NSG 6440 Week 4 APEA Predictor Exam – Pre-Predictor Test latest
2026 (GRADED A+ 100% DETAILED VERIFIED ANSWERS)
1. 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.
Explanation: in this instance, the NP has a difference of 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 the NP’s beliefs is neither against the law nor a violation of the standards of
practice
2. 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
Explanation: Psoriasis is characterized by erythematous papules, as well as itchy, red,
precisely defined plaques 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.
3. 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
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 or occasionally 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.
4. 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 to
treat 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
7-10 days. Women may be treated for 3 days for uncomplicated UTI
5. 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)
,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 of childbearing age must use an effective method of contraception because
isotretinoin is teratogenic. There are many restrictions in prescribing this medication
because of the teratogenic effects is given during pregnancy. Therefore, it is a pregnancy
category X.
6. 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 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 single dose of
contraceptive does not require additional protection, missing more than one doses does.
7. 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 and reducing 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.
8. 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. Negligence
d. 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 with sings and symptoms indicating appendicitis and the NP failed to refer the
patient..
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 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
2026 (GRADED A+ 100% DETAILED VERIFIED ANSWERS)
1. 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.
Explanation: in this instance, the NP has a difference of 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 the NP’s beliefs is neither against the law nor a violation of the standards of
practice
2. 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
Explanation: Psoriasis is characterized by erythematous papules, as well as itchy, red,
precisely defined plaques 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.
3. 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
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 or occasionally 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.
4. 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 to
treat 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
7-10 days. Women may be treated for 3 days for uncomplicated UTI
5. 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)
,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 of childbearing age must use an effective method of contraception because
isotretinoin is teratogenic. There are many restrictions in prescribing this medication
because of the teratogenic effects is given during pregnancy. Therefore, it is a pregnancy
category X.
6. 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 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 single dose of
contraceptive does not require additional protection, missing more than one doses does.
7. 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 and reducing 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.
8. 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. Negligence
d. 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 with sings and symptoms indicating appendicitis and the NP failed to refer the
patient..
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 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
