APEA PREDICTOR EXAM 2023-2024 REAL EXAM QUESTIONS AND CORRECT ANSWERS WITH RATIONALES|ALRE, Exams of Nursing

Download APEA PREDICTOR EXAM 2023-2024 REAL EXAM QUESTIONS AND CORRECT ANSWERS WITH RATIONALES|ALRE and more Exams Nursing in PDF only on Docsity! APEA PREDICTOR EXAM 2023-2024 REAL EXAM QUESTIONS AND CORRECT ANSWERS WITH RATIONALES|ALREADY GRADED A+|BRAND NEW!! 1).A 15 years old high school student with a mild sore throat and low-grade fever that has persisted for about 3 weeks. She reports general malaise, fatigue, and loss of appetite. The NP suspects mononucleosis. Which of the following is the LEAST appropriate intervention? A.Palpate the lymph nodes and spleen B .Examine the posterior oropharynx for petechiae Obtain a CBC, throat culture, and heterophil antibody test. C. Obtain an urinalyses and serum for LFTs and amylase - ANSWERS- Obtain an urinalyses and serum for LFTs and amylase Explanation: mononucleosis is a symptomatic infection caused by the Epstein-Bar virus. Common is people 15-24 years of age. Common signs and symptoms following incubation period (1-2 months) include fatigue, chills, malaise, anorexia, white tonsillar exudates and lymphadenopathy or posterior cervical region. Splenomegaly can be present. A maculopapular or occasionally a petechial rash occurs in less than 15% of patients. A diagnosis is usually made using the Monospot. In addition, neutropenia and lymphocytosis are usually detected in the CBC 2)A 32 years old male patient complaint of urinary frequency and burning on urination for 3 days. Urinalyses reveals bacteriuria and positive nitrites. He denies any past hx. Of urinary tract infections. The initial treatment should be: a. trimethoprim-sulfamethoxazole (Bactrim, Sulfatrim) for 7-10 day b. ciprofloxacin (Cipro) for 3-5 days c. Trimethoprim-Sulfamethoxazole for 3 days d. 750 mg ciprofloxacin as a one-time dose - ANSWERS- . trimethoprim-sulfamethoxazole (Bactrim, Sulfatrim) for 7-10 day Explanation: trimethoprim-sulfamethoxazole (TMPS) is usually n appropriate medication to treat urinary tract infections in most patients. In the case of community resistance to TMPS >20%^, another medication should be substituted. In men, the appropriate length of time is 7 10 days. Women may be treated for 3 days for uncomplicated UTI 3)Which agent is most effective for the treatment of nodulocystic acne? a.Benzoyl peroxide (Benzac) b.Retinoic acid (Retin A) c.Topical tetracycline d.Isotretinoin - ANSWERS- Isotretinoin Explanation: Isotretinoin (Accutane) is a systemic agent indicated for treatment with severe inflammatory acne. Guidelines for its use must be clearly understood by the patient. A woman of childbearing age must use an effective method of contraception because isotretinoin is 1 There are many restrictions in prescribing this medication because of the teratogenic effects is given during pregnancy. Therefore, it is a pregnancy category X. 4)An 18 y/o woman is taking a combined hormonal oral contraceptive. She should be instructed to use a backup method for the prevention of pregnancy a. Throughout the week of placebo pills b.If prescribed topiramate (Topamax) for the treatment of migraines. c.If prescribed amoxicillin/clavulanate (Augmentin) for a sinus infection d.if she forgets to take a single dose of the contraceptive - ANSWERS- If prescribed topiramate (Topamax) for the treatment of migraines. Explanation: Anticonvulsant including phenytoin (Dilantin), carbamazepine (Tegretol), primidone (Mysoline), topiramate (Topamax) and oxcarbazepine (Trileptal) reduce the effectiveness of contraceptives. Depo-medroxyprogesterone acetate injections or levonorgestrel-releasing intrauterine devices would be a better method of contraceptive for patients taking anticonvulsants. Most commonly used antibiotics have not been proven to reduce the effectiveness of contraceptives. Rifampin is an exception, and additional .... Be used by women taking this drug and using oral contraceptives, transdermal, or vaginal ring preparations. Additional backup contraception should be used if taking antifungal agents. No additional protection is needed thought the week of placebo pills. Missing one single dose of contraceptive does not require additional protection, missing more than one doses does. 5) mmol/L), LDL= 190 mg/dL (4.94 mmol/L), HDL= 25 mg/dL (65 mmol/L), and triglycerides= 344 mg/dL (8.94 mmol/L). What agent have the greatest effect on improving her lipid profile and reducing morbidity and mortality associates with dyslipidemia? a.Atorvastatin b.Niacin (Niaspan) c.Omega 3 fatty acids d.Fenofibrates - ANSWERS- Atorvastatin Explanation: First and foremost, it is essential to educate individuals on a heart-healthy lifestyle. LDL-C is one of the major culprits in the development of atherosclerotic heart disease. The target level of LDL-C is between 50 to 70mg/dl to prevent plaque formation in the blood vessels. Guidelines strongly recommend statin therapy because they primarily lower LDL-C Explanation: The first step is to establish trust in the therapeutic relationship. without trust future collaboration, intervention and client outcome cannot be accomplished to facilitate appropriate and safe behavior. The experience of abuse is a traumatic psychological crisis that must be addressed as such. The healthcare providers must emphasize the fact that the victim has not done anything wrong and they must also emphasize the fact that the victim's life and the lives of their children can be in danger if the abuse is not addressed. It will not disappear with a lack of action. An order of protection against the perpetrator is often recommended. 