APEA 3P Actual Exam Test Bank with 100% Correct Verified Answers, Exams of Community Health

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2024 APEA 3P ACTUAL EXAM {TEST BANK}

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150) A 74 y/o man who recently lost his spouse of 50 years in an auto accident tells the

NP that“ he has no purpose in this life”

a. Have you told your family how you feel?

b. Have you thought about hurting yourself?

c. Are you taking your medication?

d. Do you have any friends?

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151) A 67 y/o woman with Hx of A-fib and an ejection fraction of 48% has had normaldigoxin levels. Which can cause a decrease of digoxin level?

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a. Decrease creatinine clearance

b. Weight loss

c. Increase exercise

d. Regular use of antacid

152) 5-alpha reductase inhibitor work to improve symptoms of benign prostatic hyperplasia by?

a. Decreasing the size of the prostate

b. Increasing blood flow to the prostate

c. Relaxing smooth muscle in the bladder neck

d. Relaxing smooth muscle in the prostate capsule

5-alpha reductase such as finasteride reduced amount of dihydrotestosterone in the prostatecausing it to shrink. This helps you to pass urine more easily.

153) which medication is indicated for patients with generalized anxiety disorder?

a. Buspirone (Buspar)

b. Citalopram (Celexa)

c. Imipramine (Tofranil)

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d. Bupropion HCL (Welbutrin)

Buspirone (Buspar) is an antianxiolytic, the other choices are antidepressants

154) pregnant women are evaluated for syphilis with serology testing because:

a. Syphilis during pregnancy predisposes the fetus to spontaneously abort orthe newborn to have congenital syphilis

b. Hormonal changes associated with pregnancy may trigger activation of latent syphilis

c. Syphilis may be passed to the fetus beginning in the third trimester

d. Untreated syphilis can cause neonatal respiratory distress

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Syphilis can seriously complicate pregnancy and result in spontaneous abortion, stillborn, non- immune hydrops, intrauterine growth restriction and perinatal death, as well as liveborn infectedchildren

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155) when treating a patient with asthma who is experiencing acute wheezing, which medicationshould be given to relieve the symptoms?

a. Short acting bronchodilator

b. Long acting bronchodilator

c. Inhaled corticosteroid

d. Combination of methylaxanthine and long acting bronchodilator

156) Recommended combination therapy for uncomplicated anorectal and pharyngealgonorrhea is?

a) Ceftriaxone and benzathine penicillin

b) benzathine penicillin and doxycycline

c) Doxycycline and ciprofloxacin

d) Ceftriaxone and azithromycin

157) An example of synovial joints would be

a) Vertebrate bodies of the spine

b) Scalp

c) Shoulder

d) Pubic symphysis of the pelvis

1. Rh negative women should receive Rho (D) immunoglobulin at what gestational time? a) 6 weeks

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b) 12 weeks

c) 28 weeks

d) 35 weeks

What happens is the client is Rh negative and has a negative antibody screen? She will need repeat antibody screens and should receive Rho(D) immune globulin (RhoGAM) at 28 weeks' gestation (Quizlet Antepartum Diagnostic Testing Saunders)

2. When interpreting a complete blood count (CBC) lab report which of the followingresults describes the size of the RBCs?

a) Hemoglobin

b) Mean corpuscular volume (MCV)

c) Red cell distribution width (RDw)

d) Hematocrit

The mean corpuscle (cell) volume (MCV) is a measurement of the average size of the RBCs. Small-sized RBCs result in a lower MCV, while larger RBCs result in a higher MCV.

