APEA PREDICTOR EXAM |PRE-
PREDICTOR EXAM 336 QUESTIONS
ANSWERS WITH RATIONALES 2025-
2026 update already A graded New
!!! (NSG 6440)
,1) 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.
2) 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
3) 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.
4) 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.
5) 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.
6) 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..
7) 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
PREDICTOR EXAM 336 QUESTIONS
ANSWERS WITH RATIONALES 2025-
2026 update already A graded New
!!! (NSG 6440)
,1) 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.
2) 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
3) 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.
4) 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.
5) 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.
6) 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..
7) 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
