medications of inhaled corticosteroids and long acting
bronchdilators. Oral leukotriene blockers may be added to this regimen.
A child has just scalded her index finger with hot water at home. The mother calls
the NP within 5 minutes of the injury. All of the following are appropiate
instructions for the mother regarding the care of the patient with a 2nd degree
burn EXCEPT: - ANSWER Applying butter, cooking oil, or lanolin for pain relief.
Flushing first or second degree burn with cool water is appropriate to prevent
further thermal injury and to provide pain relief. Oil should NEVER be applied to a
burn injury. Consider consultation for burns in patients who are under 10 years of
age and over 50 years of age. Physician referral is recommended for all 3rd degree
burns, for 2nd and 3rd degree burns involving more than 10% of the body surface
area, any deep thickness burns involving more than 2% of the body surface area,
and burns involving the face.
What is the recommended treatment for cat scratch disease? - ANSWER usually
self-limiting and presents with lymphadenopathy that goes away on it's own;
severe cases may benefit from azithromycin
What is the most common cause of traveler's diarrhea? - ANSWER e coli
What bacteria is responsible for causing cat scratch disease? - ANSWER
bartonella henselae
What are the 4 different components of tetralogy of fallot? - ANSWER overriding
aorta, pulmonary stenosis, right ventricular hypertrophy, and a ventricular septal
defect
APEA PREDICTOR EXAM
The diagnosis of Meniere's disease is based on: - ANSWER The exclusion of other
pathologies.
Most cases of Meniere's disease are idiopathic and the diagnosis is based on the
exclusion of other pathologies. Central vertigo is present with many vestibular
problems. Low frequency hearing loss is more commonly associated with
Meniere's disease. MRI is helpful to rule out acoustic neurome, but not to
diagnose Meniere's disease.
The reason beta-adrenergic blockers should be avoided in patients with diabetes
is because they may: - ANSWER Mask symptoms of hypoglycemia.
Beta blockers may mask the peripheral signs of hypoglycemia like jitteriness and
tachycardia. However, beta blockers will not mask diaphoresis. Therefore diabetics
on betablockers should be taught to look for this specific symptom as a possible
indication of hypoglycemia.
An adult female patient is seeking information about her ideal weight. She is 5
feet 7 inches tall. Using the "height-weight formula" what is her ideal body
weight? - ANSWER 135 lbs
The height-weight formula is a quick method of determining ideal weight. Females
allow 100 lbs for the first 5 feet of height plus 5 lbs for each additional inch. Males
allow 106 lbs for the first 5 feet plus 6 lbs for each additional inch. This method
can only be used as an estimate because it does not account for body composition
or age.
,2
The nurs practitioner is caring for a 19 year old female college student with iron
deficiency anemia secondary to heavy menstrual bleeding. An appropriate INITIAL
treatment for this patient is: - ANSWER Oral ferrous sulfate.
With iron deficiency anemia, iron stores of the body must be replenished as well
as the underlying cause corrected. A daily iron supplement is used initially. The
most common form is ferrous sulfate. Intramuscular iron dextran is usually not
needed, but may be required in the presence of a malabsorption disorder,
inflammatory bowel disease, intolerance to oral iron, or blood loss too great to be
compensated by oral iron.
A male patient with chronic atrial fibrillation takes a generic brand of Coumadin
(warfarin). He should report all of these to his health care provider EXCEPT: -
ANSWER one missed dose of warfarin.
This patient takes warfarin for prevention of emboli secondary to chronic atrial
fibrillation. According to the NHLBI and ACCP, warfarin is the standard of care
when anticoagulation is required for this condition. Warfarin is a drug with a
narrow therapeutic index. This means that fluctuation in its level (increased or
decreased) can potentiall cause big changes in its therapeutic effect.
Consequently, warfarin levels are checked frequently to maintain therapeutic
levels. If changes such as medication substitutions occur, warfarin levels should be
checked in 3-7 days. Levels should be checked minimally every 4-6 weeks once
regulation has occurred. While it is important NOT to omit doses of warfarin, this
is the least important of all the choices because the effect of warfarin lasts beyond
24 hours.
Which of the following medication or medication class that does NOT have
dizziness or vertigo as potential adverse side effects? - ANSWER Meclizine
(Antivert)
Dizziness is associated with a sensation of body movement when there is no body
movement occurring. (The person is spinning and the room is not). Vertigo is the
,3
sensation that the person is still and the room is spinning. There is no associated
muscle weakeness or visual disturbance with either of these conditions. The most
common causes are related to drug ingestion, hypotension, inner or middle ear
pathology, and positional vertigo. Dizziness is an adverse reaction associated with
certain antibiotics (gentomycin and strptomycin) and high-dose salicylates. Vertigo
is associated with certain inner ear pathology such as labyrinthitis and Meniere's
disease. Meclizine is a long-acting antihistamine which is used to treat chronic
vertigo.
A PPD is considered positive at 5 millimeters or more for which population? -
ANSWER Confirmed or suspected HIV infection, injecting drug users, close
contacts of a TB case, persons with a chest X-ray suggestive of TB
A PPD greater than or equal to 10 mm is considered positive for injecting drug
users known to be HIV negative, occupants of long-term care facilities, age less
than 4 years, groups with a high prevalance for TB, the medically underserved,
and healthcare workers. A PPD is considered positive at 15mm or more in those
with no known risk factors.
Considering mortality statistics for the adolescent age group. education targeted
toward this group should first focus on: - ANSWER alcohol abuse.
Alcohol is the most commonly used psychoactive substance in the United States
today. It has been used by about 90% of adolescents by 16 years of age. Motor
vehicle accidents related to driving under the influence of alcohol are the leading
cause of death in the 15-24 year old age group.
A patient with moderate persistent asthma will probably be most effectively
managed with daily: - ANSWER inhaled steroids and long acting bronchodilators.
, 4
A patient with moderate persistent asthma has symptoms daily. He is best
managed with daily medications of inhaled corticosteroids and long acting
bronchdilators. Oral leukotriene blockers may be added to this regimen.
A child has just scalded her index finger with hot water at home. The mother calls
the NP within 5 minutes of the injury. All of the following are appropiate
instructions for the mother regarding the care of the patient with a 2nd degree
burn EXCEPT: - ANSWER Applying butter, cooking oil, or lanolin for pain relief.
Flushing first or second degree burn with cool water is appropriate to prevent
further thermal injury and to provide pain relief. Oil should NEVER be applied to a
burn injury. Consider consultation for burns in patients who are under 10 years of
age and over 50 years of age. Physician referral is recommended for all 3rd degree
burns, for 2nd and 3rd degree burns involving more than 10% of the body surface
area, any deep thickness burns involving more than 2% of the body surface area,
and burns involving the face.
What is the recommended treatment for cat scratch disease? - ANSWER usually
self-limiting and presents with lymphadenopathy that goes away on it's own;
severe cases may benefit from azithromycin
What is the most common cause of traveler's diarrhea? - ANSWER e coli
What bacteria is responsible for causing cat scratch disease? - ANSWER
bartonella henselae
What are the 4 different components of tetralogy of fallot? - ANSWER overriding
aorta, pulmonary stenosis, right ventricular hypertrophy, and a ventricular septal
defect
