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APEA Predictor Test Bank| Questions
with Correct Answers| 2024/
Update with Complete Solution
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What is the biggest side effect of colchicine? ✔✔diarrhea How would you describe the appearance of molluscum contagiosum? ✔✔papules that are umbilicated and contain a caseous plug How do we treat a broken clavicle in an infant? ✔✔no treatment; it should heal on it's own At what week of pregnancy is the uterus palpable just above the pubic symphysis? ✔✔week 12 At what week of pregnancy is the fundus palpable halfway between the pubic symphysis and umbilicus? ✔✔week 16 At what week of pregnancy is the fundus of the uterus at the umbilicus? ✔✔week 20 At what week of pregnancy is the fundus of the uterus halfway between the xiphoid process and umbilicus? ✔✔week 28 At what week of pregnancy is the fundus just below the xiphoid process? ✔✔week 34 Increased sweat production is a sign of what endocrine disorder? ✔✔hyperthyroidism
What is Paget's disease? ✔✔there is localized increased bone turnover and blood flow resulting in the breakdown of bone and replacing it with weakened and highly vascular bone putting the indiv at increased risk of fractures How do we treat Paget's diseease? ✔✔bisphosphonates How should pregnant women wear their seatbelt? ✔✔with the shoulder strap like a normal person and then the groin strap below the belly and across the hips What is another name for fifth disease? ✔✔parvovirus aka slapped cheek disease aka erythema infectiosum Which type of prevention are vaccinations? ✔✔primary When should patients begin antiretroviral therapy for HIV infection? ✔✔as soon as it is detected, even if in the acute phase What are the first generation antihistamines? ✔✔diphenhydramine (benadryl) and chlorpeniramine (actifed) What are s/s of the secondary stage of syphilis? ✔✔rash on hands and feet, lymphadenopathy, fever What is the recommended treatment for chronic bacterial prostatitis? ✔✔a fluoroquinolone (cipro or levo) + bactrim What is the recommended treatment for acute prostatitis? ✔✔cipro (if not STI related) or ceftriaxone What are s/s of an intraductal breast papilloma? ✔✔clear to bloody unilateral nipple discharge (bilateral is usually benign), and also a wart like lump palpated in the nipple area
If a patient is on Coumadin but then they may need to go on Rifampin, what should you do? ✔✔Rifampin decreases INR so we'd want to increase the coumadin dose If a patient on coumadin's INR is 3.1-4 ,what should you do? ✔✔decrease the weekly dose by 5- 10% If a patient on coumadin's INR is 4.1-5.0, what should you do? ✔✔hold one dose then decrease the weekly dose by 10% If a patient's INR is greater than 5, what should you do? ✔✔consult cards, likely would hold two doses then decrease the weekly dose An anorexic patient will have a BMI of what? ✔✔less than 18 What is primary amenorrhea? ✔✔when the patient has never gotten their period before (there is an absence of menarche) but they have all of their secondary sex characteristics Secondary amenorrhea is a lack of menses after _________ of not having a period; but you have had one before ✔✔3 months What do we need to do first when a patient comes in with secondary amenorrhea? ✔✔rule out pregnancy Anorexia can put you at risk for what? ✔✔osteoporosis, amenorrhea, cardiac damage Amenorrhea is considered a risk factor for what? ✔✔osteoporosis What is the best indication of an anorexic patient doing better? They tell you they are eating more, they have weight gain, or they get their period back? ✔✔they get their period back
If a pregnant woman has syphilis, what should we do? ✔✔treat it with penicillin while she is pregnant because there is risk for spontaneous abortion What is the causative organism of mastitis? ✔✔staph What is the first line treatment for mastitis? ✔✔keflex (a cephalosporin). If that doesn't work, then try another antibiotic. If that STILL doesn't work, then refer for an ultrasound What is one of the biggest risk factors for cervical cancer? ✔✔numerous sexual partners Preeclampsia most commonly shows up at what time in pregnancy? ✔✔around week 20 How do we treat UTIs in a pregnant woman? ✔✔can either do penicillin, cephalosporin, or a macrolide (can NOT do doxy or a fluoroquinolone) When do fibrocystic breasts tend to flare up and cause tenderness and lumps? ✔✔about 10 days before menses What can be a sequelae of an ectopic pregnancy? ✔✔pelvic inflammatory disease and infertility due to scarring of the fallopian tube (salpingitis) What is the Coomb's test and when is this completed? ✔✔test given 8 weeks in to pregnancy to determine a woman's RH compatibility If a patient's Coomb's test is positive, what do we do? ✔✔nothing, she is RH positive so we do not need to treat If a patient's Coomb's test is negative, what do we do? ✔✔give rhogam at 28 weeks and 72 hours after birth
