APEA PRE-PREDICTOR ACTUAL EXAM COMPLETE 250
QUESTIONS AND CORRECT DETAILED ANSWERS
Cranial nerve IX - ANSWER: Glossopharyngeal- swallowing and rise of the palate, gag
reflex
Cranial Nerve VIII - ANSWER: Acoustic (Hearing and balance)
Cranial Nerve XI - ANSWER: Spinal Accessory (upper trapezius)
Deep tendon reflex - ANSWER: Ankle- S1 primarily
Knee- Lumbar 2,3,4
Supinator(brachioradialis)-C5,6
BicepTriceps-C6,7
Stroke risk scale - ANSWER: CHADS2
C-Congestive heart failure
H-Hypertension
A-Age >75 years
D- Diabetes
S-prior Stroke/TIA
In the majority of children, the first permanent teeth start to erupt at the age of 6
years. Which of the following are the first permanent teeth to erupt in this time
period?
A. First Molars
B. Second Molars
C. Lower or upper incisors
D. Canines - ANSWER: A. First Molars
All of the following are classified as activities of daily living (ADLs) except:
A. ability to feed self
B. Ability to manage bladder and bowel elimination
C. Personal hygiene and grooming
D. Grocery Shopping - ANSWER: D. Grocery shopping
You note the following result on a routine urinalysis of a 37-year old primigravida
who is at 30 weeks gestation. Leukocyte=trace, nitrite=negative, protein=2+,
blood=negative. Her weight has increased by 5 lbs during the past week. Which of
the following is most likely?
A.HELLP syndrome
B. Pregnancy-induced hypertension (pre-eclampsia)
C. Eclampsia of pregnancy
D. Primary hypertension - ANSWER: B. Pregnancy-induced hypertension (pre-
eclampsia). Classic triad of symptoms of preeclampsia include hypertension, edema
(weight gain), and proteinuria.
,The mother of a 12 month old infant reports to the nurse practitioner that her child
had a high fever for several days, which spontaneously resolved. After the fever
resolved, the child developed a maculopapular rash. Which of the following is the
most likely diagnosis?
A. Fifth Disease (erythema infectiosum)
B. Roseola infantum (exanthema subitum)
C. Varicella
D. Infantile maculopapular rashes - ANSWER: B. Roseola Infantum (Exanthema
subitum)
A 70-year old male patient complains of a bright red-colored spot in his left eye for 2
days. He denies eye pain, visual changes, or headaches. He has a new onset of cough
from a recent viral upper respiratory infection. The only medicine he is on Bayer
aspirin, 1 tablet a day. Which of the following is most likely?
A. Corneal abrasion
B. Acute bacterial conjunctivitis
C. Acute uveitis
D. Subconjunctival hemorrhage - ANSWER: D. Subconjunctival hemorrhage. Bright
red blood in a sharply defined area surrounded by normal-appearing conjunctiva
indicates subconjunctival hemorrhage.
A woman is being evaluated by the nurse practitioner for complaints of dyspareunia.
A microscopy slide reveals a large number of atrophic squamous epithelial cells. The
vaginal pH is 4.0. There are very few leukocytes and no RBCs are seen on the wet
smear. Which of the following is most likely?
A. Atrophic vaginitis
B. Bacterial Vaginosis
C. Trichomoniasis
D. This is a normal finding. - ANSWER: A. Atrophic vaginitis. Symptoms of atrophic
vaginitis include painful intercourse, atrophic squamous epithelial cells, and a
decrease in pH. Vaginal atrophy is caused by lack of or imbalance of estrogen.
Normal pH of the vagina is 4.0-5.0 (acidic)
The most common type of skin malignancy is:
A. Squamous cell cancer
B. Basal skin cancer
C. Melanoma
D. Dysplastic nevi - ANSWER: B. Basal skin cancer. It is several times more common
that squamous cell skin cancer according to the NIH.
Koplik's spots are associated with:
A. Poxvirius infections
B. Measles
C. Kawasaki's disease
D. Reye's syndrome - ANSWER: B. Measles. S/S include fever over 101, coryza, cough,
conjunctivitis, rash, and koplik's spots on buccal mucosa
,At what level of prevention would you classify for lung cancer?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Primordial prevention - ANSWER: D. primordial prevention. Screening for lung
cancer is not currently recommended in the general population, but it is secondary
prevention.
