APEA Predictor Test Questions and Answers with Rationales, Newest 2025
NSG6440 Final Exam PREDICTOR QUESTIONS AND ANSWERS/NSG 6440
FINAL EXAM
A 15 years old high school student with a mild sore throat and the low-grade fever has
been haspersistedforabout3weeks. She reports general malaise, fatigue, and loss of appetite.
The NP suspects mono nucleosides. Which of the following is the LEAST appropriate
intervention?
Palpate the lymph nodes and spleen
Examinetheposteriororopharynxforpetechiae
Obtain a CBC, throat culture, and heterophil antibody test.
Obtain 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. Following the incubation period (1-2 months), common
signs and symptoms include fatigue, chills, malaise, anorexia, white tonsillar exudates, and
lymphadenopathy or posterior cervical region. Splenomegaly can be present. A maculopapular
or occasionally petechial rash occurs in less than 15% of patients. A diagnosis is usually made
using the Monospot.In addition,neutropeniaandlymphocytosisareusuallydetectedintheCBC.
A 32-year-old male patient complaint of urinary frequency and burning on urination for
three days. Urinalyses reveal bacteriuria and positive nitrites. He denies any past hx. Of urinary
tract infections. The initial treatment should be:
a. trimethoprim-sulfamethoxazole(Bactrim,Sulfatrim)for7-10day
ciprofloxacin(Cipro)for3-5days
Trimethoprim-Sulfamethoxazolefor3days
750mg ciprofloxacinasa one-timedose
Explanation: trimethoprim-sulfamethoxazole(TMPS)is usually n appropriate medication for
most patients' urinary tract infections.In the case of community resistancetoTMPS
>20%^, another medication should be substituted. In men, the appropriate length of time is 7-10
days.Womenmaybetreatedfor3 days for uncomplicated UTI
Which agent is most effective for the treatment of nodulocystic acne?
Benzoyl peroxide(Benzac)
Retinoic acid(RetinA)
Topical
tetracycline
Isotretinoin)
Explanation: Isotretinoin (Accutane) is a systemic agent indicated for treating severe
inflammatory acne. The patient must clearly understand the guidelines for its use. A woman
of childbearing age must use an effective method of contraception because isotretinoin is
teratogenic. Many restrictions are in prescribing this medication because of the teratogenic
effects given during pregnancy. Therefore, it is a pregnancy category X.
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
Throughouttheweekofplacebopills
If prescribed to piramate(Topamax)for the treatment of migraines.
2
1
, Ifprescribedamoxicillin/clavulanate(Augmentin)for sinus infection
if she forgets totakeasingledoseofthecontraceptive
Explanation: Anticonvulsants, 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 contraception 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 contraceptive dose does
not require additional protection; missing more than one dose does.
A 44 years old female patient has diabetes. Her total cholesterol (TC) is 250 mg/dl
(6.5mmol/L), LDL= 190 mg/dL (4.94 mmol/L), HDL= 25 mg/dL (65 mmol/L), and
triglycerides=344mg/dL(8.94mmol/L).What agent significantly improves her lipid profile and
reduces morbidity and mortality associated with dyslipidemia?
a.
Niacin(Niaspan)
Atorvastatin
Omega3fattyacids
Fenofibrates
Explanation: First and foremost, educating individuals on a heart-healthy lifestyle is essential.
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 also
has the secondary effects of lowering triglyceride and increasing HDL-C levels.
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 dies. This is an example of
Failureofdiligence
Professional liability
Negligence
. Malpractice
Explanation: malpractice, a negligence tort, occurs when a healthcare professional’s actions
fall Bellow the appropriate standard of care and hurts the patient. In this case, the patient came
with signs and symptoms indicating appendicitis and the NP failed to refer the patient..
A NP has recently been hired to work in a fast-track facility. The NP employer asked
ifshe has “a problem prescribing medications for emergency contraception.” The NP
replies affirmatively.This is:
Groundsfordismissal
An ethical dilemma for the NP
Illegalaccordingtothestandardsofnursing
3
2
, Patient abandonment.
