NUR 504 3P APEA ACTUAL REAL PRACTICE EXAM UPDATED QUESTIONS AND ANSWERS.

The NP is counseling a 25 y/o sexually active male patient about condom use, which of the following statement is INCORRECT a. Adequate lubrication is needed to prevent damage to the condom b. Roll the condom over an erect penis before any sexual contact c. Make sure the condom is tight against the head of the penis d. Withdraw while the penis is erect, so that the condom stays in place Explanation: Condoms - correct answer c. Make sure the condom is tight against the head of the penis The NP is counseling a 25 y/o sexually active male patient about condom use, which of the following statement is INCORRECT a. Adequate lubrication is needed to prevent damage to the condom b. Roll the condom over an erect penis before any sexual contact c. Make sure the condom is tight against the head of the penis d. Withdraw while the penis is erect, so that the condom stays in place Explanation: Condoms - correct answer c. Make sure the condom is tight against the head of the penis Which of the following descriptions of Denver II Developmental Screening Test is most accurate? a. Applicable to children from birth to 2 years; evaluates four major categories of development: motor, intellectual, emotional, and language to determine whether a child is within normal range for various behaviors or is developmentally delayed b. Applicable to children from birth to 5 years; evaluates four major categories of development: motor, vision, hearing and psychosocial to determine whether a child is normal or developmentally compromised d. Applicable to children from birth to 6 years; evaluates four major categories of development: gross motor, fine motor-adaptive, language, and personal social to determine whether a child is within normal range for behaviors or is developmentally delayed. - correct answer d. Applicable to children from birth to 6 years; evaluates four major categories of development: gross motor, fine motor-adaptive, language, and personal social to determine whether a child is within normal range for behaviors or is developmentally delayed. 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 NP suspects 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 - correct answer d. Obtain an urinalyses and serum for LFTs and amylase 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 - correct answer a. trimethoprim-sulfamethoxazole (Bactrim, Sulfatrim) for 7-10 day Which agent is most effective for the treatment of nodulocystic acne? a. Benzoyl peroxide (Benzac) b. Retinoic acid (Retin A) c. Topical tetracycline d. Isotretinoin - correct answer d. Isotretinoin 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 - correct answer b. If prescribed topiramate (Topamax) for the treatment of migraines. 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= 344 mg/dL (8.94 mmol/L). What agent have the greatest effect on improving her lipid profile and reducing morbidity and mortality associates with dyslipidemia? a. Niacin (Niaspan) b. Atorvastatin c. Omega 3 fatty acids d. Fenofibrates - correct answer b. Atorvastatin A NP has recently been hired to work in a fast track facility. The NP employer asked if she has "a problem 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. - correct answer b. An ethical dilemma for the NP 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. Negligence d. Malpractice - correct answer d. Malpractice A patient presents with pruritic lesions on both knees. There are visible silver scales. How Should this condition be managed? a. Topical antifungal cream or ointment b. Oral antibiotics c. Topical corticosteroids cream d. Topical anti-fungal/ steroid cream - correct answer c. Topical corticosteroids cream 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 - correct answer d. Gradually tapers SSRI use Patient with benign prostatic hyperplasia (BPH) should be taught to avoid which one of the following drug classes? a. Alpha adrenergic antagonist b. Anti-androgen agents c. Tricyclic antidepressant (TCA) d. Sulfonamides - correct answer c. Tricyclic antidepressant (TCA) Which of the following is the best response to a woman who has just admitted she is a victim of spousal abuse? a. What was if you did to make him angry? b. You must seek refuge immediately c. I am concerned about your safety d. I am going to call a shelter for you - correct answer c. I am concerned about your safety For which patient group does the US Preventive Services Task Force recommend routine screening for asymptomatic bacteriuria a. pregnant woman b. Children c. Patients with diabetes d. patients over the age of 70 - correct answer a. pregnant woman What diabetic complications result from hyperglycemia? 1. Retinopathy 2. Hypertension resistant to treatment 3. Peripheral neuropathy 4. Accelerated atherosclerosis a. 1,2,3 b. 2,3,4 c. 1,3,4 d. 1,2,4 - correct answer c. 1,3,4 A 6 y/o presents w/ complaints of sore throat and fever for 2 days. He has multiple vesiculated ulcerations on his tonsils and uvula. There are no other remarkable findings. What i the most likely diagnosis? a. Viral pharyngitis b. Herpangina c. Epiglottitis d. Tonsillitis - correct answer b. Herpangina A patient has Kawasaki syndrome. Which characteristics would be UNUSUAL? a. Age > 15 years b. Fever > 101 F (38.3 C) c. Exudative pharyngitis d. Painful rash - correct answer a. Age > 15 years According to the JNC 8 guideline hypertension in a 40 y/o can be diagnosed when blood pressure exceeds a. 140/90 b. 130/90 c. 125/85 d. 150/100 - correct answer a. 140/90 A 7-year old female patient presents with severe injuries that are inconsistent with the explanation given for them. The nurse practitioner questions the mother about abuse. She admits that her husband, the child's father, beat the child. How should the nurse practitioner proceed? a. Inform the mother that the abuse must be reported to child protection authorities. b. Counsel the mother that if it happens again it will be reported to child protection service. c. Ask the child what she did to cause the punishment d. Refer the family to the National Domestic Violence hotline. - correct answer a. Inform the mother that the abuse must be reported to child protection authorities. A 1-month-old presents with reported recurrent diarrhea, screaming, and drawing up of the legs followed by periods of lethargy. On physical examination, a "sausage-like" mass in the upper right quadrant of the distended abdomen. Which of the following is the most likely diagnosis? a. Intussusception b. Volvulus c. Crohn's disease d. Foreign body in the GI tract - correct answer a. Intussusception A 48 y/o female complains of pain and stiffness in her right hip and knee that is mild on awakening in the morning, get worse as the day progresses and is relived with hot baths and ibuprofen. Crepitus is palpated on range of motion of the knee. Signs of inflammation are notably absent. What is the most likely diagnosis? a. Rheumatoid arthritis (RA) b. Gout c. Osteoarthritis (OA) d. Osteoporosis - correct answer c. Osteoarthritis (OA) A middle-aged female complains of insomnia, night sweats, feeling intensely hot, emotional lability, extreme nervousness and impatience. The LEAST likely cause of her symptoms is a. Thyrotoxicosis b. Menopausal vasomotor instability c. Alcohol or another drug withdrawal d. New onset type 2 diabetes mellitus - correct answer New onset type 2 diabetes mellitus A young couple is being seen by the NP for preconception counseling. They express a wish for pregnancy within the next 3 month and are very eager to know what they can do now to"make the baby as healthy as possible". Which of the following should the NP encourage to decrease the chance of neural tube defect in the fetus? a. Maternal alpha-fetoprotein level b. Folic acid 0.4 mg daily c. Rubella vaccine today d. Vitamin E 400 IU daily - correct answer b. Folic acid 0.4 mg daily A patient with a past history of documented coronary arterial blockage less than 70% complains of chest pain several time p.... which is relived with nitroglycerin. Which is the most appropriate initial action for the NP? a. Refer to a cardiologist as soon as possible b. Prescribe long-acting nitroglycerin c. Order treadmill stress test d. Prescribe an ACE inhibitor and re-evaluate in 24 to 48 hours - correct answer a. Refer to a cardiologist as soon as possible Which of the following indicated need for further evaluation? a. A 7 y/o girl with vaginal bleeding b. A 7 years old girl with no true pubic hair