A test called the visual fields by confrontation is used to evaluate for:
A. Peripheral vision
B. Central vision
C. Visual acuity
D. Accomodation - ANSWER: A. Peripheral vision
What is the most common cause of Cushing's syndrome? - ANSWER: Administration
of a glucocorticoid or ACTH.
Iatrogenic Cushing's syndrome is the most common type. Exogenous glucocorticoid
administration produces a Cushing's Syndrome that is reversible by discontinuation
of the medication.
A patient with no significant medical history has vericose veins. She complains of
'"aching legs". The intervention that will provide the greatest relief for her complaint
is to: - ANSWER: Elevate her legs periodically.
The intervention that will provide the greatest relief for this patient is elevating her
legs periodically. This will facilitate venous return. Use of support stockings will
prolong the length of time she is able to stand in place, but will not provide relief
after her legs begin aching. Support stockings should be applied prior to getting out
of bed.
A 25-yo female patient presents for a routine well-women exam. On physical exam,
the NP notes a scant nipple discharge, absence of palpable mass, and absence of
lymph node enlargement. What is the most likely diagnosis? - ANSWER: Itraductal
papilloma.
Intraductal papilloma often presents as a non-tender mass with serous or bloody
nipple discharge located in the ductal system near the areola. Breast cancer,
although usually non-tender, may present with pain. Chest wall syndrome may
present in some women as breast pain. Fibrocystic breast disease often presents
with bilateral breast pain.
According to the ANA, the role of the NP who provides primary health care is the: -
ANSWER: Direct nursing care role.
The NP with a traditional nursing care role is a primary health care provider.
Increasing numbers of nurse practitioners are assuming indirect roles such as
educator, administrator, researcher, and consultant.
, An 8-mo male presents with hemarthrosis of both knees and hematuria. The parents
give no history of trauma, but say " he has always bruised easily" The most likely
diagnosis is: - ANSWER: A type of hemophilia.
Hemophilia is usually diagnosed within the first year of life. It commonly presents
with hemarthrosis, bleeding into soft tissue, hematuria, and prolonged bleeding
times.
The nurse practitioner is following a child with juvemile rheumatoid arthritis (JRA)
who has been previously diagnosed and is being managed for the disease by a
pediatric rheumatologist. The mother asks for information about the child's long-
term prognosis. The appropriate reply is that: - ANSWER: most children with JRA
achieve complete remission by adulthood, but its effects might cause lifelong
limitations.
Although the active disease does not continue into adulthood, the contractures,
growth retardation, bone deformities, and visual impairment associated with JRA
may lead to lifelong functional impairments. A comprehensive treatment program
involving physical therapy, occupational therapy, nutrition, education, and regular
opthalmologic care can limit residual functional limitations.
Approximately 70% of the organisms found in canine oral and nasal fluids, and
consequently in fresh dog bite wounds, are: - ANSWER: Staphylococcus and
Pasteurella multocida.
All of these organisms are found in canine oral and nasal fluids, and cultured from
fresh dog bite wounds, but the most common (70%) are Staph and Pasteurella
multocida.
Education of women with fibrocystic breast disease should include which of the
following statements? - ANSWER: Caffeine may trigger breast pain.
Avoidance of all methylxanthines (eg coffee, tea, chocolate) has been shown to
reduce breast pain in women with fibrocystic breast disease. It is usually a benign
condition, not a precursor of malignancy. Mammography is recommended once at
age 35 years, at least every 1-2 years after age 40, and then annually beginning at
age 50 years. Oral contraceptives may help reduce cyclical pain and swelling.
Congenital heart disorders present with symptoms at: - ANSWER: birth, infancy, or in
childhood.
A common misconception is that congenital disorders always present
symptomatically at birth. They can present at various times throughout childhood
and are classified as cyanotic or acyanotic. Cardiac disorders in infants and children
may be acquired from rheumatic fever or kawasaki syndrome.
A 21-yo patient presents with abdominal guarding, rigid abdominal musculature,
rebound tenderness at McBurney's point, and leukocytosis. What is the most likely
diagnosis? - ANSWER: Appendicitis.
