APEA PRE-PREDICTOR EXAM 2025/2026 TEST BANK — 500+
QUESTIONS WITH CORRECT ANSWERS & DETAILED
RATIONALES (GUARANTEED A+)
1. A patient with chronic heart failure has gained 4 kg (8.8 lb) in 3 days. Which
action should the nurse take first?
A. Administer scheduled digoxin.
B. Assess the patient’s lung sounds and oxygen saturation.
C. Restrict oral fluids for 24 hours.
D. Notify the provider to increase diuretic dose.
Answer: B. Assess the patient’s lung sounds and oxygen saturation.
Rationale: Rapid weight gain suggests fluid retention and possible
pulmonary congestion. Immediate assessment of respiratory status (lung
sounds, SpO₂) is the priority to determine severity. Interventions/notification
follow assessment. Digoxin is not first-line for acute fluid overload.
,2. A patient prescribed lisinopril reports a persistent dry cough. Which is the
best next step?
A. Encourage the patient to continue medication; cough will resolve.
B. Switch to an angiotensin receptor blocker (ARB) after consulting the
provider.
C. Stop the lisinopril immediately and start a beta blocker.
D. Recommend over-the-counter cough suppressants.
Answer: B. Switch to an angiotensin receptor blocker (ARB) after
consulting the provider.
Rationale: ACE inhibitors commonly cause a persistent dry cough; ARBs
(e.g., losartan) are an alternative without this side effect. The nurse should
notify the provider; do not abruptly stop meds without provider guidance.
3. A 28-week pregnant client is admitted with preterm labor; magnesium
sulfate infusion is started for neuroprotection. Which assessment finding
requires immediate action?
A. Urine output 30 mL/hr.
B. Respiratory rate 10 breaths/min.
C. Presence of mild pedal edema.
, D. Maternal serum magnesium within therapeutic range.
Answer: B. Respiratory rate 10 breaths/min.
Rationale: Magnesium sulfate can depress respiratory drive and cause loss
of deep tendon reflexes. RR <12 and decreased reflexes are signs of toxicity
and require stopping the infusion and notifying provider. UOP 30 mL/hr is
borderline — monitor; therapeutic magnesium is expected.
4. A patient receiving morphine PCA reports nausea and itching after a bolus
dose. Respiratory status is stable. Which is the most appropriate nursing
action?
A. Administer naloxone immediately.
B. Stop PCA pump and call the provider.
C. Give antiemetic and an antihistamine as ordered, monitor closely.
D. Encourage the patient to deep breathe and cough.
Answer: C. Give antiemetic and an antihistamine as ordered, monitor
closely.
Rationale: Nausea and pruritus are common opioid side effects; if
respiratory status is adequate, treat symptoms (antiemetic, antihistamine) per
orders and continue monitoring. Naloxone is reserved for respiratory
depression/oversedation.
, 5. Which lab result is most important for the nurse to review before giving
vancomycin?
A. Potassium.
B. Serum creatinine.
C. Hemoglobin.
D. Platelet count.
Answer: B. Serum creatinine.
Rationale: Vancomycin is nephrotoxic and dosing must consider renal
function (serum creatinine, creatinine clearance). Monitor levels and adjust
dosing as needed.
6. A toddler with acute otitis media is irritable and is pulling at the ear. Parent
asks if ibuprofen is OK. The nurse’s best response:
A. “No — use acetaminophen only for ear pain.”
B. “Yes — ibuprofen is appropriate for pain and fever if no
contraindications.”
C. “Only give ibuprofen if the doctor prescribes it.”
D. “Avoid all analgesics; the child needs antibiotics first.”
Answer: B. “Yes — ibuprofen is appropriate for pain and fever if no
QUESTIONS WITH CORRECT ANSWERS & DETAILED
RATIONALES (GUARANTEED A+)
1. A patient with chronic heart failure has gained 4 kg (8.8 lb) in 3 days. Which
action should the nurse take first?
A. Administer scheduled digoxin.
B. Assess the patient’s lung sounds and oxygen saturation.
C. Restrict oral fluids for 24 hours.
D. Notify the provider to increase diuretic dose.
Answer: B. Assess the patient’s lung sounds and oxygen saturation.
Rationale: Rapid weight gain suggests fluid retention and possible
pulmonary congestion. Immediate assessment of respiratory status (lung
sounds, SpO₂) is the priority to determine severity. Interventions/notification
follow assessment. Digoxin is not first-line for acute fluid overload.
,2. A patient prescribed lisinopril reports a persistent dry cough. Which is the
best next step?
A. Encourage the patient to continue medication; cough will resolve.
B. Switch to an angiotensin receptor blocker (ARB) after consulting the
provider.
C. Stop the lisinopril immediately and start a beta blocker.
D. Recommend over-the-counter cough suppressants.
Answer: B. Switch to an angiotensin receptor blocker (ARB) after
consulting the provider.
Rationale: ACE inhibitors commonly cause a persistent dry cough; ARBs
(e.g., losartan) are an alternative without this side effect. The nurse should
notify the provider; do not abruptly stop meds without provider guidance.
3. A 28-week pregnant client is admitted with preterm labor; magnesium
sulfate infusion is started for neuroprotection. Which assessment finding
requires immediate action?
A. Urine output 30 mL/hr.
B. Respiratory rate 10 breaths/min.
C. Presence of mild pedal edema.
, D. Maternal serum magnesium within therapeutic range.
Answer: B. Respiratory rate 10 breaths/min.
Rationale: Magnesium sulfate can depress respiratory drive and cause loss
of deep tendon reflexes. RR <12 and decreased reflexes are signs of toxicity
and require stopping the infusion and notifying provider. UOP 30 mL/hr is
borderline — monitor; therapeutic magnesium is expected.
4. A patient receiving morphine PCA reports nausea and itching after a bolus
dose. Respiratory status is stable. Which is the most appropriate nursing
action?
A. Administer naloxone immediately.
B. Stop PCA pump and call the provider.
C. Give antiemetic and an antihistamine as ordered, monitor closely.
D. Encourage the patient to deep breathe and cough.
Answer: C. Give antiemetic and an antihistamine as ordered, monitor
closely.
Rationale: Nausea and pruritus are common opioid side effects; if
respiratory status is adequate, treat symptoms (antiemetic, antihistamine) per
orders and continue monitoring. Naloxone is reserved for respiratory
depression/oversedation.
, 5. Which lab result is most important for the nurse to review before giving
vancomycin?
A. Potassium.
B. Serum creatinine.
C. Hemoglobin.
D. Platelet count.
Answer: B. Serum creatinine.
Rationale: Vancomycin is nephrotoxic and dosing must consider renal
function (serum creatinine, creatinine clearance). Monitor levels and adjust
dosing as needed.
6. A toddler with acute otitis media is irritable and is pulling at the ear. Parent
asks if ibuprofen is OK. The nurse’s best response:
A. “No — use acetaminophen only for ear pain.”
B. “Yes — ibuprofen is appropriate for pain and fever if no
contraindications.”
C. “Only give ibuprofen if the doctor prescribes it.”
D. “Avoid all analgesics; the child needs antibiotics first.”
Answer: B. “Yes — ibuprofen is appropriate for pain and fever if no
