APEA PRE-PREDICTOR PRACTICE EXAM
SAMPLE QUESTIONS WITH VERIFIED ANSWERS
AND RATIONALES
Question 1
A 15-year-old high school student presents 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 a urinalysis and serum for LFTs and amylase
Correct Answer: D. Obtain a urinalysis and serum for
LFTs and amylase
Rationale: Mononucleosis is a symptomatic infection
caused by the Epstein-Barr virus, commonly seen in
people 15-24 years of age. Common signs and symptoms
following the incubation period (1-2 months) include
fatigue, chills, malaise, anorexia, white tonsillar exudates,
and lymphadenopathy of the posterior cervical region.
Splenomegaly can be present. Diagnosis is usually made
using the Monospot test. In addition, neutropenia and
, lymphocytosis are typically detected on CBC. Urinalysis,
LFTs, and amylase are not indicated as part of the routine
diagnostic workup for mononucleosis and would be the
least appropriate interventions .
Question 2
A 32-year-old male patient complains of urinary frequency
and burning on urination for 3 days. Urinalysis reveals
bacteriuria and positive nitrites. He denies any past
history of urinary tract infections. The initial treatment
should be:
A. Trimethoprim-sulfamethoxazole (Bactrim) for 7-10 days
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) for 7-10 days
Rationale: Trimethoprim-sulfamethoxazole (TMP-SMX) is
usually an appropriate medication to treat urinary tract
infections in most patients. If community resistance to
TMP-SMX exceeds 20%, another medication should be
substituted. In men, the appropriate duration of treatment
is 7-10 days. Women may be treated for 3 days for
uncomplicated UTI. The 3-day regimen (option C) is
appropriate for women, not men. Fluoroquinolones
(options B and D) are generally reserved as alternative
agents .
SAMPLE QUESTIONS WITH VERIFIED ANSWERS
AND RATIONALES
Question 1
A 15-year-old high school student presents 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 a urinalysis and serum for LFTs and amylase
Correct Answer: D. Obtain a urinalysis and serum for
LFTs and amylase
Rationale: Mononucleosis is a symptomatic infection
caused by the Epstein-Barr virus, commonly seen in
people 15-24 years of age. Common signs and symptoms
following the incubation period (1-2 months) include
fatigue, chills, malaise, anorexia, white tonsillar exudates,
and lymphadenopathy of the posterior cervical region.
Splenomegaly can be present. Diagnosis is usually made
using the Monospot test. In addition, neutropenia and
, lymphocytosis are typically detected on CBC. Urinalysis,
LFTs, and amylase are not indicated as part of the routine
diagnostic workup for mononucleosis and would be the
least appropriate interventions .
Question 2
A 32-year-old male patient complains of urinary frequency
and burning on urination for 3 days. Urinalysis reveals
bacteriuria and positive nitrites. He denies any past
history of urinary tract infections. The initial treatment
should be:
A. Trimethoprim-sulfamethoxazole (Bactrim) for 7-10 days
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) for 7-10 days
Rationale: Trimethoprim-sulfamethoxazole (TMP-SMX) is
usually an appropriate medication to treat urinary tract
infections in most patients. If community resistance to
TMP-SMX exceeds 20%, another medication should be
substituted. In men, the appropriate duration of treatment
is 7-10 days. Women may be treated for 3 days for
uncomplicated UTI. The 3-day regimen (option C) is
appropriate for women, not men. Fluoroquinolones
(options B and D) are generally reserved as alternative
agents .