McBurney's point is the RLQ abdominal landmark for the appendix. Rigid abdominal
musculature, rebound tenderness, and positive psoas sign (inflamed psoas muscle),
indicates inflammation of the peritoneum. Cholecystitis presents with RUQ pain and
QUESTIONS AND CORRECT DETAILED ANSWERS
Cranial nerve IX - ANSWER: Glossopharyngeal- swallowing and rise of the palate, gag
reflex
Cranial Nerve VIII - ANSWER: Acoustic (Hearing and balance)
Cranial Nerve XI - ANSWER: Spinal Accessory (upper trapezius)
Deep tendon reflex - ANSWER: Ankle- S1 primarily
Knee- Lumbar 2,3,4
Supinator(brachioradialis)-C5,6
BicepTriceps-C6,7
Stroke risk scale - ANSWER: CHADS2
C-Congestive heart failure
H-Hypertension
A-Age >75 years
D- Diabetes
S-prior Stroke/TIA
In the majority of children, the first permanent teeth start to erupt at the age of 6
years. Which of the following are the first permanent teeth to erupt in this time
period?
A. First Molars
B. Second Molars
C. Lower or upper incisors
D. Canines - ANSWER: A. First Molars
All of the following are classified as activities of daily living (ADLs) except:
A. ability to feed self
B. Ability to manage bladder and bowel elimination
C. Personal hygiene and grooming
D. Grocery Shopping - ANSWER: D. Grocery shopping
You note the following result on a routine urinalysis of a 37-year old primigravida
who is at 30 weeks gestation. Leukocyte=trace, nitrite=negative, protein=2+,
blood=negative. Her weight has increased by 5 lbs during the past week. Which of
the following is most likely?
A.HELLP syndrome
B. Pregnancy-induced hypertension (pre-eclampsia)
C. Eclampsia of pregnancy
D. Primary hypertension - ANSWER: B. Pregnancy-induced hypertension (pre-
eclampsia). Classic triad of symptoms of preeclampsia include hypertension, edema
(weight gain), and proteinuria.
,The mother of a 12 month old infant reports to the nurse practitioner that her child
had a high fever for several days, which spontaneously resolved. After the fever
resolved, the child developed a maculopapular rash. Which of the following is the
most likely diagnosis?
A. Fifth Disease (erythema infectiosum)
B. Roseola infantum (exanthema subitum)
C. Varicella
D. Infantile maculopapular rashes - ANSWER: B. Roseola Infantum (Exanthema
subitum)
A 70-year old male patient complains of a bright red-colored spot in his left eye for 2
days. He denies eye pain, visual changes, or headaches. He has a new onset of cough
from a recent viral upper respiratory infection. The only medicine he is on Bayer
aspirin, 1 tablet a day. Which of the following is most likely?
A. Corneal abrasion
B. Acute bacterial conjunctivitis
C. Acute uveitis
D. Subconjunctival hemorrhage - ANSWER: D. Subconjunctival hemorrhage. Bright
red blood in a sharply defined area surrounded by normal-appearing conjunctiva
indicates subconjunctival hemorrhage.
A woman is being evaluated by the nurse practitioner for complaints of dyspareunia.
A microscopy slide reveals a large number of atrophic squamous epithelial cells. The
vaginal pH is 4.0. There are very few leukocytes and no RBCs are seen on the wet
smear. Which of the following is most likely?
A. Atrophic vaginitis
B. Bacterial Vaginosis
C. Trichomoniasis
D. This is a normal finding. - ANSWER: A. Atrophic vaginitis. Symptoms of atrophic
vaginitis include painful intercourse, atrophic squamous epithelial cells, and a
decrease in pH. Vaginal atrophy is caused by lack of or imbalance of estrogen.
Normal pH of the vagina is 4.0-5.0 (acidic)
The most common type of skin malignancy is:
A. Squamous cell cancer
B. Basal skin cancer
C. Melanoma
D. Dysplastic nevi - ANSWER: B. Basal skin cancer. It is several times more common
that squamous cell skin cancer according to the NIH.
Koplik's spots are associated with:
A. Poxvirius infections
B. Measles
C. Kawasaki's disease
D. Reye's syndrome - ANSWER: B. Measles. S/S include fever over 101, coryza, cough,
conjunctivitis, rash, and koplik's spots on buccal mucosa
,At what level of prevention would you classify for lung cancer?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Primordial prevention - ANSWER: D. primordial prevention. Screening for lung
cancer is not currently recommended in the general population, but it is secondary
prevention.