Explanation: In this instance, thee NP has a different opinion with her employer based on her
religious or moral belief about providing emergency contraception. This situation is an
example of an ethical dilemma. Failure to participate in the provision of care to the patient
based on theNP’sbeliefsisneither against the lawn or a violation of the standards of practice
A patient presents with pruritic lesions on both knees. There are visible silver
scales. HowShouldthis condition be managed?
Topicalantifungalcreamorointment
Oral antibiotics
Topicalcorticosteroidscream
Topical anti-fungal/steroid cream
Explanation: Psoriasis is characterized by erythematous papules, as well as itchy, red, precisely-
defined plaques with silvery scales. Auspitz sings it is another common finding. Topical agents
containing tar and salicylic acid may be used. Topical steroids, such as betamethasone, may also
be ordered.
Antidepressant discontinuation syndrome is less likely if the patient
Ismael
Islessthan35y/o
Has taken an SSRI with a short half-life
d.GraduallytapersSSRIuse
Explanation: Antidepressant discontinuation syndrome is most often seen in the primary care
office in association with SSRI discontinuation because SSRIs are the most commonly
prescribed class of antidepressant medications. Interruption of treatment with an anti-depressant
medication is sometimes associated with an antidepressant discontinuation syndrome; in early
reports, it was referred to as a “withdrawal reaction. Symptoms of antidepressant
discontinuation syndrome can include flu-like symptoms, insomnia, nausea, imbalance, sensory
disturbances, and hyperarousal. Experts recommend tapering.
Patientwithbenignprostatichyperplasia (BPH)should be taught to avoid which one of
the following drug classes?
Alphaadrenergicantagonist
Anti-androgenagents
Tricyclicantidepressant(TCA)
Sulfonamides
Explanation: tricyclic antidepressants should not be used by men with benign
prostatichyperplasiabecauseoftheincreasedriskofurinaryretentionsecondarytotheanticholigergiceff
ectsofTCAs.
Which of the following is the best response to a woman who has just admitted she is
a victim of spousal abusee?
What if you did to make him angry?
Youmustseekrefugeimmediately
c. I am concerned about your
4
3
, safety
I am going to call a shelter for you
Explanation: The first step is to establish trust in the therapeutic relationship. Without trust,
future collaboration, intervention, and client outcomes cannot be accomplished to facilitate
appropriatee and safe behavior. The experience of abuse is a traumatic psychological crisis that
must be addressed; healthcare providers must emphasize the fact that the victim has not done
anything wrong, and they must also emphasize the fact that the victim's life and the lives of
their children can be in danger if the abuse is not addressed. It will not disappear with vav lack
of action. Anorder of protection against the perpetrator is often recommended.
ForwhichpatientgroupdoestheUSPreventiveServicesTaskForcerecommendroutinescreeni
ngfor asymptomatic bacteriuria
pregnant woman
Children
Patients with diabetes
patients over the age of 70
Explanation: increased incidence of bacteriuria is found in all the populations listed. However,
bacteriuria in pregnant women increases the mother…..Also increased is the risk of pre-term
delivery, increasing perinatal and fetal morbidity and mortality. The recommended….
13) Whatdiabeticcomplicationsresultfromhyperglycemia?
Retinopathy
Hypertensionresistanttotreatment
Peripheral neuropathy
Acceleratedatherosclerosis
1,2,3
2,3,4
1,3,4
1,2,4
explanation:Complicationsofuntreatedoruncontrolledhyperglycemiaoveraprolongedperiodoftim
einclude:
Microvascular complications: Retinopathy, Nephropathy, Neuropathy
Macrovascular complications: Coronary artery disease, Cerebrovascular disease,
Peripheral vascular disease
A 6 y/o presents w/ complaints of sore throat and fever for two days. He has multiple
vesiculated ulcerations on his tonsils and uvula.Therearenootherremarkablefindings.What is
the most likely diagnosis?
