3P APEA EXAM
+what is the significance of AV nicking? - ANS this is indicative of longstanding
hypertension
A 15-year-old male has worked this summer as a lifeguard at a local swimming pool.
He complains of itching in the groin area. He is dx with tinea cruris. The NP is likely
to identify - ANS well marginated half moon shape macules on the inner thigh
A 30-year-old female pt. with complaints of fatigue undergoes a screening TSH. Her
TSH is 8 what should be done next? - ANS repeat the TSH and add T4
a 38-year-old male pt. presents for his annual exam. He reports nervousness and
weight loss, but denies any change in his dietary intake or exercise level. Based on
this findings and the following lab values: TSH 0.01, free T4 6, free T3 205. what is
the most likely dx? - ANS Hyperthyroidism
A 40-year-old African-American pt. has a b/p of 175/100 and 170/102. What is a
reasonable plan of care for this pt today? - ANS initiate amlodipine 5mg daily
a 40-year-old pt. with newly dx of T2DM asks what his target b/p should be. the most
correct answer is: - ANS less than 140/90
A 43 year old Hispanic male has an audible diastolic murmur best heard in the mitral
listening point. There is no audible click. His status has been monitored for the past
two years. This murmur is probably - ANS mitral stenosis
A 45-year-old female pt has fatigue for the past 3 months and a 10-lbs weight gain.
She previously had regular menses occurring about every 30 days, but in the last 3
months her menses have varied between 30-45 days . Her TSH value is 13. It was
repeated 1week later and found to be 15. What explains this finding? - ANS
hypothyroidism
A 50-year-old patient with hypertension has taken HCTZ 25mg daily for the past 4
weeks. Her b/p has decreased from 155/95 to 145/90. How should the NP proceed?
- ANS add another drug from another class to the daily 25mg HCTZ
A 52-year-old presents w/thirst and frequent urination today. His glucose is 352. How
should this be managed today? - ANS start insulin
A 65-year-old diabetic has been on oral antihyperglycemic agents and is still having
poor glycemic control. His AM fasting glucose range from 140-160. You decide to
, add insulin. He weighs 127 kg. What should the NP order as an initial starting dose?
- ANS 10u of long-acting insulin at bedtime
A 70-year-old pt. has begun to have hearing loss. She relates that her elderly
parents had difficulty hearing. Which complaints below is typical of presbycusis? -
ANS inability to hear consonants
A 74 year old patient has PAD. Which item listed below is an important
nonmodifiable risk factor for PAD? - ANS diabetes
A 74-year-old is dx w/shingles. The NP is deciding how to best manage her care.
What should be prescribed? - ANS an oral antiviral agent
a 74-year-old patient has had an increase in b/p since the last exam. his b/p has
increased from 144/90 to reading in the upper 160's/upper 80's. If medication is to be
started on this patient, what would be a good first choice? - ANS Calcium
channel blocker
A 75 year old patient who has aortic stenosis wants to know what symptoms indicate
worsening of his stenosis. the NP replies: - ANS shortness of breath and
syncope
A 76-year-old obese pt. has fatigue, thirst, and frequent urination. She was asked to
measure AM fasting glucose values for 1 week. The values range from 142-175 this
pt: - ANS can be dx w/DMT2
a 93-year-old demented pt. has been recently treated w/an URI but drainage from
the right nostril persists. What should the NP suspect? - ANS presence of
foreign body
a diabetic pt. w/albuminuria has been placed on an ACE inhibitor. How soon can the
antiproteinuric effect of the ACEi be realized for this pt. - ANS 6-8 weeks
a low-potency topical hydrocortisone cream would be most appropriate in a pt. who
has been dx with? - ANS atopic dermatitis
A microscopic exam of the sample taken from a skin lesion indicates hyphae. What
type of infection might this indicate? - ANS fungal
A patient has poorly controlled hypertension for more than 10 years. Indicate the
most likely position of his point of maximal impulse (PMI) - ANS 5th ICS, left of
MCL
+what is the significance of AV nicking? - ANS this is indicative of longstanding
hypertension
A 15-year-old male has worked this summer as a lifeguard at a local swimming pool.
