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APEA Exam Questions and Answers
- An 18 - year old female applying for college admission presents to the health clinic because evidence of rubella vaccination is required for admission. She says” I don’t ever remember getting that shot” she has a negative serologic evidence of rubella antibody. The nurse practitioner should: a. Administer the vaccination after negative pregnancy test and advise the patient that she must not get pregnant for 28 - days.
- An overweight male complains of low back pain after helping to move a refrigerator over 2 days ago. To avoid future problems, the nurse practitioner should teach him: a. Exercises to strengthen his lower back
- Infants with celiac disease (gluten enteropathy) are at risk for multiple complications. The most urgent complication of the disease is: a. Intussusception or volvulus
- An elderly patient’s digoxin level has decreased to 0.4 ng/dl and she has begun to have atrial fibrillation again. For the past 14 months, her digoxin level had been well
controlled when her digoxin level was 1.4 to 1.5 ng/dl. What could not have accounted for this change in digoxin level? Normal digoxin level is (0.8-2 ng/dl). a. Decreased creatinine clearance
- An 83 - year-old man has a resting tremor. What disease process is this type of tremor most commonly associated with? a. Parkinson’s disease
- A 70 - year-old patient presents with left lower quadrant abdominal pain, markedly tender palpable abdominal wall, fever, and leukocytosis. Of the following terms, which correctly describes the suspected condition? a. Diverticulitis
- A 16 - year-old sexually active female presents to the clinic. She has never had vaccinations for hepatitis A or B, she has had one MMR immunization, and her last
tetanus vaccination was four years ago. Which vaccination would be contraindicated without further testing? a. MMR
- Patients with human immunodeficiency virus (HIV) are at increased risk for pneumocystis carinii pneumonia (PCP) which is associated with significant morbidity and mortality. For this reason, prophylaxis is recommended. Which of the following is inappropriate drug for PCP prophylaxis? a. Trimethoprim-sulfamethoxazole Bactrim)
- A 15 - year-old female reports she is a strict vegetarian. Which of the following is the most appropriate response by the nurse practitioner? a. Include a wide variety of legumes, enriched grains, nuts, and seeds in your diet
- Right sided heart failure is characterized by all of the following clinical findings except: a. A fourth heart sound
- The nurse practitioner diagnoses eczema on the cheeks of a two-year-old female. The patient’s mother explains that she is embarrassed to take the child in public because her face is so red, dry, and crusted. She asked for a “strong” cortisone cream so the eczema will clear rapidly. The nurse practitioner knows that: a. A high potency cortisone cream may cause atrophy, telangiectasia, purpura, or striae if used on the face
- A patient presents with a normal complete blood count and a positive stool for occult blood. The nurse practitioner decides to repeat this stool for occult blood after having the patient eliminate certain foods from the diet for 72 hours. Which of the following should be included in the list of foods to omit? a. Steak
- Which term most accurately describes the prostate gland of a patient with prostate cancer? a. Hard
- A 30 year old female patient presents to the clinic with heat intolerance, tremors, nervousness and weight loss inconsistent with appetite. Which choice below would be most helpful in identifying the etiology of this patient’s complaints?