A test called the visual fields by confrontation is used to evaluate for:
A. Peripheral vision
B. Central vision
C. Visual acuity
D. Accomodation - ANSWER: A. Peripheral vision
What is the most common cause of Cushing's syndrome? - ANSWER: Administration
of a glucocorticoid or ACTH.
Iatrogenic Cushing's syndrome is the most common type. Exogenous glucocorticoid
administration produces a Cushing's Syndrome that is reversible by discontinuation
of the medication.
A patient with no significant medical history has vericose veins. She complains of
'"aching legs". The intervention that will provide the greatest relief for her complaint
is to: - ANSWER: Elevate her legs periodically.
The intervention that will provide the greatest relief for this patient is elevating her
legs periodically. This will facilitate venous return. Use of support stockings will
prolong the length of time she is able to stand in place, but will not provide relief
after her legs begin aching. Support stockings should be applied prior to getting out
of bed.
A 25-yo female patient presents for a routine well-women exam. On physical exam,
the NP notes a scant nipple discharge, absence of palpable mass, and absence of
lymph node enlargement. What is the most likely diagnosis? - ANSWER: Itraductal
papilloma.
Intraductal papilloma often presents as a non-tender mass with serous or bloody
nipple discharge located in the ductal system near the areola. Breast cancer,
although usually non-tender, may present with pain. Chest wall syndrome may
present in some women as breast pain. Fibrocystic breast disease often presents
with bilateral breast pain.
According to the ANA, the role of the NP who provides primary health care is the: -
ANSWER: Direct nursing care role.
The NP with a traditional nursing care role is a primary health care provider.
Increasing numbers of nurse practitioners are assuming indirect roles such as
educator, administrator, researcher, and consultant.
, An 8-mo male presents with hemarthrosis of both knees and hematuria. The parents
give no history of trauma, but say " he has always bruised easily" The most likely
diagnosis is: - ANSWER: A type of hemophilia.
Hemophilia is usually diagnosed within the first year of life. It commonly presents
with hemarthrosis, bleeding into soft tissue, hematuria, and prolonged bleeding
times.
The nurse practitioner is following a child with juvemile rheumatoid arthritis (JRA)
who has been previously diagnosed and is being managed for the disease by a
pediatric rheumatologist. The mother asks for information about the child's long-
term prognosis. The appropriate reply is that: - ANSWER: most children with JRA
achieve complete remission by adulthood, but its effects might cause lifelong
limitations.
Although the active disease does not continue into adulthood, the contractures,
growth retardation, bone deformities, and visual impairment associated with JRA
may lead to lifelong functional impairments. A comprehensive treatment program
involving physical therapy, occupational therapy, nutrition, education, and regular
opthalmologic care can limit residual functional limitations.
Approximately 70% of the organisms found in canine oral and nasal fluids, and
consequently in fresh dog bite wounds, are: - ANSWER: Staphylococcus and
Pasteurella multocida.
All of these organisms are found in canine oral and nasal fluids, and cultured from
fresh dog bite wounds, but the most common (70%) are Staph and Pasteurella
multocida.
Education of women with fibrocystic breast disease should include which of the
following statements? - ANSWER: Caffeine may trigger breast pain.
Avoidance of all methylxanthines (eg coffee, tea, chocolate) has been shown to
reduce breast pain in women with fibrocystic breast disease. It is usually a benign
condition, not a precursor of malignancy. Mammography is recommended once at
age 35 years, at least every 1-2 years after age 40, and then annually beginning at
age 50 years. Oral contraceptives may help reduce cyclical pain and swelling.
Congenital heart disorders present with symptoms at: - ANSWER: birth, infancy, or in
childhood.
A common misconception is that congenital disorders always present
symptomatically at birth. They can present at various times throughout childhood
and are classified as cyanotic or acyanotic. Cardiac disorders in infants and children
may be acquired from rheumatic fever or kawasaki syndrome.
A 21-yo patient presents with abdominal guarding, rigid abdominal musculature,
rebound tenderness at McBurney's point, and leukocytosis. What is the most likely
diagnosis? - ANSWER: Appendicitis.
McBurney's point is the RLQ abdominal landmark for the appendix. Rigid abdominal
musculature, rebound tenderness, and positive psoas sign (inflamed psoas muscle),
indicates inflammation of the peritoneum. Cholecystitis presents with RUQ pain and