What is placenta previa? ✔✔when the placenta blocks the cervical opening of the uterus What is placenta abruptio? ✔✔when the placenta either fully or partially detaches from the uterine wall When does placental abruption most commonly occur? ✔✔in the third trimester What is the major difference in symptomalogy between placenta abruptio and placenta previa? ✔✔a placental abruption is painful whereas placenta previa is painless If a pregnant woman comes in with painless vaginal bleeding, what should we be considering? ✔✔placenta previa What is the recommended treatment for polymyalgia rheumatica? ✔✔steroids Patients with SLE are going to have what abnormal labwork? ✔✔elevated ESR and CRP How do we treat lupus flares? ✔✔steroids What are common sequelae of fibromyalgia? ✔✔insomnia and depression What is a great treatment option for fibromyalgia? ✔✔amitriptyline (a TCA) because it helps with chronic pain, sleep, and depression How is fibromyalgia diagnosed? ✔✔when at least 8 out of 11 points bilaterally are tender to touch and the symptoms have lasted longer than 3 months What is slipped capital femoral epiphysis? ✔✔when the femoral head of the hip is out of place
What is the trendelenburg sign and when is it positive? ✔✔when the patient is standing straight and the pelvis on the unaffected side drops; this is a sign of a slipped capital femoral epiphysis What is the main characteristic of a slipped capital femoral epiphysis? ✔✔walking with a limp SCFE is most common in which patient population? ✔✔adolescents What is legg-calve-perthe disease? ✔✔avascular necrosis of the femoral head due to a lack of blood supply Legg-calve-perthes disease is most common in which patient population? ✔✔young children What is the radiographic study of choice for the knee? ✔✔MRI What is the radiographic study of choice for the back? ✔✔x ray What is bursitis? ✔✔a fluid collection in the bursa of a joint How is bursitis treated? ✔✔a needle to instill intraarticular steroids and then pull off fluid Bursitis can be a __________ issue ✔✔recurrent The medical term for knock knees ✔✔genu valgum The medical term for bow legs ✔✔genu varum What is myasthenia gravis? ✔✔an autoimmune disorder that causes muscle weakness of the voluntary muscles
What is the hook test? ✔✔used to assess for a bicep tendon issue How do we treat any rotator cuff injuries? ✔✔wear a sling to stabilize the arm and refer to ortho How long do migraine headaches last? ✔✔ 4 - 72 hours How can we abort cluster headaches? ✔✔calcium or 100% oxygen application Which type of headaches come with lacrimation and sinus symptoms? ✔✔cluster headaches What does the apprehension test assess for? ✔✔used to assess for stability of the shoulder or knee; assesses for stability How does the parathyroid gland regulate calcium? ✔✔when parathyroid hormone is released, it pulls calcium out of the blood and into the circulation in response to hypocalcemia. it also increases absorption of calcium from the intestine What is the first line treatment for trigeminal neuralgia? ✔✔carbamazepine (tegretol) or amitriptyline. also want to do gabapentin or something for nerve pain What is the recommended treatment for Bell's palsy? ✔✔steroids and anti-virals How is the pain of trigeminal neuralgia vs temporal arteritis different? ✔✔in trigeminal neuralgia, the pain is like a shock hitting the side of your face whereas temporal arteritis is more like a headache What are the preventative treatment options for migraines? ✔✔beta blockers, amitriptyline, venlafaxine, topamax, valproate