a. A serum thyroid stimulating hormone level
- Diagnosis of systemic lupus erythematosus (SLE) is made: a. Considering symptom complex with confirmation by laboratory tests
- A three-year-old female with a palpable right upper quadrant abdominal mass, anemia, and fever is being evaluated for Wilms’ tumor. Which of the following diagnostic test would be most useful? a. Abdominal ultrasound
- In July 1996, the advisory committee on immunization practices of the centers for disease control and prevention issued which of the following recommendations for the use of the live attenuated varicella vaccine? a. Varicella vaccine has been approved for routine use and all healthy children age 12 months to 12 years
- Advances in obstetrics in neonatal care have: a. Had no effect on the incidence of cerebral policy
- What is the most common chronic condition in the elder population in the United States? a. Arthritis
- In comparing sensitivity to specificity, sensitivity refers to a: a. True positive
- The best way for a pregnant woman to avoid injury to herself and her fetus in the event of a motor vehicle accident is to: a. Use both the lap and shoulder restraint
- A 25 year old female patient presents for routine well woman exam. On physical examination, the nurse practitioner notes a scant nipple discharge, absence of a palpable mass, and absence of lymph node enlargement. Which of the following is the most likely diagnosis? a. Intraductal papilloma
- A 22-year-old patient has a single, nontender, freely movable lump in her
right breast. She denies any nipple discharge. Which of the following diagnosis is this clinical presentation most consistent with? a. Fibroadenoma
- The most effective treatment for anemia of chronic disease is: a. Treatment of the underlying disease
- A 65 year old African-American patient was screened at his local church for “High cholesterol”. His total cholesterol (nonfasting) was 215mg/dl. What action below is most appropriate for the nurse practitioner? a. Recommend a fasting lipid profile
- A patient report that she is taking kava kava regularly for anxiety with the results. What should the nurse practitioners evaluate? a. Liver function studies
- A person with 20/80 vision: HAS POORER VISION THAN SOMEONE WITH 20/ VISION
- One exception to the recommendation to limit dietary fat intake is CHILDREN UNDER 2 YEARS OF AGE
- The most effective treatment for anemia of chronic disease is: TREATMENT OF UNDERLYING DISEASE Rationale: The key phrase is “anemia of chronic disease” and with this, the pt’s chronic disease has caused the deficiency so once you correct and or treat the chronic disease, then the anemia will correct itself.
- Salicylates and other non-steroidal anti-inflammatory agents have all of the following actions EXCEPT- ANTI-EMETIC EFFECTS VIA SUPPRESSION OF GASTRIC ACID SECRETION
- Which of the following does NOT increase a woman’s risk of developing cervical cancer? NULLIPARITY
- All of the following principles apply to drug therapy for elders except ENCOURAGE
THE ELDERLY TO CONTINUE SELF-MEDICATION ADMINISTRATION TO
FACILITATE INDEPENDENCE AND SELF-SUFFIENCY
- A female patient believes that she was exposed to HIV through sexual intercourse several months ago. She asks for “the test for AIDS.” Which statement is NOT correct? THE ELISA IS USED FOR SCREENING, BUT MAY YIELD A FALSE NEGATIVE THIS SOON AFTER EXPOSURE
- The nurse practitioner teaches the parents of a 2-month-old infant with GERD that treatment typically includes all of the following interventions except MAINTAINING THE USUAL FEEDING REGIMEN AND BURPING THE INFANT WELL WHEN THE FEEDING IS COMPLETED
- A widowed 85 - year-old was recently moved from her home of 65 years to a bedroom in her daughter’s home. According to reports by family members, she is now
“cantankerous” gets “mixed up” easily and cries for no apparent reason. Factors in the client history that are consistent with delirium may include all of the following except a. INSIDIOUS ONSET AND CHRONIC PROGRESSIVE COURSE
- The two tests that can indicate current infection with hep B are: a. Presents of hep B antigen and IgM
- A characteristic of elders which affects the pharmacotherapeutics of drug therapy in that population is an increase in PERCENT OF BODY FAT
- An elder’s caretaker is planning the elder’s menu. The elder is on a bland diet. The nurse practitioner reviews the meal plans and notes that which of the following is NOT appropriate? a. Coffee, tea, carbonated sodas, Orange juice
- The leading cause of death from injury in childhood is MOTOR VEHICE ACCIDENTS
- Therapeutic International normalized ratio (INR) for a patient taking warfarin (coumadin) for a chronic atrial fibrillation is expected to be: a. Increased
- The most accepted recommendation regarding a skin cancer prevention is: a. Avoidance of excessive sun exposure