3. What medication should be avoided when prescribe prophylactic therapy for headache a) Verapamil

b) Propranolol

c) Venlataxin (Effexor)

d) Nimodipine

Serotonin Norepinephrine Reuptake inhibitor have the most serious side effect. Patients should have drug free period for 3-4 weeks after every 6 months of treatment (pharmacology book page1047)

4. What is the mechanism of action of prostaglandin E1 (PG1) in a patient with transpositionof the great arteries

a) To maintain equal pressure in the ventricles

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b) To maintain patency of the great arteries

c) To produce vasodilation on …………….

d) To prevent cyanotic episodes by trapping blood in the lower …………

5. Which of the following complaints best describes lower extremity calf pain associatedwith peripheral artery disease

a) A sharp stabbing pains

b) A dull pain or cramp

c) An electric shock

d) A pulsating pain

Peripheral artery disease signs and symptoms include: Painful cramping in one or both of yourhips, thighs or calf muscles after certain activities, such as walking or climbing stairs (claudication) Leg numbness or weakness. Coldness in your lower leg or foot, especially whencompared with the other side. (Mayoclinic)

6. When performing a visual acuity test the nurse practitioner notes 20/30 in the left eyeand 20/40 in the right eye using the Snellen eye chart. This means:

a) have the patient returning in two weeks for a follow up vision screen

b) dilated the eye and retest

c) refer the patient to an ophthalmologist

d) document this as a normal finding

7. The American psychiatric association’s diagnostic and statistical manual of mentaldisorder defines Munchausen Syndrome By Proxy

a) a self-inflicted injury to gain attention

b)

c) an

abusive behavior that does not involve the caregiver

a caregiver making up or causing an illness or injury in a person under

his orher care

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d) a situation in which the abuser is often inattentive and uncaring toward the victim

Munchausen syndrome by proxy is a mental illness and a form of child abuse. The caretaker of a child, most often a mother, either makes up fake symptoms or causes real symptoms to makeit look like the child is sick.

8. Symptoms of depression are a side effect of which neurotransmitter medication?

a) dopamine serotonin, norepinephrine

b) gabapentin

c) mil

d) cortisol

9. Which lesion is dark raised and asymmetric with irregular border? Quizlet Bates Chapter

20

a) Nevus

b) Actinic keratosis

c) Keratoacanthoma

d) Melanoma

10. A 32 years old woman presents with dull puffiness of the ayes pronounced notpitting periorbital edema this finding is suggestive of this condition?

APEA

a) Nephrotic syndrome

b) Myxedema

c) Cushing syndrome

d) Sinusitis

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Myxedema is a deposition of mucopolysaccarides in the dermis. Is commonly found if patients with advanced hypothyroidism. The classic skin changes are: swelling of face, lips, eyelids, and tongue or swelling and thickening of skin anywhere on the body, especially in the lower legs.

Myxedema is the hallmark of Grave’s disease, an autoimmune form of hyperthyroidism. Myxedema can also occur in Hashimoto’s thyroiditis a form of hypothyroidism.

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11. A 42 years old woman with a past medical history of migraine headaches is requesting prophylactic medication treatment. Which medication should the Nursepractitioner prescribe?

a) Sumatriptan (Imitrex)

b) Amitriptyline (Elavil)

c) Verapamil (verelan)

d) Metoprolol (Lopressor)

Amitriptyline (Elavil) is a tricyclic antidepresant and is considered offlabel use for prophylactic treatment of migrane. Sumatriptan (Imimtrex) Is aTriptans used to abort migraine

12. A pediatric patient has areas of scaling on the scalp with round patches of alopecia.This clinical finding is consistent with:

a) Tinea capitis

a) Seborrheic dermatitis

c) Trichotillomania

d) Alopecia areata

13. What is the appropriate prophylactic medication for an 18 years old woman with apast medical history of migraine headaches? a) Sumatriptan

(Imitrex)

b) Propanolol

(Inderal)

c) Ibuprofeno (motrin)

d) Dihydroergotamine (DHE)

14. Why would a combined hormonal contraceptive be contraindicated in a 36 year old patient with a past medical history of type 2 diabetes, obesity, chronic smoking andsedentary life

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a) She is obese

b) She has type 2 diabetes mellitus

c) Her age and tobacco use

d) She leads a sedentary lifestyle

Combined oral contraceptive is contraindicated in women older than 45, breastfeeding, smoking,HTN, diabetes or hx of stroke