What is Addison's disease? ✔✔adrenal insufficiency; the patient will be low in cortisol and sodium but their potassium will be high What are s/s of Addison's disease? ✔✔bronze or discolored skin, salt cravings a rare complication of pregnancy characterized by the abnormal growth of trophoblasts, the cells that normally develop into the placenta ✔✔molar pregnancy What bacteria is the leading cause of urethritis? ✔✔neisseria gonorrhea What is the most common cause of hypercortisolism? ✔✔excessive ACTH production How do we treat developmental hip dysplasia in a child under 6 months? ✔✔Pavlik harness; if older than 6 months may need surgery It is recommended that all children younger than __________ with sickle cell anemia take daily prophylactic antibiotics. What antibiotic is this? ✔✔5 years old; penicillin When can cervical cancer screening stop if no abnormal screening history is present? ✔✔age 65 When should breast cancer screening begin and end with a biannual mammogram? ✔✔age 50- 74 When should colorectal cancer screening stop? ✔✔age 85 Who qualifies for a low dose CT scan for lung cancer screening purposes? ✔✔age 50-80 years anyone who currently smokes or has stopped smoking within the last 5 years
a normal rise in blood sugar as a person's body prepares to wake up due to a release of cortisol and growth hormone ✔✔dawn phenomenon How can you tell between the dawn and somogyi effect? ✔✔If the blood sugar level is low at 2 a.m. to 3 a.m., suspect the Somogyi effect. If the blood sugar level is normal or high at 2 a.m. to 3 a.m., it's likely the dawn phenomenon. A 14yo male with bronchitis is being treated with fluids and expectorants. He returns to the clinic with a fever of 103F, right pleuritic chest pain, and green sputum. Which of the following examination results would be expected? A. Right lower lobe crackles B. Decreased Fremitus C. Bilateral Wheezing D. Normal Percussion ✔✔A. Right lower lobe crackles. 2 year old child is diagnosed with radial head subluxation ("nursemaid's elbow"). After closed manipulation, the best indication of successful treatment is that: A. Swelling dissipates immediately B. Pulse and sensation are restored C. The child quickly begins to use the affected arm D. A click is felt while the child is extending and rotating the arm ✔✔C. The child quickly begins to use the affected arm. Which of the following would be an appropriate alternative to erythromycin therapy in an 18 year old patient with Mycoplasma pneumoniae infection? A. Azithromycin (Zithromax) B. Cephalexin (Keflex) C. Amoxicillin D. Clindamycin (Cleocin) ✔✔A. Azithromycin
A 10-month old presents with a rash, runny nose, and cough. Examination reveals a cluster of tiny white papuls with an erythematous base on the buccal mucosa. What does this suggest? A. Scarlet fever B. Rubella C. Erythema infectiosum D. Measles ✔✔D. Measles Office Spriometry performed with an albuterol nebulizer treatment can confirm a diagnosis of asthma because it indicates: A. Oxygen saturation B. Whether airway obstruction is from pulmonary fibrosis C. Chronic carbon dioxide retention D. Whether a patient has reversible airway obstruction ✔✔D. Whether a patient has reversible airway obstruction An 18yr old patient presents with complaints of maxillary facial pain and yellow nasal discharge for 14 days. What is the appropriate initial pharmacologic intervention? A. Amoxicillin-Clavulanate (Augmentin) B. Ceftriaxone (Rocephin) C. Levofloxacin (Levaquin) D. Erythromycin ✔✔A. Amoxicillin-Clavulanate (Augmentin) Which of the following is the leading cause of cancer-related deaths in the majority of women? A. cervical Cancer B. Ovarian Cancer C. Breat Cancer D. Lung Cancer ✔✔D. Lung Cancer A 29-year old male with noncomplicated Chlamidia infection may exhibit:
D. Dementia, delirium, and pna ✔✔B. Depression, Unresolved grief, and hypothyroidism The parent of a 13-year old diagnosed with seizure disorder calls to report that the child is exhibiting symptoms of a cold, but has no fever. The nurse practitioner should advise the parent that development of fever may: A. make the seizure medication less effective B. Lower the seizure threshold C. Increase the seizure threshold D. Have no effect on the seizure threshold ✔✔B. Lower the seizure threshold After a 3-week camping trip, an 11-year old is seen for a target lesion with central clearing, located in the inguinal area. The patient has had a severe headache, malaise, fatigue, and generalized musculoskeletal pain for several days. Pharmacologic management of this condition includes: A. trimethoprim-sulamethoxazole (Bactrim) B. Azithromycin (Zithromax) C. Metronidazole (Flagyl) D. Doxycycline (Doryx) ✔✔D. Doxycycline An 88 year old male presents with concerns about memory loss. He feels good, takes an aspirin daily, and has no chronic diseases. He lives alone, drives his own car, and manages his financial affairs. To evaluate his memory, which of the following tests should the nurse practitioner choose? A. Folstein Mini-Mental State examination B. Geriatric Depression Scale C. Minnesota Multiphasic Personality Inventory Myers-Briggs Test ✔✔A. Folstein Mini-mental state examination During development of a treatment plan for an 84 year old patient with hypothyroidism, the nurse practitioner has to keep in mind the worsening of: A. renal insufficiency