- Antibiotic administration has been demonstrated to be of little benefit in the treatment of which of the following disease processes? a. Acute bronchitis
- An anxious parent brings her three-day old female infant to see the nurse practitioner because of the serosanguineous vaginal discharge. The nurse practitioner tells the mother:
a. This is a normal finding in female newborns
- A common finding associated with temporal arteritis is: a. Severe headache
- What information would best help the parent who is concerned about a school age child eating habits? a. Establish a consistent schedule for meals and allow the child to participate in meal planning
- Which of the following scenarios in a 75 - year-old patient would be inappropriately managed in an outpatient setting (i.e. the patient should be referred for hospital admission)? a. UNSTABLE ANGINA
- A patient with diabetes brings his glucose diary from the past seven days for the nurse practitioner to review and evaluate. What changes should be made? Day one through seven AM 67, 52, 61, 48, 39, 68, 70 PM 138, 161, 148, 168, 121, 142, 176. a. Decreased the PM dose of NPH insulin
- Appropriate nutritional guidance for the pregnant patient is: a. Increase caloric intake buy 300 cal/day and add iron and folic acid supplementation
- The most successful patient interview is likely to: a. Be a collaborative process
- RhoGAM is not administered to an Rh-negative mother with negative anti-d antibodies WITHIN 72 HOURS OF BIRTH OF AN RH-NEGATIVE INFANT
- A benign thyroid nodule, that’s painless presents as SMOOTH
- Initial treatment of a child presenting with a severe head injury is: a. Aimed at resuscitation, then maintenance of oxygenation and blood flow
- Which red blood cell (RBC) index is most useful for differentiating types of anemias? a. Mean corpuscular volume (MCV)
- A 31 - year-old female is informed that her pregnancy test is positive, and she is about three weeks pregnant. The nurse practitioner is very concerned about the patient reported history of alcohol use. She correctly tells the patient that babies born to women who drink alcohol during pregnancy are at risk for all of the following except:
- The most common presentation of thyroid cancer is A SOLITARY THYROID NODULE
a. Post maturity delivery
- According to Erikson, the developmental task of the early adult is: a. Ego integrity vs. despair
- The parents of a two-year-old Report that she is not saying any words, but make sounds, babbles, and understand simple commands from her parents. The parents are not concerned. The nurse practitioner responds: a. Your child should be saying a few words by this time. She should be referred for further assessment
- Which group is considered to be at high risk for the development of testicular tumors? a. Late adolescence to early adulthood (you need to know the actual age groups)
- An urgent call is received from a patient’s wife who states that her husband is having chest pain I’m relieved by three nitroglycerin tablets. The nearest hospital is 40 minutes away. Besides having the patient reach the hospital as soon as possible, what intervention can the nurse practitioners suggest might influence a positive outcome? A. Have the patient to an aspirin on the way to the hospital
- Which of the following postpartum mothers should receive RhoGAM (BayRho-D) to prevent Rh iso-immunization? a. A G1 P1 mother who is Rh negative without Rh antibodies; cord blood is Coombs negative; newborn is Rh positive.
- A patient with a history of alcohol abuse presents with acute nausea, vomiting, and severe retrosternal pain that radiates to the back. Based on the most probable diagnosis, the nurse practitioner would appropriately order a CBC, chemistry profile, and: a. serum amylase and lipase, and liver function studies
- A female patient asks, “how do I calculate my ideal body weight?” The nurse practitioner response: a. Start with 100 pounds, and add 5 pounds for every inch in height over 5 feet
- A 35-year-old woman with prior history of extreme nervousness has been treated with
- A benign thyroid nodule, that’s painless presents as SMOOTH
- Initial treatment of a child presenting with a severe head injury is: a. Aimed at resuscitation, then maintenance of oxygenation and blood flow
- Which red blood cell (RBC) index is most useful for differentiating types of anemias? a. Mean corpuscular volume (MCV)
- A 31 - year-old female is informed that her pregnancy test is positive, and she is about three weeks pregnant. The nurse practitioner is very concerned about the patient reported history of alcohol use. She correctly tells the patient that babies born to women who drink alcohol during pregnancy are at risk for all of the following except: diazepam (valium) for four weeks. She reports improvement. Today her pulse is 112bpm and blood pressure is 130/92 mmHg. She is 5’4” in weighs 105 pounds. What is the most likely diagnosis?
