APEA Predictor Exam Missed Questions with Correct Answers, Exams of Nursing

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APEA Predictor Exam Missed Questions with Correct Answers What is the biggest side effect of colchicine? - CORRECT ANSWER diarrhea How would you describe the appearance of molluscum contagiosum? - CORRECT ANSWER papules that are umbilicated and contain a caseous plug How do we treat a broken clavicle in an infant? - CORRECT ANSWER no treatment; it should heal on it's own At what week of pregnancy is the uterus palpable just above the pubic symphysis? - CORRECT ANSWER week 12 At what week of pregnancy is the fundus palpable halfway between the pubic symphysis and umbilicus? - CORRECT ANSWER week 16 At what week of pregnancy is the fundus of the uterus at the umbilicus? - CORRECT ANSWER week 20 At what week of pregnancy is the fundus of the uterus halfway between the xiphoid process and umbilicus? - CORRECT ANSWER week 28 At what week of pregnancy is the fundus just below the xiphoid process? - CORRECT ANSWER week 34 Increased sweat production is a sign of what endocrine disorder? - CORRECT ANSWER hyperthyroidism What is Paget's disease? - CORRECT ANSWER 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? - CORRECT ANSWER bisphosphonates How should pregnant women wear their seatbelt? - CORRECT ANSWER 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? - CORRECT ANSWER parvovirus aka slapped cheek disease aka erythema infectiosum Which type of prevention are vaccinations? - CORRECT ANSWER primary When should patients begin antiretroviral therapy for HIV infection? - CORRECT ANSWER as soon as it is detected, even if in the acute phase What are the first generation antihistamines? - CORRECT ANSWER diphenhydramine (benadryl) and chlorpeniramine (actifed) What are s/s of the secondary stage of syphilis? - CORRECT ANSWER rash on hands and feet, lymphadenopathy, fever What is the recommended treatment for chronic bacterial prostatitis? - CORRECT ANSWER a fluoroquinolone (cipro or levo) + bactrim What is the recommended treatment for acute prostatitis? - CORRECT ANSWER cipro (if not STI related) or ceftriaxone What are s/s of an intraductal breast papilloma? - CORRECT ANSWER clear to bloody unilateral nipple discharge (bilateral is usually benign), and also a wart like lump palpated in the nipple area If a patient has GABHS but has an allergy to penicillins, what is the second line option? - CORRECT ANSWER first generation cephalosporins, unless the allergy is severe, then you would consider macrolides like a -mycin PDE5 inhibitors (sildenafil, tadalafil) are contraindicated in which patient populations? - CORRECT ANSWER in those who are on any type of nitrate or triptan because it could result in hypotension How do we treat UTIs in a pregnant woman? - CORRECT ANSWER 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? - CORRECT ANSWER about 10 days before menses What can be a sequelae of an ectopic pregnancy? - CORRECT ANSWER pelvic inflammatory disease and infertility due to scarring of the fallopian tube (salpingitis) What is the Coomb's test and when is this completed? - CORRECT ANSWER 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? - CORRECT ANSWER 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? - CORRECT ANSWER give rhogam at 28 weeks and 72 hours after birth What is the only form of non-hormonal contraception other than barrier methods such as condoms? - CORRECT ANSWER IUD The vaginal ring for contraception must be taken out how often? - CORRECT ANSWER every 3 weeks If a patient is on birth control and is currently having breakthrough bleeding, then what do we do? - CORRECT ANSWER increase the progesterone How do we treat temporal arteritis? - CORRECT ANSWER steroids If a patient is on birth control and they miss one pill, what should they do? - CORRECT ANSWER double up If a patient is on birth control and they miss two pills, what should they do? - CORRECT ANSWER double up for 2 days If any woman comes in with painless vaginal bleeding between periods (esp if she is postmenopausal), what should you do? - CORRECT ANSWER do a pregnancy test and then refer for endometrial biopsy to rule out endometrial cancer In terms of the breasts, _____________ is used for screening and _____________ is used for diagnosis. - CORRECT ANSWER mammogram; ultrasound When do we screen for group B strep in pregnancy? - CORRECT ANSWER weeks 35-37 When do we perform alpha fetoprotein screening in pregnancy? - CORRECT ANSWER 15-20 weeks Alpha fetoprotein screening in pregnancy can help determine the presence of what in pregnancy? - CORRECT ANSWER spina bifida and anencephaly What is