B. Osteoporosis C. Dementia D. Anemia ✔✔B. Osteoporosis A 16 year old female in the first month of taking Ortho-Novum 7/7/7 complains of midcycle spotting. She hasn't missed any doses and uses no other medication. Which of the following is appropriate? A. Modifying use B. Double dosing for 2 days C. Changing to Ortho-Novum 1/ D. Providing reassurance ✔✔D. Providing reassurance The management of choice for polymyalgia rheumatica includes: A. whirlpool B. Prednisone C. Anelgesics D. Celebrex ✔✔B. Prednisone A 50 year old male presents with a chief complaint of malaise. Further questioning reveals that his primary concern is delayed ejaculation. He is currently taking the following medications: atenolol (Tenormin), 50 mg daily; paroxetine (Paxil), 20 mg daily; loratadine (Claritin-D), 1 tablet daily; and hydrochlorthoriazide (HCTZ), 25 mg daily. The most likely cause of the patient's concern would be: A. loratadine B. hydrochlorthoriazide (HCTZ) C. lisinopril (Zestril) D. paroxetine (Paxil) ✔✔D. Paroxetine (Paxil) A 3 year old patient presents at an inner-city clinic with fever, cough, malaise, and loss of appetite. The patient lives with several relatives, including a grandmother who also has a cough. Which of the following diagnostic tests would be most appropriate for the patient?
Which of the following is NOT an indication of preeclampsia? A. visual disturbances B. Glucosuria C. Edema of the face and hands D. Headaches ✔✔B. Glucosuria Which of the following pharmacotherapeutics would be most important to administer to a patient who has a corneal abrasion? A. Olopatadine (Patanol) B. Cromolyn opthalmic (Crolom) C. Timolol (Timoptic) D. Gentamycin Opthalmic (Genoptic) ✔✔D. Gentamycin Opthalmic (Genoptic) An 88 year old patient presents with right-sided weakness after being unable to rise unassisted following a fall to the bathroom floor. History includes aphasia and noncompliance with hypertension medication regimen. What is the most likely diagnosis? A. Seizure B. Right-sided Stroke C. Left-sided stroke D. Trans ischemic attack ✔✔C. Left-sided Stroke A nurse pracitioner is evaluating a 40 year old patient suspected of having a pulmonary embolus. The patient complains of anxiety and cough. A stat chest x-ray is normal. Which of the following tests should the nurse practitioner perform next? A. Spirometry B. MRI C. Contrast venography D. Helical CT pulmonary angiography ✔✔D. Helical CT pulmonary angiography
A routine laboratory assessment of a 12 year old patient with a family history of thalassemia and anemia reveals Tanner II presentation and Hct=355. In addition to a complete blood count (CBC), the nurse practitioner should order which of the following? A. serum folic acid B. Vitamin B12 level C. Hemoglobin Electrophoresis D. 24-hour urine creatinine ✔✔C. Hemoglobin electrophoresis A patient who is 28 weeks pregnant reports a single episode of vaginal bleeding. History indicates normal prenatal progress to date, and the patient denies pain, vaginal itching, or discharge. Which of the following is the most appropriate intervention to aid in the diagnosis of this case? A. Nitrazine test B. Non-Stress test C. Ultrasound D. Bimanual cervical exam ✔✔C. Ultrasound The common bacteria responsible for pneumonia in older adults residing in the community is: A. Staphylococcus aureus B. Streptococcus pneumoniae C. Pseudomonas Aeruginosa D. Moraxelle catarrhalis ✔✔B. Strep Pneumo A 40 year old male patient presents with a 2 week history of rectal pain and itching. He reports a past history of constipation, and finding spots of bright red blood on toilet paper several times a week. Rectal exam reveals a tender, swollen, bluish, ovoid mass. The stool guaiac test is negative. Which of the following actions should the nurse practitioner take? A. Prescribe diphenoxylate/atropine( Lomotil) B. Schedule a colonoscopy to rule out colon cancer C. Repeat the guaiac test three times and obtain complete blood count
