APEA Predictor Exam 2025 – 2026 UPDATE TESTBANK – Full-
Length Practice Test with 100% Verified Questions & Rationales
FREQUENTLY SET | Comprehensive FNP Board Exam Prep |
Clinical Guidelines, Test-Taking Strategies & Must-Know Topics
Study Guide for High Scores
At what level of prevention would you classify for lung cancer?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Primordial prevention
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
A. Peripheral vision
What is the most common cause of Cushing's syndrome?
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:
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?
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:
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:
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:
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:
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?
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:
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?
,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 positive Murphy's inspriatory arrest. Ilcerative colitis presents with
LLQ pain. Pain associated with pancreatitis is typically in the epigastric region.
Atenolol (Tenormin) should be avoided in:
a 43-yo female with asthma.
Atenolol is a beta blocker. It should be avoided in pateints with asthma or other bronchospastic conditions.
These patients often require beta stimulation, not beta blockade. Although atenolol is a beta 1-selective agent, at
higher doses beta 2 receptors (bronchial and vascular) are blocked. Beta blockers, specifically atenolol, are
beneficial post-myocardial infarction because they have demonstrated a reduction in morbidity and mortality.
All of the following interventions with pediatric patients are appropriate EXCEPT:
Pre-medicate the patient prior to all painful interventions.
Pre-medication is not warranted prior to all painful interventions. For example, premedication is not warranted
prior to routine immunizations but it certainly is prior to suturing. Pain management should be an integral part
of patient management.
Infants with veliac disease (gluten eneteropathy) are at risk for multiple complications. The most urgen
complication of this disease is:
Intususseption or volvulus.
Intuseusseption and volvulus are surgical emergencies. Delay releasing the invaginated or "telescoped" bowel
(intususseption), or releasing the twisted bowel (volvulus) may result in tissue death and gangrene, perforation,
peritonitis, and/or sepsis, and fatality. There is also a high rate of intususseption and volvulus among infants
with cistic fibrosis.
Which activities are NOT characteristic of preschool children?
Always follow rules during playground games.
Since preschoolers are just beginning to learn moral behaviors, they often cheat to win. While most
preschoolers toilet independently, accidents occasionally occur and bed-wetting is not unusual. The use of a
security item such as a blanket is common.
A 38-yo pregnant patient at 18 weeks gestation, complains of feeling light-headed when standing. Which of the
following is an appropriate response by the NP?
Blood pressure normally decreases during pregnancy and can cause this symptom.
Blood pressure normally decreases during pregnancy, reaching the lowest point during the second or third
trimesters and rising there after. Patient education to rise slowly from sitting or lying is important. Low blood
glucose may be the etiology, but an oral glucose tolerance test at this point is not indicated. A fasting blood
glucose could be ordered, however, an electrocardiogram is not indicated.
An 80 year old Caucasian female has heart failure. What symptom is an early indicator of failure?
Weight gain.
Early signs of heart failure include weight gain (the most sensitive indicator), S3 gallop, dyspnea on exertion,
, peripheral edema. Moderate signs include nocturnal cough, tachycardia. Late signs include ascities, frothy
sputum, and hypotension.
A 6 yo had an acute onset of fever, pharyngitis, and headache 2 days ago. Today, he presents with cervical
lymphadenopathy and sandpaper textured rash everywhere except on his face. A rapid streptococcal antigen test
is positive. The remainder of the assessment in unremarkable. What is the most likely diagnosis and the most
appropriate action?
Scarlet fever; treat with antibiotics.
This disease is due to infection with Group A Beta-hemolytic streptococcus. The rash is thought to be due to a
systemic reaction to the toxin produced by the microorganism. The rash fades with pressure and ultimately
desquamates. A deep, nonblanching rash on the flexor surfaces of the skin is referred to as pastia lines.
A patient has been diagnosed with hypothyroidism and thyroid hormone replacement therapy is prescribed.
When should the nurse practitioner check the patient's TSH?
6 weeks.
The half-life of levothyroxine, the treatment of choice for thyroid replacement, is 7 days. The earliest that
meaningful changes will be observed is at 4-6 weeks. Therefore, the NP should wait a minimum of 4-6 weeks
before checking the patient's TSH.
A 15 yo malue has a history of cryptorchidism which was surgically repaired. Because of this information, it is
essential for the nurse practitioner to teach him about:
testicular self-examination.
Cryptorchidism, even with surgical repair, is associated with increased risk for testicular cancer.
The treatment of choice for chronic bacterial prostatitis (CBP) is:
a flouroquinolone twice daily for 3 weeks to 4 months.
The treatment of chice is a flouroquinolone twice daily for 3 weeks to 4 months. The cure rate with Bactrim-DS
is only about 30-40%.
A 25 yo female has a history of frequent candidal vaginal infections in the past year. She is in a monogamous
sexual relationship and uses and IUD for contraception. Of the following, which is the most likely underlying
conidition predisposing her to recurring candidal vaginitis?
Diabetes.
A common underlying cause of frequent infections is diabetes mellitus. Pregnancy increases the incidence of
candidiasis, but is unlikely a factor with this patient.
Which of the following is NOT a characteristic of the S3 heart sound?
The sound is high-pitched and occurs just prior to the S1 heart sound.
The S3 heart sound is low-pitched and occurs just after the S2 heart sound. It is produced by rapid ventricular
filling and is best auscultated in the mitral area. It is a common finding with right-sided heart failure, rapid
growth, and the last trimester of pregnancy.