15. During the breast examination of a perimenopausal woman the NP detects abloody spontaneous discharge from the right nipple. This indicates further evaluation.

a) Fibroadenoma

b) Polycystic breast disease Generalized breast pain or tenderness. Green or dark brown

nonbloody nipple discharge that tends to leak without pressure or squeezing

c) An intraductal papilloma

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d) Pituitary prolactinoma

Intraductal papillomas are usually solitary and smaller than 1 cm. They are located in large lactiferous sinuses or ducts and have a tendency to bleed. Quizlet Nipple Discharge

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16. Which of the following conditions is NOT a typical finding of hyperprolactinemia in a47- year-old premenopausal woman?

a) Hirsutism

b) Gynecomastia

c) Oligomenorrhea

d) Acne

Hyperprolactinemia causes typical symptoms in premenopausal women and in men, but not in postmenopausal women. Premenopausal women — Hyperprolactinemia in premenopausalwomen causes hypogonadism, with symptoms that include infertility, oligomenorrhea, or amenorrhea and less often galactorrhea. (uptodate.com/clinical- manifestations)

17. When treating a patient with asthma who is experiencing acute wheezing whichmedication should be given to relieve the symptom?

a) Short acting bronchodilator

b) Long acting bronchodilator

c) Inhaled corticosteroid

d) Combination of methylxanthine and long acting bronchodilator

Short-Acting Beta Agonist (SABA) inhalers; used for acute asthma attacks; quickly reduce airway constriction & restore normal airflow; agonists/stimulators of adrenergic receptors in SNS (sympathomimetics); albuterol (Ventolin), levalburterol

(Xopenex), pirbuterol (Maxair),terbutaline (Brethine), metaproterenol (Alupent). (Quizlet Pharm Ch 37 Respiratory drugs)

18. Which immunization reduces a patient’s risk for infection with the virus that causespainful localized blistering rash?

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a) Smallpox vaccine

b) Varicella vaccine (chicken Pox)

c) Shingles (herpes zoster) vaccine

d) Meningococcal vaccine

Shingles (herpes zoster) is an extremely painful skin rash caused by the varicella zoster virus, thesame virus that causes chickenpox. In people who have had chickenpox, the virus is never fully cleared from the body; instead, it remains dormant in the nerve tissues.

(medicinet.com/shingles)

c) On an empty stomach between meals

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19. Headache warning signs that need prompt investigation include all of thefollowing EXCEPT:

a) new onset after age 50

b) aggravated or relieved by change of position

c) precipitated by Valsalva maneuver

d) Headache relieved with mild infrequent use of analgesics

20. The client with iron deficiency anemia should be advised to take the iron supplement

a) With milk to avoid stomach upset

b) With milk of magnesia at bedtime to avoid constipation

d) For 30 days to 5 weeks

Because iron is best absorbed on an empty stomach, patients should be advised to take the supplement an hour before meals. Most patients can use the less expensive, more standard formsof ferrous sulfate (Quizlet Hematology Cht 33)

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21. Which one of the following statements is true of Munchausen syndrome by proxy?

a) The injury is self-inflicted as the patient is seeking attention from others

b) Under the supervision of adults other than the abuser, the patient does notexhibit

symptoms

c) The caregiver is usually not involver in the abusive behavior

d) The abuser is often inattentive and uncaring towards the victim

Munchausen syndrome by proxy (MSP) is a mental illness. It is also a form of child abuse. Itaffects caregivers, especially caregivers of children. It is also known as factitious disorder byproxy. Mothers of small children are most often affected by this condition. Fathers or other caregivers can have it as well.