a. Hyperthyroidism
- Which of the following is not a common early sign of benign prosthetic hyperplasia (BPH)? a. Increased force of urine flow
- Acute idiopathic thrombocytopenia purpura (ITP) is most commonly seen in childhood following: a. Acute infection
- The nurse practitioner diagnosis epididymitis in a 24 - year-old sexually active male patient. The drug of choice for treatment of this patient is: a. Oral doxycycline (Vibramycin) plus intramuscular ceftriaxone
- A 55 - year-old man is diagnosed with basal cell carcinoma. The nurse practitioner correctly tells him: a. It can be cured with surgical excision or radiation therapy.
- A characteristic of delirium that is typically absent and dementia is: a. Acute onset of confusion in a previously alert and oriented patient
- A 42 - year-old male executive has been diagnosed with depression. He is otherwise healthy. And appropriate initial treatment choice is a: a. Selective serotonin reuptake inhibitor (SSRI)
- the CAGE/ AUDIT questionnaire is useful to assess: a. alcohol use disorders (but you need to know a little more about
- A 16 - year-old athlete complains of pain underneath his heel every time he walks. There is verrucous surface level with the skin of the heel. What pharmacologic intervention should the nurse practitioner prescribed for this patient? a. Salicylic acid plasters
- Previously immunized elderly patients should receive a tetanus and diphtheria (Td) booster every: a. 10 years
- The nurse practitioner is canceling a young woman who desires pregnancy. She
discontinued her oral contraceptives for months ago. Her urine pregnancy test is negative. She expresses concern that she might have an infertility problem. The nurse
practitioner accurately tells her that a couple is not considered infertile until there has been unprotected intercourse without conception for what period of time? A. One year
- When a patient presents with symptoms of acute gallbladder disease, what is the appropriate nurse practitioner action? a. Order abdominal ultrasound
- An eight-year-old female has been brought to the nurse practitioner on five occasions in the past nine weeks with a complaint of abdominal pain. The evaluation each time is negative, but her mother is convinced the child is truly experiencing pain. The most likely diagnosis is: a. Recurrent abdominal pain
- What is the most common cause of Cushing’s syndrome? a. Administration of a glucocorticoid or ACTH
- Which of the following maternal situations is considered an absolute contraindication to breast-feeding? a. Early HIV infection
- A three-year-old male patient is being evaluated by a nurse practitioner for frequent respiratory infections and fatigue. His laboratory test show thrombocytopenia, granulocytopenia, and anemia. Which of the following is consistent with these lab bindings? a. Acute lymphocytic leukemia (ALL)
- Factors known to be associated with early sexual activity include: a. Lower socioeconomic status, use of tobacco, alcohol or other drugs, and single parent household
- A 26-year-old female presents with elbow pain that is described as aching in burning. There is point tenderness along the lateral aspect of the elbow and painful passive flexion and extension. She reports she has been playing tennis almost daily for the past month. The most likely diagnosis is:
A. Lateral epicondylitis ------ tennis elbow
- A two-year-old African-American child is being evaluated by the nurse practitioner. His clinical appearance and history are consistent with sickle cell anemia. What is the appropriate laboratory test to diagnose sickle cell anemia? a. Hemoglobin electrophoresis
- Which activities are not characteristic of preschool children? a. Always follow rules during playground games
- What type of question is most useful when opening an interview? a. Open ended
- All of the following agents/ medication classes are generally contraindicated in pregnancy except: a. Cephalosporins, parenteral insulin, parenteral heparin.