Viral pharyngitis
Herpangina
Epiglottitis
Tonsillitis
5
4
NSG6440 Final Exam PREDICTOR QUESTIONS AND ANSWERS/NSG 6440
FINAL EXAM
A 15 years old high school student with a mild sore throat and the low-grade fever has
been haspersistedforabout3weeks. She reports general malaise, fatigue, and loss of appetite.
The NP suspects mono nucleosides. Which of the following is the LEAST appropriate
intervention?
Palpate the lymph nodes and spleen
Examinetheposteriororopharynxforpetechiae
Obtain a CBC, throat culture, and heterophil antibody test.
Obtain 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. Following the incubation period (1-2 months), common
signs and symptoms include fatigue, chills, malaise, anorexia, white tonsillar exudates, and
lymphadenopathy or posterior cervical region. Splenomegaly can be present. A maculopapular
or occasionally petechial rash occurs in less than 15% of patients. A diagnosis is usually made
using the Monospot.In addition,neutropeniaandlymphocytosisareusuallydetectedintheCBC.
A 32-year-old male patient complaint of urinary frequency and burning on urination for
three days. Urinalyses reveal bacteriuria and positive nitrites. He denies any past hx. Of urinary
tract infections. The initial treatment should be:
a. trimethoprim-sulfamethoxazole(Bactrim,Sulfatrim)for7-10day
ciprofloxacin(Cipro)for3-5days
Trimethoprim-Sulfamethoxazolefor3days
750mg ciprofloxacinasa one-timedose
Explanation: trimethoprim-sulfamethoxazole(TMPS)is usually n appropriate medication for
most patients' urinary tract infections.In the case of community resistancetoTMPS
>20%^, another medication should be substituted. In men, the appropriate length of time is 7-10
days.Womenmaybetreatedfor3 days for uncomplicated UTI
Which agent is most effective for the treatment of nodulocystic acne?
Benzoyl peroxide(Benzac)
Retinoic acid(RetinA)
Topical
tetracycline
Isotretinoin)
Explanation: Isotretinoin (Accutane) is a systemic agent indicated for treating severe
inflammatory acne. The patient must clearly understand the guidelines for its use. A woman
of childbearing age must use an effective method of contraception because isotretinoin is
teratogenic. Many restrictions are in prescribing this medication because of the teratogenic
effects given during pregnancy. Therefore, it is a pregnancy category X.
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
Throughouttheweekofplacebopills
If prescribed to piramate(Topamax)for the treatment of migraines.
2
1
, Ifprescribedamoxicillin/clavulanate(Augmentin)for sinus infection
if she forgets totakeasingledoseofthecontraceptive
Explanation: Anticonvulsants, 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 contraception 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 contraceptive dose does
not require additional protection; missing more than one dose does.
A 44 years old female patient has diabetes. Her total cholesterol (TC) is 250 mg/dl
(6.5mmol/L), LDL= 190 mg/dL (4.94 mmol/L), HDL= 25 mg/dL (65 mmol/L), and
triglycerides=344mg/dL(8.94mmol/L).What agent significantly improves her lipid profile and
reduces morbidity and mortality associated with dyslipidemia?
a.
Niacin(Niaspan)
Atorvastatin
Omega3fattyacids
Fenofibrates
Explanation: First and foremost, educating individuals on a heart-healthy lifestyle is essential.
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 also
has the secondary effects of lowering triglyceride and increasing HDL-C levels.
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 dies. This is an example of
Failureofdiligence
Professional liability
Negligence
. Malpractice
Explanation: malpractice, a negligence tort, occurs when a healthcare professional’s actions
fall Bellow the appropriate standard of care and hurts the patient. In this case, the patient came
with signs and symptoms indicating appendicitis and the NP failed to refer the patient..
A NP has recently been hired to work in a fast-track facility. The NP employer asked
ifshe has “a problem prescribing medications for emergency contraception.” The NP
replies affirmatively.This is:
Groundsfordismissal
An ethical dilemma for the NP
Illegalaccordingtothestandardsofnursing
3
2
, Patient abandonment.
