1|Page
APEA PRE-PREDICTOR TEST EXAM|| QUESTIONS
AND 100% CORRECT ANSWERS ALREADY GRADED
A+|| LATEST AND COMPLETE UPDATE WITH
VERIFIED SOLUTIONS GUARANTEED PASS!!!
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? - ANSWER: 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? - ANSWER: 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: - ANSWER: testicular self- examination.
Cryptorchidism, even with surgical repair, is associated with increased risk for
testicular cancer.
,2|Page
The treatment of choice for chronic bacterial prostatitis (CBP) is: - ANSWER: 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? - ANSWER: 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? -
ANSWER: 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.
Following the finding of prostate gland abnormalities on DRE, the NP orders the
appropriate labs. Whem preparing to review lab reports with the patient, the nurse
practitioner knows all of the following are true EXCEPT: - ANSWER: normal
PSA is 10ng/ml or less.
Normal PSA is 4ng/ml or less. PSA levels greater the 4 and less than 10 are
associated with BPH. A 10 or greater PSA level suggests prostate cancer. Positive
serum acid phosphatase is associated with malignancy of the prostate gland with
bone metasasis.
,3|Page
A 66 yo female presents to your clinic. She states that yesterday evening she had
chest pain for 20-30 minutes. Which finding most strongly correlates with
myocardial infarction? - ANSWER: Elevated Troponin I levels
An elevated creatinine kinase (CK) is not diagnostic of a myocardial infarction
(MI). CK may be elevated from an IM injection, surgery, ot any type of extensive
skeletal muscle trauma or prolonged, strenuous physical exertion. ST segment
depression on EKG usually indicates an ischemic myocardium, but, not
necessarily, one post-MI. Elevated ST seghments reflect mycardial damage. MB
bands are specific for myocardial smooth muscle. If these are elevated, the patient
MAY HAVE had a very recent MI. The most accurate marker of cardiac damage,
because it is more specific and sensitive than CK MB, is a troponin measurement.
What is a secondary cause of hyperlipidemia? - ANSWER: hypothyroidism
Hypothyroidism is a common secondary cause of hyperlipidemia. In the evaluation
of a patient with hyperlipidemia, a TSH should always be checked and corrected
before attempting treatment for hyperlipidemia. Other possible causes of seconday
hyperlipidemia include pregnancy, excessive weight gain, excessive alcohol intake,
insulin resistance or deficiency, obstructive liver disease, and uremia.
Some medications can produce secondary hypothyroidism too: thiazide diuretics,
some beta-blockers, oral contraceptives, and corticosteroids.
A 35-yo male presents with a complaint of low pelvic pain, dysuria, hesitancy,
urgency, and reduced for of stream. The nurse practitioner suspects acute bacterial
prostatitis. The NP would appropriately collect all of the following specimens
EXCEPT a: sterile in-and-out catheter urine specimen. - ANSWER: A sterile
in-and-out catheter specimen would identify only organisms in the bladder and
would not differentiate
, 4|Page
between bladder, kidney, or prostate site infection. The sequence for obtaining
specimens when prostat infection is suspected is: 1. voided urethral urine, 2.
Voided mid-stream bladder urine, and 3. voided post-prostate massage urine.
A 24 yo female taking an oral contraceptive has missed her last 2 pills. What
should the nurse practitioner advise her to do to minimize her risk of pregnancy? -
ANSWER: Double today's dose and tomorrow's dose and use a barrier method for
the rest of the month.
If 2 mills are missed on consecutive days, the next 2 days' doseages should be
doubled and a barrier method recommended for the remainder of the cycle.
A 50yo, non-smoker, with no co-morbidity presents to the clinica and is diagnosed
with pna. His vital signs are normal except for temperature of 101.6 degrees. A
sputum specimen is collected and sent for culture and sensitivity. What action
should the nurse practitioner take today? - ANSWER: Start Clarithromycin
(Biaxin) 500mg 2 times a day for 10 to 14 days.
Most treatment guidelines for outpatient pna in non-smokers without co-morbidity
and 60 years of age or younger, recommend erythromycin or another macrolide
like Biaxin. Pcn s indicated for patient swith pneumococcal pna and ciprofloxacin
is recommended for Legionella species.
A 38 year old patient is being treated the by the NP for heavy vaginal bleeding
secondary to multiple uterine leiomyomas. Her uterus is greater than 12 weeks
gestational size, her hematocrit is 28%, and she has not responded to hormonal
therapy. Which of the following would be the most appropriate intervention at this
time? - ANSWER: Obtain a gynecological consultation
APEA PRE-PREDICTOR TEST EXAM|| QUESTIONS
AND 100% CORRECT ANSWERS ALREADY GRADED
A+|| LATEST AND COMPLETE UPDATE WITH
VERIFIED SOLUTIONS GUARANTEED PASS!!!