Length Practice Test with 100% Verified Questions & Rationales
FREQUENTLY SET | Comprehensive FNP Board Exam Prep |
Clinical Guidelines, Test-Taking Strategies & Must-Know Topics
Study Guide for High Scores
At what level of prevention would you classify for lung cancer?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Primordial prevention
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
A. Peripheral vision
What is the most common cause of Cushing's syndrome?
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:
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?
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:
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:
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:
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:
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?
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:
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?
,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 positive Murphy's inspriatory arrest. Ilcerative colitis presents with
LLQ pain. Pain associated with pancreatitis is typically in the epigastric region.
Atenolol (Tenormin) should be avoided in:
a 43-yo female with asthma.
Atenolol is a beta blocker. It should be avoided in pateints with asthma or other bronchospastic conditions.
These patients often require beta stimulation, not beta blockade. Although atenolol is a beta 1-selective agent, at
higher doses beta 2 receptors (bronchial and vascular) are blocked. Beta blockers, specifically atenolol, are
beneficial post-myocardial infarction because they have demonstrated a reduction in morbidity and mortality.
All of the following interventions with pediatric patients are appropriate EXCEPT:
Pre-medicate the patient prior to all painful interventions.
Pre-medication is not warranted prior to all painful interventions. For example, premedication is not warranted
prior to routine immunizations but it certainly is prior to suturing. Pain management should be an integral part
of patient management.
Infants with veliac disease (gluten eneteropathy) are at risk for multiple complications. The most urgen
complication of this disease is:
Intususseption or volvulus.
Intuseusseption and volvulus are surgical emergencies. Delay releasing the invaginated or "telescoped" bowel
(intususseption), or releasing the twisted bowel (volvulus) may result in tissue death and gangrene, perforation,
peritonitis, and/or sepsis, and fatality. There is also a high rate of intususseption and volvulus among infants
with cistic fibrosis.
Which activities are NOT characteristic of preschool children?
Always follow rules during playground games.
Since preschoolers are just beginning to learn moral behaviors, they often cheat to win. While most
preschoolers toilet independently, accidents occasionally occur and bed-wetting is not unusual. The use of a
security item such as a blanket is common.
A 38-yo pregnant patient at 18 weeks gestation, complains of feeling light-headed when standing. Which of the
following is an appropriate response by the NP?
Blood pressure normally decreases during pregnancy and can cause this symptom.
Blood pressure normally decreases during pregnancy, reaching the lowest point during the second or third
trimesters and rising there after. Patient education to rise slowly from sitting or lying is important. Low blood
glucose may be the etiology, but an oral glucose tolerance test at this point is not indicated. A fasting blood
glucose could be ordered, however, an electrocardiogram is not indicated.
An 80 year old Caucasian female has heart failure. What symptom is an early indicator of failure?
Weight gain.
Early signs of heart failure include weight gain (the most sensitive indicator), S3 gallop, dyspnea on exertion,
, peripheral edema. Moderate signs include nocturnal cough, tachycardia. Late signs include ascities, frothy
sputum, and hypotension.
A 6 yo had an acute onset of fever, pharyngitis, and headache 2 days ago. Today, he presents with cervical
lymphadenopathy and sandpaper textured rash everywhere except on his face. A rapid streptococcal antigen test
is positive. The remainder of the assessment in unremarkable. What is the most likely diagnosis and the most
appropriate action?
Scarlet fever; treat with antibiotics.
This disease is due to infection with Group A Beta-hemolytic streptococcus. The rash is thought to be due to a
systemic reaction to the toxin produced by the microorganism. The rash fades with pressure and ultimately
desquamates. A deep, nonblanching rash on the flexor surfaces of the skin is referred to as pastia lines.
A patient has been diagnosed with hypothyroidism and thyroid hormone replacement therapy is prescribed.
When should the nurse practitioner check the patient's TSH?
6 weeks.
The half-life of levothyroxine, the treatment of choice for thyroid replacement, is 7 days. The earliest that
meaningful changes will be observed is at 4-6 weeks. Therefore, the NP should wait a minimum of 4-6 weeks
before checking the patient's TSH.
A 15 yo malue has a history of cryptorchidism which was surgically repaired. Because of this information, it is
essential for the nurse practitioner to teach him about:
testicular self-examination.
Cryptorchidism, even with surgical repair, is associated with increased risk for testicular cancer.
The treatment of choice for chronic bacterial prostatitis (CBP) is:
a flouroquinolone twice daily for 3 weeks to 4 months.
The treatment of chice is a flouroquinolone twice daily for 3 weeks to 4 months. The cure rate with Bactrim-DS
is only about 30-40%.
A 25 yo female has a history of frequent candidal vaginal infections in the past year. She is in a monogamous
sexual relationship and uses and IUD for contraception. Of the following, which is the most likely underlying
conidition predisposing her to recurring candidal vaginitis?
Diabetes.
A common underlying cause of frequent infections is diabetes mellitus. Pregnancy increases the incidence of
candidiasis, but is unlikely a factor with this patient.
Which of the following is NOT a characteristic of the S3 heart sound?
The sound is high-pitched and occurs just prior to the S1 heart sound.
The S3 heart sound is low-pitched and occurs just after the S2 heart sound. It is produced by rapid ventricular
filling and is best auscultated in the mitral area. It is a common finding with right-sided heart failure, rapid
growth, and the last trimester of pregnancy.
