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APEA Predictor Exam Review, Exams of Nursing

Chamberlain College of NursingNursing

APEA Predictor Exam Review latest

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2023/2024

Available from 08/31/2024

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APEA Predictor Exam Review
First-Pass Effect
1. What cytochrome metabolizes a medication drug during the FIRST-PASS Effect?
2. CYP450 enzyme is the most _____________.
3. It can either be induced or inhibited (T/F) - verified answer 1. CYP450 metabolizes the drug in the
liver to release the drug to the body where it can be used.
2. Active
3. True
Pharmacokinetics
1. What are age-related changes?
(Distribution, Metabolism, Excretion)? - verified answer 1. Increase in fat-to-water ratio, decrease in
liver function, decrease in GFR
Pharmacology: Cardiac Glycosides
1. What order of line of treatment is Digoxin?
2. Signs of Digoxin Overdose
3. Laboratory tests
4. Treatment - verified answer 1. Second and Third
2. N/V, Hyperkalemia, Confusion, visual color changes
3. Digoxin level, CMP, EKG
4. Digoxin-specific antibodies
Pharmacology: Warfarin (Coumadin)
1. Category ____ for pregnancy.
2. Target INR for patients without mitral prosthetic valves? With prosthetic valves?
3. Referral to ________ for initiation and stabilization of warfarin dose.
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APEA Predictor Exam Review

