APEA MAJOR
Which one of the following is an ethical infraction when using electronic medical records? -
ANS-Copying and pasting outdated notes
Practice authority for advanced practice registered nurses (APRNs) is granted by: - ANS-each
state's board of nursing
Which answer is true about full practice authority for nurse practitioners? - ANS-Full practice
authority is the authorization of nurse practitioners to evaluate patients; diagnose, order and
interpret diagnostic tests; and to initiate and manage treatments—including prescribing
medications—without required physical collaboration or supervision.
Which of the following scenarios reflects "incident to" billing for Medicare-covered services? -
ANS-An NP bills 100% of the allowable Medicare fee schedule for follow-up care
The scope of practice for nurse practitioners is determined by: - ANS-the state government
Medicare Part B covers - ANS-physician services, outpatient services, and durable medical
equipment
Select the statement that best describes the role of a women's health nurse practitioner (WHNP)
- ANS-The role of the WHNP is to assess, diagnose, and treat the healthcare needs of women
throughout their lifespan
Statistical significance is represented by the P value. Which statement about P value is correct?
- ANS-
When counseling a patient diagnosed with generalized anxiety disorder (GAD) or panic
disorder, lifestyle modifications to decrease symptoms should include - ANS-exercising
vigorously for 20 minutes three times a week
Which of the following is used to evaluate suspected obstructive sleep apnea (OSA) in patients
who present with a sleep disorder? - ANS-Polysomnography
Why is it often challenging to differentiate between the diagnosis of major depressive disorder
(MDD) and bipolar disorder? - ANS-Patients with bipolar disorder often present for treatment
during their low mood
Which statement about grief/bereavement and major depressive disorder (MDD) is correct? -
ANS-Depression cannot be distinguished from grief/bereavement for at least 1 year after a loss
,The first-line drug class for the treatment of patients with generalized anxiety disorder (GAD) is -
ANS-selective serotonin reuptake inhibitors (SSRIs)
Which of the following tools is considered the validated screening tool for identifying generalized
anxiety disorder (GAD)? - ANS-Generalized Anxiety Disorder questionnaire
When initiating pharmacologic treatment for depression, what is the recommended interval for
monitoring therapeutic effects? - ANS-Every 2-4 weeks until therapeutic dose is reached
According to DSM-5 criteria, what core symptoms must be present to diagnosis major
depressive disorder (MDD)? - ANS-Anhedonia
Because of the high prevalence of postpartum depression, screening is recommended for all
women in the perinatal period. The evidence-based tool recommended for outpatient perinatal
and postpartum depression screening is the: - ANS-Edinburgh scale
The highly sensitive and specific assessment tool that should be used in primary care to
evaluate patients suspected of alcohol use disorder (AUD) is: - ANS-AUDIT
Which one of the following physical attributes is most common in patients who have obstructive
sleep apnea? - ANS-Enlarged neck circumference
The medication approved by the U.S. Food and Drug Administration (FDA) for use in the
treatment of patients diagnosed with opioid use disorder (OUD) is: - ANS-buprenorphine
When prescribing zolpidem for patients diagnosed with insomnia, it is important to stress that
the potentially serious side effect of this medication is - ANS-amnesia
Which of the following is an accepted instrument for initial general depression screening in the
outpatient setting? - ANS-Patient Health Questionnaire-2 (PHQ-2)
When considering primary treatment goals for chronic insomnia, the priorities should include: -
ANS-improving symptoms of insomnia-related daytime impairment
Which of the following is the best choice for treating community-acquired pneumonia (CAP) in
an outpatient with no antibiotic use in the prior 3 months? - ANS-Azithromycin monotherapy
Expiratory airway restriction is a distinct characteristic of: - ANS-chronic obstructive pulmonary
disease (COPD).
The tool used to confirm a suspected diagnosis of chronic obstructive pulmonary disease
(COPD) is: - ANS-spirometry.
,Differential diagnoses for the common cold would NOT include: - ANS-varicella.