Explanation: In this instance, thee NP has a different opinion with her employer based on her
religious or moral belief about providing emergency contraception. This situation is an
example of an ethical dilemma. Failure to participate in the provision of care to the patient
based on theNP’sbeliefsisneither against the lawn or a violation of the standards of practice
A patient presents with pruritic lesions on both knees. There are visible silver
scales. HowShouldthis condition be managed?
Topicalantifungalcreamorointment
Oral antibiotics
Topicalcorticosteroidscream
Topical anti-fungal/steroid cream
Explanation: Psoriasis is characterized by erythematous papules, as well as itchy, red, precisely-
defined plaques with silvery scales. Auspitz sings it is another common finding. Topical agents
containing tar and salicylic acid may be used. Topical steroids, such as betamethasone, may also
be ordered.
Antidepressant discontinuation syndrome is less likely if the patient
Ismael
Islessthan35y/o
Has taken an SSRI with a short half-life
d.GraduallytapersSSRIuse
Explanation: Antidepressant discontinuation syndrome is most often seen in the primary care
office in association with SSRI discontinuation because SSRIs are the most commonly
prescribed class of antidepressant medications. Interruption of treatment with an anti-depressant
medication is sometimes associated with an antidepressant discontinuation syndrome; in early
reports, it was referred to as a “withdrawal reaction. Symptoms of antidepressant
discontinuation syndrome can include flu-like symptoms, insomnia, nausea, imbalance, sensory
disturbances, and hyperarousal. Experts recommend tapering.
Patientwithbenignprostatichyperplasia (BPH)should be taught to avoid which one of
the following drug classes?
Alphaadrenergicantagonist
Anti-androgenagents
Tricyclicantidepressant(TCA)
Sulfonamides
Explanation: tricyclic antidepressants should not be used by men with benign
prostatichyperplasiabecauseoftheincreasedriskofurinaryretentionsecondarytotheanticholigergiceff
ectsofTCAs.
Which of the following is the best response to a woman who has just admitted she is
a victim of spousal abusee?
What if you did to make him angry?
Youmustseekrefugeimmediately
c. I am concerned about your
4
3
, safety
I am going to call a shelter for you
Explanation: The first step is to establish trust in the therapeutic relationship. Without trust,
future collaboration, intervention, and client outcomes cannot be accomplished to facilitate
appropriatee and safe behavior. The experience of abuse is a traumatic psychological crisis that
must be addressed; healthcare providers must emphasize the fact that the victim has not done
anything wrong, and they must also emphasize the fact that the victim's life and the lives of
their children can be in danger if the abuse is not addressed. It will not disappear with vav lack
of action. Anorder of protection against the perpetrator is often recommended.
ForwhichpatientgroupdoestheUSPreventiveServicesTaskForcerecommendroutinescreeni
ngfor asymptomatic bacteriuria
pregnant woman
Children
Patients with diabetes
patients over the age of 70
Explanation: increased incidence of bacteriuria is found in all the populations listed. However,
bacteriuria in pregnant women increases the mother…..Also increased is the risk of pre-term
delivery, increasing perinatal and fetal morbidity and mortality. The recommended….
13) Whatdiabeticcomplicationsresultfromhyperglycemia?
Retinopathy
Hypertensionresistanttotreatment
Peripheral neuropathy
Acceleratedatherosclerosis
1,2,3
2,3,4
1,3,4
1,2,4
explanation:Complicationsofuntreatedoruncontrolledhyperglycemiaoveraprolongedperiodoftim
einclude:
Microvascular complications: Retinopathy, Nephropathy, Neuropathy
Macrovascular complications: Coronary artery disease, Cerebrovascular disease,
Peripheral vascular disease
A 6 y/o presents w/ complaints of sore throat and fever for two days. He has multiple
vesiculated ulcerations on his tonsils and uvula.Therearenootherremarkablefindings.What is
the most likely diagnosis?
Viral pharyngitis
Herpangina
Epiglottitis
Tonsillitis
5
4
