A
NSG 6440 Week 4 APEA Predictor Exam – Pre-Predictor
Actual Questions and Answers
100% Guarantee Pass.
This Exam contains:
100% Guarantee Pass.
Actual Questions and Answers
Multiple choice (single best answer)
Case Studies/Scenario-Based Questions
Verified Rationales
,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 NPsuspects
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 oroccasionally 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 totreat 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 7-10days.
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 tetracyclined.
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 ofchildbearing age must
use an effective method of contraception because isotretinoin is teratogenic. There are many restrictions in
prescribing this medication because of the teratogeniceffects 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
a. Throughout the week of placebo pills
b. If prescribed topiramate (Topamax) for the treatment of migraines.
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 womentaking 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 contraceptivedoes 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 andreducing 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. Negligenced.
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 withsings and
symptoms indicating appendicitis and the NP failed to refer the patient..
7. /NP/has/recently/been/hired/to/work/in/a/fast/track/facility./The/NP/employer/asked/if/she/has/“a/probl
em/prescribing/medications/for/emergency/contraception.”/The/NP/replies/affirmatively./This/is:
a. Grounds/for/dismissal
b. An/ethical/dilemma/for/the/NP
c. Illegal/according/to/the/standards/of/nursing
d. Patient/abandonment.
Explanation:/in/this/instance,/the/NP/has/a/difference/of/opinion/with/her/employer/based/on/her/religious/or/mo
ral/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/the/NP’s/beliefs/is/neither/against/the/law/nor/a/viol
ation/of/the/standards/of/practice
, 8. A/patient/presents/with/pruritic/lesions/on/both/knees./There/are/visible/silver/scales./How/Should/this/c
ondition/be/managed?
a. Topical/antifungal/cream/or/ointment
b. Oral/antibiotics
c. Topical/corticosteroids/cream
d. Topical/anti-fungal//steroid/cream
Explanation:/Psoriasis/is/characterized/by/erythematous/papules,/as/well/as/itchy,/red,/precisely/defined/plaqu
es/with/silvery/scales./Auspitz/sings/is/another/common/finding./Topical/agents/containing/tar/and/salicylic/acid/
may/be/used./Topical/steroids,/such/as/betamethasone,/may/also/be/ordered.
9. Antidepressant/discontinuation/syndrome/is/less/likely/if/the/patient
a. Is/male
b. Is/less/than/35/y/o
c. Has/taken/an/SSRI/with/a/short/half/life/d.
Gradually/tapers/SSRI/use
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/a
ntidepressant/medications./Interruption/of/treatment/with/an/anti-
depressant/medication/is/sometimes/associated/with/an/antidepressant/discontinuation/syndrome;/in/early/re
ports/it/was/referred/to/as/a/“withdrawal/reaction./Symptoms/of/antidepressant/discontinuation/syndrome/can/i
nclude/flu-
like/symptoms,/insomnia,/nausea,/imbalance,/sensory/disturbances,/and/hyperarousal./Tapering/is/recomme
nded/by/experts.
10. Patient/with/benign/prostatic/hyperplasia/(BPH)/should/be/taught/to/avoid/which/one/of/the/following/dru
g/classes?
a. Alpha/adrenergic/antagonist
b. Anti-androgen/agents
c. Tricyclic/antidepressant/(TCA)
d. Sulfonamides
Explanation:/tricyclic/antidepressant/should/not/be/used/by/men/with/benign/prostatic/hyperplasia/because/of/
the/increased/risk/of/urinary/retention/secondary/to/the/anticholigergic/effects/of/TCAs.
11. Which/of/the/following/is/the/best/response/to/a/woman/who/has/just/admitted/she/is/a/victim/of/spo
usal/abuse?
a. What/was/if/you/did/to/make/him/angry?
NSG 6440 Week 4 APEA Predictor Exam – Pre-Predictor
Actual Questions and Answers
100% Guarantee Pass.
This Exam contains:
100% Guarantee Pass.
Actual Questions and Answers
Multiple choice (single best answer)
Case Studies/Scenario-Based Questions
Verified Rationales
,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 NPsuspects
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 oroccasionally 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 totreat 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 7-10days.
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 tetracyclined.
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 ofchildbearing age must
use an effective method of contraception because isotretinoin is teratogenic. There are many restrictions in
prescribing this medication because of the teratogeniceffects 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
a. Throughout the week of placebo pills
b. If prescribed topiramate (Topamax) for the treatment of migraines.
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 womentaking 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 contraceptivedoes 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 andreducing 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. Negligenced.
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 withsings and
symptoms indicating appendicitis and the NP failed to refer the patient..
7. /NP/has/recently/been/hired/to/work/in/a/fast/track/facility./The/NP/employer/asked/if/she/has/“a/probl
em/prescribing/medications/for/emergency/contraception.”/The/NP/replies/affirmatively./This/is:
a. Grounds/for/dismissal
b. An/ethical/dilemma/for/the/NP
c. Illegal/according/to/the/standards/of/nursing
d. Patient/abandonment.
Explanation:/in/this/instance,/the/NP/has/a/difference/of/opinion/with/her/employer/based/on/her/religious/or/mo
ral/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/the/NP’s/beliefs/is/neither/against/the/law/nor/a/viol
ation/of/the/standards/of/practice
, 8. A/patient/presents/with/pruritic/lesions/on/both/knees./There/are/visible/silver/scales./How/Should/this/c
ondition/be/managed?
a. Topical/antifungal/cream/or/ointment
b. Oral/antibiotics
c. Topical/corticosteroids/cream
d. Topical/anti-fungal//steroid/cream
Explanation:/Psoriasis/is/characterized/by/erythematous/papules,/as/well/as/itchy,/red,/precisely/defined/plaqu
es/with/silvery/scales./Auspitz/sings/is/another/common/finding./Topical/agents/containing/tar/and/salicylic/acid/
may/be/used./Topical/steroids,/such/as/betamethasone,/may/also/be/ordered.
9. Antidepressant/discontinuation/syndrome/is/less/likely/if/the/patient
a. Is/male
b. Is/less/than/35/y/o
c. Has/taken/an/SSRI/with/a/short/half/life/d.
Gradually/tapers/SSRI/use
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/a
ntidepressant/medications./Interruption/of/treatment/with/an/anti-
depressant/medication/is/sometimes/associated/with/an/antidepressant/discontinuation/syndrome;/in/early/re
ports/it/was/referred/to/as/a/“withdrawal/reaction./Symptoms/of/antidepressant/discontinuation/syndrome/can/i
nclude/flu-
like/symptoms,/insomnia,/nausea,/imbalance,/sensory/disturbances,/and/hyperarousal./Tapering/is/recomme
nded/by/experts.
10. Patient/with/benign/prostatic/hyperplasia/(BPH)/should/be/taught/to/avoid/which/one/of/the/following/dru
g/classes?
a. Alpha/adrenergic/antagonist
b. Anti-androgen/agents
c. Tricyclic/antidepressant/(TCA)
d. Sulfonamides
Explanation:/tricyclic/antidepressant/should/not/be/used/by/men/with/benign/prostatic/hyperplasia/because/of/
the/increased/risk/of/urinary/retention/secondary/to/the/anticholigergic/effects/of/TCAs.
11. Which/of/the/following/is/the/best/response/to/a/woman/who/has/just/admitted/she/is/a/victim/of/spo
usal/abuse?
a. What/was/if/you/did/to/make/him/angry?