placenta previa? - CORRECT ANSWER when the placenta blocks the cervical opening of the uterus What is placenta abruptio? - CORRECT ANSWER when the placenta either fully or partially detaches from the uterine wall When does placental abruption most commonly occur? - CORRECT ANSWER in the third trimester What is the major difference in symptomalogy between placenta abruptio and placenta previa? - CORRECT ANSWER 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? - CORRECT ANSWER placenta previa What is the recommended treatment for polymyalgia rheumatica? - CORRECT ANSWER steroids Patients with SLE are going to have what abnormal labwork? - CORRECT ANSWER elevated ESR and CRP How do we treat lupus flares? - CORRECT ANSWER steroids What are common sequelae of fibromyalgia? - CORRECT ANSWER insomnia and depression What is a great treatment option for fibromyalgia? - CORRECT ANSWER amitriptyline (a TCA) because it helps with chronic pain, sleep, and depression How is fibromyalgia diagnosed? - CORRECT ANSWER 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? - CORRECT ANSWER when the femoral head of the hip is out of place What is the trendelenburg sign and when is it positive? - CORRECT ANSWER 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? - CORRECT ANSWER walking with a limp SCFE is most common in which patient population? - CORRECT ANSWER adolescents What is legg-calve-perthe disease? - CORRECT ANSWER avascular necrosis of the femoral head due to a lack of blood supply Legg-calve-perthes disease is most common in which patient population? - CORRECT ANSWER young children What is the radiographic study of choice for the knee? - CORRECT ANSWER MRI What is the radiographic study of choice for the back? - CORRECT ANSWER x ray What is bursitis? - CORRECT ANSWER a fluid collection in the bursa of a joint What is the recommended treatment for Bell's palsy? - CORRECT ANSWER steroids and anti-virals How is the pain of trigeminal neuralgia vs temporal arteritis different? - CORRECT ANSWER 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? - CORRECT ANSWER beta blockers, amitriptyline, venlafaxine, topamax, valproate What is Addison's disease? - CORRECT ANSWER 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? - CORRECT ANSWER 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 - CORRECT ANSWER molar pregnancy What bacteria is the leading cause of urethritis? - CORRECT ANSWER neisseria gonorrhea What is the most common cause of hypercortisolism? - CORRECT ANSWER excessive ACTH production How do we treat developmental hip dysplasia in a child under 6 months? - CORRECT ANSWER 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? - CORRECT ANSWER 5 years old; penicillin When can cervical cancer screening stop if no abnormal screening history is present? - CORRECT ANSWER age 65 When should breast cancer screening begin and end with a biannual mammogram? - CORRECT ANSWER age 50-74 When should colorectal cancer screening stop? - CORRECT ANSWER age 85 Who qualifies for a low dose CT scan for lung cancer screening purposes? - CORRECT ANSWER age 50-80 years anyone who currently smokes or has stopped smoking within the last 5 years What does an ASC-US (atypical squamos cells of undetermined significance) pap smear result necessitate? - CORRECT ANSWER Do HPV testing with this. If positive, repeat in one year if age 21-24 or send for colposcopy if older than 25. If negative, repeat pap in 3 years. Which pap smear result is considered to be HPV positive? - CORRECT ANSWER LSIL If a patient has LSIL with a negative HPV test, what would you do? - CORRECT ANSWER repeat in 1 year If a patient has LSIL with no HPV test or a positive HPV test, what should you do? - CORRECT ANSWER refer for colposcopy If a patient's pap results show NILM, what should you do? - CORRECT ANSWER repeat in 3 years If a patient's pap results show ASC-H or HSIL what should you do? - CORRECT ANSWER refer for colposcopy The valgus stress test assesses what? - CORRECT ANSWER the medial collateral ligament The varus stress test assesses what? - CORRECT ANSWER the lateral collateral ligament The Lachman's test assesses what? - CORRECT ANSWER the ACL The McMurray's test assesses for what? - CORRECT ANSWER a torn meniscus The anterior drawer test assesses what? - CORRECT ANSWER the acl The posterior drawer test assesses what? - CORRECT ANSWER the posterior cruciate ligament (pcl) a normal rise in blood sugar as a person's body prepares to wake up due to a release of cortisol and growth hormone - CORRECT ANSWER dawn phenomenon How can you tell between the dawn and somogyi effect? - CORRECT ANSWER 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.