12) For which patient group does the US Preventive Services Task Force recommend routine screening for asymptomatic bacteriuria pregnant woman . Children Patients with diabetes patients over the age of 70 - ANSWERS- pregnant woman Explanation: an increased incidence of bacteriuria is found in all the population listed. However, bacteriuria in pregnant women increases the mother.....Also increased is the risk of a pre-term delivery, which then increases perinatal and fetal morbidity and mortality. The recommended it 13) What diabetic complications result from hyperglycemia? select all that apply Retinopathy Hypertension resistant to treatment Peripheral neuropathy Accelerated atherosclerosis - ANSWERS- Retinopathy Hypertension resistant to treatment Accelerated atherosclerosis 14) A 6 y/o presents w/ complaints of sore throat and fever for 2 days. He has multiple vesiculated ulcerations on his tonsils and uvula. There are no other remarkable findings. What is the most likely diagnosis? a. Viral pharyngitis b. Herpangina c. Epiglottitis d.Tonsillitis - ANSWERS- Herpangina Explanation: Herpangina is a viral infection common in toddlers and young children caused by Coxsackie virus. The clinical findings of numerous, small (1-2 mm) ulcerations on the tonsils and uvula are typical of herpangina. The ulcerations can be very painful but usually resolve in 7 to 10 days. Treatment is symptomatic. 19) A patient has Kawasaki syndrome. Which characteristics would be UNUSUAL? Age > 15 years . Fever > 101 F (38.3 C) Exudative pharyngitis Painful rash - ANSWERS- Age > 15 years explanation: Kawasaki disease is an acute febrile vasculitis syndrome that evolves inflammation of the blood vessels. This condition often causes cardiac complication in children by damaging the coronary arteries is most prevalent in children of Asian ethnicity. Diagnosis of Kawasaki disease requires presentation of fever and 4 of the following criteria: bilateral bulbar conjunctival injection, oral mucous membrane changes, peripheral extremity changes, polymorphous rash, and cervical lymphadenopathy. 20) According to the JNC 8 guideline hypertension in a 40 y/o can be diagnosed when blood pressure exceeds a.140/90 b.130/90 . c.125/85 d.150/100 - ANSWERS- 140/90 Explanation: According to JNC 8 guidelines, hypertension is a sustained elevation of systolic BP greater than or equal to 140 mmHg or diastolic BP greater or equal than 90mmHg, taken from 2 or more readings on 2 different occasions after an initial screening. 21) A 48 y/o female complains of pain and stiffness in her right hip and knee that is mild on awakening in the morning, get worse as the day progresses and is relived with hot baths and ibuprofen. Crepitus is palpated on range of motion of the knee. Signs of inflammation are notably absent. What is the most likely diagnosis?. Gout Osteoarthritis (OA) Rheumatoid arthritis (RA) d. Osteoporosis - ANSWERS- Osteoarthritis (OA) Explanation: Rheumatoid arthritis is characterized by several joint deformities, usually bilaterally symmetrical. RA is characterized by inflammatory processes, while OA is not. RA and OA are chronic conditions. Gout is characterized by acute exacerbations related to a defect in purine metabolism, increased uric acid production, or decreased uric acid excretion. 22) A 7-year old female patient presents with severe injuries that are inconsistent with the explanation given for them. The nurse practitioner questions the mother about abuse. She admits that her husband, the child's father, beat the child. How should the nurse practitioner proceed? a. Inform the mother that the abuse must be reported to child protection authorities. b.Counsel the mother that if it happens again it will be reported to child protection service. c.Ask the child what she did to cause the punishment d.Refer the family to the National Domestic Violence hotline - ANSWERS- Inform the mother that the abuse must be reported to child protection authorities Explanation: An awareness of all the unique presentations of child abuse, subjective or objective, physical, sexual, or neglect, is essential for NPs. Objective findings, such as broken bones, burns, and bruises, may be as a result of an intentional injury from physical abuse or from an unintentional injury as a result of neglect. Both must be considered. Repeated visits to the emergency department, frequent or suspicious injuries, or bilateral or multiple healing fractures are often indicators of physical abuse. Once the diagnosis of child abuse has been made, the primary role of the NP is to ensure the child is safe. If the NP suspect that a child is undergoing abuse, it's critical to report it—and to continue reporting each separate incidence if it continues to recur. 23) A 1-month-old presents with reported recurrent diarrhea, screaming, and drawing up of the legs followed by periods of lethargy. On physical examination, a "sausage-like" mass in the upper right quadrant of the distended abdomen. Which of the following is the most likely diagnosis? Volvulus Crohn's disease Foreign body in the GI tract Intussusception - ANSWERS- Intussusception explanation: Intussusception is one of the most common causes of abdominal obstruction in children prior 2 years of age; is best described as a portion of the intestine which telescopes into a more distal intestinal segment. The classic triad of intussusception include crampy (intermittent, also known as colicky) abdominal pain, vomiting, and bloody stools. The patient may pull up his knees with crying. The patient may develop vomiting with bilious emesis.