When evaluating a patient's asthma symptom control over the prior 4 weeks, which of the
following should be documented? - ANS-Frequency of nighttime awakening due to asthma
symptoms
The CURB-65 criteria (confusion, urea, respiratory rate, blood pressure, age 65 or older) is a
decision making tool used in the treatment of pneumonia when determining whether: -
ANS-inpatient management is advisable.
Which one of the following has been proven effective in symptom management for the common
cold? - ANS-Acetaminophen
When evaluating a patient who reports variable expiratory airflow restriction triggered by
exercise, allergens, or irritant exposure, the differential diagnosis list should include: -
ANS-asthma.
For patients diagnosed with bronchitis, which drug class is associated with improvement in
cough without wheezing? - ANS-Expectorants
Which of the following statements about the use of codeine-based cough suppressants in viral
upper respiratory illness is correct? - ANS-Codeine-based cough suppressants are not
recommended due to their potential to induce respiratory depression.
While evaluating a patient with cough, the NP notes egophony over the middle lobe of the right
lung. This finding raises concern for: - ANS-a pulmonary consolidation.
When considering a diagnosis of acute bacterial respiratory illness, the MOST concerning sign
is: - ANS-worsening symptoms with fever.
When initiating treatment for mild asthma according to guidelines from the Global Initiative for
Asthma (GINA), the first step is to prescribe a: - ANS-low-dose inhaled corticosteroid (ICS) and
formoterol preparation.
Which one of the following raises concern for worsening asthma? - ANS-Any number of
nighttime symptoms
A combination of breathing through pursed lips, use of accessory chest muscles, and increased
anteroposterior chest diameter is characteristic of what disease process? - ANS-Chronic
obstructive pulmonary disease (COPD)
Which one of the following is expected between asthma exacerbations? - ANS-An absence of
symptoms
, A patient asks about the optimal gestational age to perform first trimester screening. She wants
to maximize Trisomy 21 detection and decrease the possibility of false-positive results. Based
on her goal, when should a cell-free DNA test be performed? - ANS-At 11 weeks' gestation
A patient presents for an initial obstetric physical and reports a family history of autism. Which of
the following would be most appropriate to include in her prenatal screening? - ANS-Fragile X
syndrome (FMR1 gene)
A multiparous pregnant woman at 36 weeks' gestation complains about having only one or two
bowel movements each week. She has been eating fresh vegetables and drinking at least 64
ounces of water daily. Her provider recommends a bulk-forming laxative. What is the correct
way to explain how it works? - ANS-It absorbs water and expands and increases moisture in
the stool, making it easier to pass.
Which category of medication is associated with the highest risk for fetal growth restriction
(FGR)? - ANS-Antiepileptic drugs
A 25-year-old primigravida woman presents for an initial prenatal exam. Based on her last
menstrual period (LMP), her calculated estimated gestational age (EGA) is 12 weeks. Based on
her estimated gestational age, the fundus should be palpable: - ANS-just above her pubic
bone.
During an initial obstetric physical exam, which finding would be considered normal for the
cardiovascular portion of the examination? - ANS-An S3 gallop
When talking with a pregnant patient about hormonal effects she may be experiencing, what
system is most likely to be noticeably slowed in response to her pregnancy progesterone
levels? - ANS-Bowel evacuation
At what point would a woman exposed to congenital cytomegalovirus (CMV) have an increased
risk of infant infection? - ANS-During periconception or the first trimester
A pregnant patient in her second trimester has noticed more heartburn and flatulence. The
WHNP explains that these symptoms are most likely the result of: - ANS-decreased gastric
acidity.