He complains of itching in the groin area. He is dx with tinea cruris. The NP is likely
to identify - ANS well marginated half moon shape macules on the inner thigh
A 30-year-old female pt. with complaints of fatigue undergoes a screening TSH. Her
TSH is 8 what should be done next? - ANS repeat the TSH and add T4
a 38-year-old male pt. presents for his annual exam. He reports nervousness and
weight loss, but denies any change in his dietary intake or exercise level. Based on
this findings and the following lab values: TSH 0.01, free T4 6, free T3 205. what is
the most likely dx? - ANS Hyperthyroidism
A 40-year-old African-American pt. has a b/p of 175/100 and 170/102. What is a
reasonable plan of care for this pt today? - ANS initiate amlodipine 5mg daily
a 40-year-old pt. with newly dx of T2DM asks what his target b/p should be. the most
correct answer is: - ANS less than 140/90
A 43 year old Hispanic male has an audible diastolic murmur best heard in the mitral
listening point. There is no audible click. His status has been monitored for the past
two years. This murmur is probably - ANS mitral stenosis
A 45-year-old female pt has fatigue for the past 3 months and a 10-lbs weight gain.
She previously had regular menses occurring about every 30 days, but in the last 3
months her menses have varied between 30-45 days . Her TSH value is 13. It was
repeated 1week later and found to be 15. What explains this finding? - ANS
hypothyroidism
A 50-year-old patient with hypertension has taken HCTZ 25mg daily for the past 4
weeks. Her b/p has decreased from 155/95 to 145/90. How should the NP proceed?
- ANS add another drug from another class to the daily 25mg HCTZ
A 52-year-old presents w/thirst and frequent urination today. His glucose is 352. How
should this be managed today? - ANS start insulin
A 65-year-old diabetic has been on oral antihyperglycemic agents and is still having
poor glycemic control. His AM fasting glucose range from 140-160. You decide to
, add insulin. He weighs 127 kg. What should the NP order as an initial starting dose?
- ANS 10u of long-acting insulin at bedtime
A 70-year-old pt. has begun to have hearing loss. She relates that her elderly
parents had difficulty hearing. Which complaints below is typical of presbycusis? -
ANS inability to hear consonants
A 74 year old patient has PAD. Which item listed below is an important
nonmodifiable risk factor for PAD? - ANS diabetes
A 74-year-old is dx w/shingles. The NP is deciding how to best manage her care.
What should be prescribed? - ANS an oral antiviral agent
a 74-year-old patient has had an increase in b/p since the last exam. his b/p has
increased from 144/90 to reading in the upper 160's/upper 80's. If medication is to be
started on this patient, what would be a good first choice? - ANS Calcium
channel blocker
A 75 year old patient who has aortic stenosis wants to know what symptoms indicate
worsening of his stenosis. the NP replies: - ANS shortness of breath and
syncope
A 76-year-old obese pt. has fatigue, thirst, and frequent urination. She was asked to
measure AM fasting glucose values for 1 week. The values range from 142-175 this
pt: - ANS can be dx w/DMT2
a 93-year-old demented pt. has been recently treated w/an URI but drainage from
the right nostril persists. What should the NP suspect? - ANS presence of
foreign body
a diabetic pt. w/albuminuria has been placed on an ACE inhibitor. How soon can the
antiproteinuric effect of the ACEi be realized for this pt. - ANS 6-8 weeks
a low-potency topical hydrocortisone cream would be most appropriate in a pt. who
has been dx with? - ANS atopic dermatitis
A microscopic exam of the sample taken from a skin lesion indicates hyphae. What
type of infection might this indicate? - ANS fungal
A patient has poorly controlled hypertension for more than 10 years. Indicate the
most likely position of his point of maximal impulse (PMI) - ANS 5th ICS, left of
MCL