- A 35 - year-old female with a history of mitral valve prolapse is scheduled for routine dental cleaning. According to the 2007 American Heart Association’s guidelines for endocarditis prophylaxis, what would you advise this patient? a. She does not need prophylaxis for any dental procedure
- What diabetic complications result from hyperglycemia? a. (1) Retinopathy, (3) peripheral neuropathy, (4) accelerated atherogenesis
- Which of the following diagnostic assessments must be considered before developing any plan of care for a 27 - year-old female presenting to a family practice clinic? a. Pregnancy test
- The process by which a professional association confers recognition that a licensed professional has demonstrated mastery of a specialized body of knowledge and skills is termed: a. Certification
- A 15-year-old male has a history of cryptorchidism which was surgically repaired. Because of this information, it is essential for a nurse practitioner to teach him about:
a. Testicular self-examination
- A 30 - year-old female comes into a clinic with classic signs and symptoms of appendicitis. The nurse practitioner fails to refer the patient tree surgeon. D appendix ruptured and the woman dies. This is an example of: a. Malpractice
- And elderly patient is being seen in the clinic for a complaint of “weak spells” relieved by sitting or lying down. The nurse practitioner checks the patient’s blood pressure while he is lying, sitting, and standing. The nurse practitioner suspects: a. Orthostatic hypertension
- The nurse practitioner knows that the frail elderly alright high risk for malnutrition. Indicators of malnutrition in this population included all of the following except: a. Hunger and increased appetite
- The patient reports, “something flew in my eyes” about an hour ago while he was splitting logs. If there was a foreign body in his eye, the nurse practitioner would expect to find all except: a. A purulent discharge
- Inappropriate initial treatment for external genital warts caused by human papilloma virus (HPV) in a non-pregnant patient is: a. Topical trichloroacetic acid (TCA)
- A new patient presents to the nurse practitioner clinic stating she wants a second opinion. She started propylthioutacil (PTU, Propyl-Thyracil) 75 mg three times today a week ago as therapy for newly diagnosed Graves’ disease. She still feels irritable and jittery. How should the nurse practitioner respond? a. Inform the patient that improvement requires 2 to 3 weeks
- What advice should be given to the parents of an infant at risk for SIDS? a. Place the baby in the supine position for sleeping
- A six-month-old patient with type III metatarsus adductus (i.e., rigid and does not correct to neutral) should be treated with: a. Surgical intervention
- Patient should be advised to purchase the same brand name for each of the following drugs except:
a. Hydrochlorothiazide
- Which activity during the first trimester could be deleterious to the fetus? a. Dieting
- The mother of an 18-month-old child is in the office. She is not yet immunized her child because the child’s grandmother “doesn’t believe in that.” The nurse practitioner should: a. Provide education and recommend beginning of the series of vaccines
- The nurse practitioner is conducting a routine health assessment of a 28- year- old patient. He states he is very “Health conscious” and that he ran 6 miles daily. He denies current Health problems and his past medical history is unremarkable. Routine urinalysis reveals proteinuria. What is the most likely cause of the proteinuria? a. Exercise
- What is the earliest age that MMR immunization can be administered? a. One year
- The nurse practitioner examines a six-year-old who has had a sore throat and fever for less than 24 hours. Based on the most common cause of pharyngitis in this age group, the most appropriate action is to: a. Encourage supportive and symptomatic care
- Physical examination findings consistent with emphysema include all of the following except: a. Pallor and cyanosis of the mucosa nail beds
- Which choice below is not a contraindication to receiving the diphtheria, pertussis, and tetanus (DPT) vaccine? a. Current antibiotic use
- All of the following are included in the differential diagnosis of hyperthyroidism except: a. Plummer’s disease
- A middle-aged patient has a history of smoking, chronic cough, and sputum production. He reports chronic dyspnea. A diagnosis of COPD should be confirmed with: a. Spirometry