A pregnant patient in her second trimester has noticed contractions each afternoon. What would
raise suspicions for preterm labor? - ANS-Cervical dilation and/or effacement
A pregnant patient has group B Streptococcus bacteriuria, at a level <105 CFU/mL. In the
absence of an allergy, what intrapartum prophylaxis should be administered? - ANS-Penicillin G
IV every 4 hours
Which one of the following is an ethical infraction when using electronic medical records? -
ANS-Copying and pasting outdated notes
Practice authority for advanced practice registered nurses (APRNs) is granted by: - ANS-each
state's board of nursing
Which answer is true about full practice authority for nurse practitioners? - ANS-Full practice
authority is the authorization of nurse practitioners to evaluate patients; diagnose, order and
interpret diagnostic tests; and to initiate and manage treatments—including prescribing
medications—without required physical collaboration or supervision.
Which of the following scenarios reflects "incident to" billing for Medicare-covered services? -
ANS-An NP bills 100% of the allowable Medicare fee schedule for follow-up care
The scope of practice for nurse practitioners is determined by: - ANS-the state government
Medicare Part B covers - ANS-physician services, outpatient services, and durable medical
equipment
Select the statement that best describes the role of a women's health nurse practitioner (WHNP)
- ANS-The role of the WHNP is to assess, diagnose, and treat the healthcare needs of women
throughout their lifespan
Statistical significance is represented by the P value. Which statement about P value is correct?
- ANS-
When counseling a patient diagnosed with generalized anxiety disorder (GAD) or panic
disorder, lifestyle modifications to decrease symptoms should include - ANS-exercising
vigorously for 20 minutes three times a week
Which of the following is used to evaluate suspected obstructive sleep apnea (OSA) in patients
who present with a sleep disorder? - ANS-Polysomnography
Why is it often challenging to differentiate between the diagnosis of major depressive disorder
(MDD) and bipolar disorder? - ANS-Patients with bipolar disorder often present for treatment
during their low mood
Which statement about grief/bereavement and major depressive disorder (MDD) is correct? -
ANS-Depression cannot be distinguished from grief/bereavement for at least 1 year after a loss
,The first-line drug class for the treatment of patients with generalized anxiety disorder (GAD) is -
ANS-selective serotonin reuptake inhibitors (SSRIs)
Which of the following tools is considered the validated screening tool for identifying generalized
anxiety disorder (GAD)? - ANS-Generalized Anxiety Disorder questionnaire
When initiating pharmacologic treatment for depression, what is the recommended interval for
monitoring therapeutic effects? - ANS-Every 2-4 weeks until therapeutic dose is reached
According to DSM-5 criteria, what core symptoms must be present to diagnosis major
depressive disorder (MDD)? - ANS-Anhedonia
Because of the high prevalence of postpartum depression, screening is recommended for all
women in the perinatal period. The evidence-based tool recommended for outpatient perinatal
and postpartum depression screening is the: - ANS-Edinburgh scale
The highly sensitive and specific assessment tool that should be used in primary care to
evaluate patients suspected of alcohol use disorder (AUD) is: - ANS-AUDIT
Which one of the following physical attributes is most common in patients who have obstructive
sleep apnea? - ANS-Enlarged neck circumference
The medication approved by the U.S. Food and Drug Administration (FDA) for use in the
treatment of patients diagnosed with opioid use disorder (OUD) is: - ANS-buprenorphine
When prescribing zolpidem for patients diagnosed with insomnia, it is important to stress that
the potentially serious side effect of this medication is - ANS-amnesia
Which of the following is an accepted instrument for initial general depression screening in the
outpatient setting? - ANS-Patient Health Questionnaire-2 (PHQ-2)
When considering primary treatment goals for chronic insomnia, the priorities should include: -
ANS-improving symptoms of insomnia-related daytime impairment
Which of the following is the best choice for treating community-acquired pneumonia (CAP) in
an outpatient with no antibiotic use in the prior 3 months? - ANS-Azithromycin monotherapy
Expiratory airway restriction is a distinct characteristic of: - ANS-chronic obstructive pulmonary
disease (COPD).
The tool used to confirm a suspected diagnosis of chronic obstructive pulmonary disease
(COPD) is: - ANS-spirometry.
,Differential diagnoses for the common cold would NOT include: - ANS-varicella.