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? - ANSWER: 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? - ANSWER: 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: - ANSWER: testicular self- examination.
Cryptorchidism, even with surgical repair, is associated with increased risk for
testicular cancer.
,2|Page
The treatment of choice for chronic bacterial prostatitis (CBP) is: - ANSWER: 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? - ANSWER: 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? -
ANSWER: 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.
Following the finding of prostate gland abnormalities on DRE, the NP orders the
appropriate labs. Whem preparing to review lab reports with the patient, the nurse
practitioner knows all of the following are true EXCEPT: - ANSWER: normal
PSA is 10ng/ml or less.
Normal PSA is 4ng/ml or less. PSA levels greater the 4 and less than 10 are
associated with BPH. A 10 or greater PSA level suggests prostate cancer. Positive
serum acid phosphatase is associated with malignancy of the prostate gland with
bone metasasis.
,3|Page
A 66 yo female presents to your clinic. She states that yesterday evening she had
chest pain for 20-30 minutes. Which finding most strongly correlates with
myocardial infarction? - ANSWER: Elevated Troponin I levels
An elevated creatinine kinase (CK) is not diagnostic of a myocardial infarction
(MI). CK may be elevated from an IM injection, surgery, ot any type of extensive
skeletal muscle trauma or prolonged, strenuous physical exertion. ST segment
depression on EKG usually indicates an ischemic myocardium, but, not
necessarily, one post-MI. Elevated ST seghments reflect mycardial damage. MB
bands are specific for myocardial smooth muscle. If these are elevated, the patient
MAY HAVE had a very recent MI. The most accurate marker of cardiac damage,
because it is more specific and sensitive than CK MB, is a troponin measurement.
What is a secondary cause of hyperlipidemia? - ANSWER: hypothyroidism
Hypothyroidism is a common secondary cause of hyperlipidemia. In the evaluation
of a patient with hyperlipidemia, a TSH should always be checked and corrected
before attempting treatment for hyperlipidemia. Other possible causes of seconday
hyperlipidemia include pregnancy, excessive weight gain, excessive alcohol intake,
insulin resistance or deficiency, obstructive liver disease, and uremia.
Some medications can produce secondary hypothyroidism too: thiazide diuretics,
some beta-blockers, oral contraceptives, and corticosteroids.
A 35-yo male presents with a complaint of low pelvic pain, dysuria, hesitancy,
urgency, and reduced for of stream. The nurse practitioner suspects acute bacterial
prostatitis. The NP would appropriately collect all of the following specimens
EXCEPT a: sterile in-and-out catheter urine specimen. - ANSWER: A sterile
in-and-out catheter specimen would identify only organisms in the bladder and
would not differentiate
, 4|Page
between bladder, kidney, or prostate site infection. The sequence for obtaining
specimens when prostat infection is suspected is: 1. voided urethral urine, 2.
Voided mid-stream bladder urine, and 3. voided post-prostate massage urine.
A 24 yo female taking an oral contraceptive has missed her last 2 pills. What
should the nurse practitioner advise her to do to minimize her risk of pregnancy? -
ANSWER: Double today's dose and tomorrow's dose and use a barrier method for
the rest of the month.
If 2 mills are missed on consecutive days, the next 2 days' doseages should be
doubled and a barrier method recommended for the remainder of the cycle.
A 50yo, non-smoker, with no co-morbidity presents to the clinica and is diagnosed
with pna. His vital signs are normal except for temperature of 101.6 degrees. A
sputum specimen is collected and sent for culture and sensitivity. What action
should the nurse practitioner take today? - ANSWER: Start Clarithromycin
(Biaxin) 500mg 2 times a day for 10 to 14 days.
Most treatment guidelines for outpatient pna in non-smokers without co-morbidity
and 60 years of age or younger, recommend erythromycin or another macrolide
like Biaxin. Pcn s indicated for patient swith pneumococcal pna and ciprofloxacin
is recommended for Legionella species.
A 38 year old patient is being treated the by the NP for heavy vaginal bleeding
secondary to multiple uterine leiomyomas. Her uterus is greater than 12 weeks
gestational size, her hematocrit is 28%, and she has not responded to hormonal
therapy. Which of the following would be the most appropriate intervention at this
time? - ANSWER: Obtain a gynecological consultation