22. Which of the following is the most common presenting sign of substance abusein adolescents?

a) Poor school performance

b) change in sleep habits

c) increased blood pressure

d) changes in behavior

23. A woman is 11 weeks pregnant and has a maternity history of one full term vaginal delivery, a set of premature triplets delivered vaginally, and a first trimester abortion. Using her TPALsystem to document her maternal status

a) Gravida 4 para 1114

b) Gravida 4, para 1314 4 is the number of living children GTPAL

c. Gravida 3, para 1114

c) Gravida 3, para 1112

Gravida, Term babies, Preterm babies, Abort and Living child

24. The nurse practitioner palpates an enlarged right epitrochlear lymph node in a 30

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yearsold patient. The Nurse Practitioner should asses the patents

a) Throat, face, and right ear

b) Neck and supraclavicular region

c) Right forearm and hand

d) Right groin and abdomen

Lower arm and hand for erythema and swelling

25. Anticholinergics are indicated for the treatment of

a) Asymptomatic bacteriuria

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b) Renal insufficiency

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c) Urge incontinence

d) Overflow incontinence

Anticholinergics are drugs that block the action of acetylcholine. Anticholinergics can treat avariety of conditions, including: urinary incontinence, overactive bladder, COPD, They alsohelp block involuntary muscle movements associated with certain diseases such as Parkinson’s disease.

26. A patient presents with signs of chest pain, the nurse practitioner observes jugularvenous distention. Their finding is consistent with

a) Hypertension

b) Heart failure

c) Asthma

d) Pneumonia

Heart failure causes decreased cardiac output when the heart fails as a pump and the circulationbecomes backed up and congested. Signs and symptoms: dyspnea, orthopnea, paroxysmal nocturnal dyspnea, decreased blood pressure, dependent, pitting edema; anxiety; confusion; jugular vein distention; fatigue. The S3 may be the earliest sign of heart failure.(Studyblue)

27. On examination of the neck, a dome shaped lesion in the dermis forming a benign closedfirm sac attached to the epidermis is noted on the right lateral side of the neck. The type of lesion is known as

a) Keloid

b) Tophi

c) A cutaneous cyst

d) Chondrodermatitis

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Dome-shaped lump in the dermis forms a benign closed firm sac attached to the epidermis. A dark dot (blackhead) may be visible on its surface. Usually either an Epidermoid cyst (commonon face/neck) or pilar (trichilemmal) cyst (common in the scalp). Both may become inflamed. Error! Filename not specified.

28. Symptoms of heartburn and regurgitation are associated with:

a) Hiatal hernia

b) Gastroesophageal reflux

c) Peptic ulcer disease

d) Esophageal cancer

Classic GERD symptoms are: Heartburn, Regurgitation: bitter, acidic fluid in the mouthwhen lying down or bending over

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29. A 70 years old man walks 20 minutes most days of the week. He has begun to complain ofpain of his left calf when he is walking. The problem has gotten gradually worse and now he

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is unable to complete his 20 minutes walks without stopping to rest. What choicebest describes the pain associated with peripheral artery disease?

a) A sharp, stabbing pain

b) A dull pain and cramp

c) An electric shock

d) A pulsating pain

Peripheral Artery disease signs and symptoms include: Painful cramping after certain activities, such as walking or climbing stairs (claudication), Leg numbness or weakness, Coldness in leg or foot, especially when compared with the other side, Sores on toes, feet or legs that won't heal,A change in the color , Hair loss or slower hair growth, Shiny skin, No pulse or a weak pulse in legs or feet

30. Papilledema is a cause for concern because it is suggestive of

a) Optic atrophy

b) Microaneurysms

c) Increased intracranial pressure

d) Retinal hemorrhage

Papilledema is the swelling of the optic disc caused by increased intracranial pressure.

31. A 38-year-old patient with a history of abdominal pain presents to the nurse practitioner.Findings reveal superficial edema and bruising in the subcutaneous fatty tissue around the umbilicus. Hemorrhagic pancreatic is suspected because of which finding?

a) A positive Gray Turner’s sign

b) A positive Cullen’s sign

c) Kaposi’s sarcoma

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d) Petechiae