When evaluating a patient's asthma symptom control over the prior 4 weeks, which of the
following should be documented? - ANS-Frequency of nighttime awakening due to asthma
symptoms
The CURB-65 criteria (confusion, urea, respiratory rate, blood pressure, age 65 or older) is a
decision making tool used in the treatment of pneumonia when determining whether: -
ANS-inpatient management is advisable.
Which one of the following has been proven effective in symptom management for the common
cold? - ANS-Acetaminophen
When evaluating a patient who reports variable expiratory airflow restriction triggered by
exercise, allergens, or irritant exposure, the differential diagnosis list should include: -
ANS-asthma.
For patients diagnosed with bronchitis, which drug class is associated with improvement in
cough without wheezing? - ANS-Expectorants
Which of the following statements about the use of codeine-based cough suppressants in viral
upper respiratory illness is correct? - ANS-Codeine-based cough suppressants are not
recommended due to their potential to induce respiratory depression.
While evaluating a patient with cough, the NP notes egophony over the middle lobe of the right
lung. This finding raises concern for: - ANS-a pulmonary consolidation.
When considering a diagnosis of acute bacterial respiratory illness, the MOST concerning sign
is: - ANS-worsening symptoms with fever.
When initiating treatment for mild asthma according to guidelines from the Global Initiative for
Asthma (GINA), the first step is to prescribe a: - ANS-low-dose inhaled corticosteroid (ICS) and
formoterol preparation.
Which one of the following raises concern for worsening asthma? - ANS-Any number of
nighttime symptoms
A combination of breathing through pursed lips, use of accessory chest muscles, and increased
anteroposterior chest diameter is characteristic of what disease process? - ANS-Chronic
obstructive pulmonary disease (COPD)
Which one of the following is expected between asthma exacerbations? - ANS-An absence of
symptoms
, A patient asks about the optimal gestational age to perform first trimester screening. She wants
to maximize Trisomy 21 detection and decrease the possibility of false-positive results. Based
on her goal, when should a cell-free DNA test be performed? - ANS-At 11 weeks' gestation
A patient presents for an initial obstetric physical and reports a family history of autism. Which of
the following would be most appropriate to include in her prenatal screening? - ANS-Fragile X
syndrome (FMR1 gene)
A multiparous pregnant woman at 36 weeks' gestation complains about having only one or two
bowel movements each week. She has been eating fresh vegetables and drinking at least 64
ounces of water daily. Her provider recommends a bulk-forming laxative. What is the correct
way to explain how it works? - ANS-It absorbs water and expands and increases moisture in
the stool, making it easier to pass.
Which category of medication is associated with the highest risk for fetal growth restriction
(FGR)? - ANS-Antiepileptic drugs
A 25-year-old primigravida woman presents for an initial prenatal exam. Based on her last
menstrual period (LMP), her calculated estimated gestational age (EGA) is 12 weeks. Based on
her estimated gestational age, the fundus should be palpable: - ANS-just above her pubic
bone.
During an initial obstetric physical exam, which finding would be considered normal for the
cardiovascular portion of the examination? - ANS-An S3 gallop
When talking with a pregnant patient about hormonal effects she may be experiencing, what
system is most likely to be noticeably slowed in response to her pregnancy progesterone
levels? - ANS-Bowel evacuation
At what point would a woman exposed to congenital cytomegalovirus (CMV) have an increased
risk of infant infection? - ANS-During periconception or the first trimester
A pregnant patient in her second trimester has noticed more heartburn and flatulence. The
WHNP explains that these symptoms are most likely the result of: - ANS-decreased gastric
acidity.
A pregnant patient in her second trimester has noticed contractions each afternoon. What would
raise suspicions for preterm labor? - ANS-Cervical dilation and/or effacement
A pregnant patient has group B Streptococcus bacteriuria, at a level <105 CFU/mL. In the
absence of an allergy, what intrapartum prophylaxis should be administered? - ANS-Penicillin G
IV every 4 hours