First-Pass Effect

  1. What cytochrome metabolizes a medication drug during the FIRST-PASS Effect?
  2. CYP450 enzyme is the most _____________.
  3. It can either be induced or inhibited (T/F) - verified answer 1. CYP450 metabolizes the drug in the liver to release the drug to the body where it can be used.
  4. Active
  5. True Pharmacokinetics
  6. What are age-related changes? (Distribution, Metabolism, Excretion)? - verified answer 1. Increase in fat-to-water ratio, decrease in liver function, decrease in GFR Pharmacology: Cardiac Glycosides
  7. What order of line of treatment is Digoxin?
  8. Signs of Digoxin Overdose
  9. Laboratory tests
  10. Treatment - verified answer 1. Second and Third
  11. N/V, Hyperkalemia, Confusion, visual color changes
  12. Digoxin level, CMP, EKG
  13. Digoxin-specific antibodies Pharmacology: Warfarin (Coumadin)
  14. Category ____ for pregnancy.
  15. Target INR for patients without mitral prosthetic valves? With prosthetic valves?
  16. Referral to ________ for initiation and stabilization of warfarin dose.
  1. How often do you check for consistently stable INR?
  2. How often do you check for single out-of-range INR?
  3. What do you educate the patient to do if the INR less than 5 with no significant bleeding risk?
  4. If one dose is missed, what do you do?
  5. What kind of foods to avoid messing up the INR? - verified answer 1. X
  6. 2.0-3.0, 2.5-3.
  7. Cardiologist or anticoagulation clinic
  8. Check every 2-4 weeks up to 12 weeks.
  9. Continue warfarin dose, retest INR in 1-2 weeks.
  10. Omit one dose, recheck INR.
  11. Take the dose as soon as possible. Do not double dose.
  12. Vitamin K foods Pharmacology: Direct Oran Anticoagulants (DOAC)
  13. Why are DOACs better than Warfarin?
  14. Example of DOACs?
  15. How long does it take for platelet function to return to normal after a patient stops taking Plavix? - verified answer 1. Less monitoring and less side effects
  16. Apixaban (Eliquis)
  17. 10 days Pharmacology: Thiazide Diuretics
  18. Examples
  19. Contraindication
  20. Adverse effects
  21. Patients with osteoporosis receive an extra benefit from thiazide diuretics by reducing __________ excretion (T/F) - verified answer 1. HCTZ, Chlorthalidone
  22. Sulfa allergy
  23. Hykpokalemia, increases uric acid and increases LDL
  24. Calcium, True
  1. Heart Failure w/ left ventricular dysfinction (HFrEF)
  2. No, because severe CKD and ACEIs and ARBs will lead to increased risk of hyperkalemia. Pharmacology: CCBs
  3. Two types and Examples of both types
  4. Cardiac contraindications for Nondihydropyridines
  5. Why does pedal edema occur with dihydropyridines? - verified answer 1. Dihydropyridines: Amlodipine, Nifedipine Nondihydropyridines: Verapamil, Diltiazem
  6. Heart block and Heart Failure
  7. Vasodilation Pharmacology: BBs
  8. Contraindications
  9. Adverse Effets - verified answer 1. Asthma, COPD
  10. Bronchospasm Pharmacology: Tetracyclines
  11. Examples:
  12. Avoid use during pregnancy and breastfeeding due to _________ of teeth.
  13. Sensitivity to what? - verified answer 1. Doxycycline
  14. Permanent Discoloration
  15. Photosensitivity Pharmacology: Macrolides
  16. Examples:
  17. Type of toxicity
  1. Which is the most tolerated macrolide from GI side effects of Nausea and vomiting? - verified answer 1. Azithromycin, Erythromycin
  2. Hepatotoxicity
  3. Azithromycin Pharmacology: Cephalosporins
  4. Examples of each of the First, Second and Third Generation
  5. First line of treatment against gonorroheal infections?
  6. Avoid ceftriaxone in hyperbilirubinemia infants because it can cause - verified answer 1. First: Cephalexin (Keflex), Second: Cefuroxime, Third: Cefdinir
  7. Ceftriaxone (3rd Generation)
  8. Kernicterus Pharmacology: PCNs
  9. Examples
  10. Avoid using amoxicillin for patients with mononucleosis because it can lead to a - verified answer
  11. PCN, Amoxicillin, Augmentin
  12. Rash Pharmacology: Fluoroquinolones
  13. Examples
  14. Complications
  15. Avoid in which population
  16. Patients should avoid sun exposure due to ___________ with thix ABX (T/F) - verified answer 1. Ciprofloxacin, Levofloxacin
  17. Achilles-Tendon Rupture, Torsades de Pointes, Abnormal bone development
  18. Pregnant women and growing children
  19. Phototoxicity; True
  1. When do we start screenings? and how often?
  2. If a patient has BRCA1 or BRCA2 gene, when you start screening for breast cancer? - verified answer 1. 50 Years of age, every 2 yers
  3. 40 years of age USPSTF Recommendations - Cervical Cancer
  4. Aged 21-29 years should receive what screening? How often?
  5. Aged 30-65 years should receive what screening? How often?
  6. If prior hysterectomy, - verified answer 1. Cervical cytology alone every 3 years
  7. Cervical Cytology alone every 3 years, of Cervical Cytology with HPV every 5 years
  8. No screening needs to be done. USPSTF Recommendations - Colorectal Cancer
  9. When do we start screenings?
  10. How often should someone get a colonoscopy? - verified answer 1. Age 45 years
  11. Every 10 years USPSTF Recommendations - Lung Cancer
  12. When do we start screening for patients with a _____-pack-year smoking history?
  13. What screening exam do you use? - verified answer 1. 50 years old; 20-pack-year smoking history
  14. Low-dose annual CT scan USPSTF Recommendations - Prostate Cancer
  15. When do we start screening?
  16. Ethnic race at risk - verified answer 1. 55-69 years old
  17. African

USPSTF Recommendations - ABD Aortic Aneurysm

  1. Abdominal Aortic Aneurysm test and onset of screening? - verified answer 1. ABD ultrasound; 65- 75 years old Vaccines & Administrations - Hepatitis B Vaccine
  2. Total of how many doses? When?
  3. Requires a minimum of ___ weeks between doses one and two? - verified answer 1. Three doses (0, 1st and 6th month)
  4. 4 Weeks Vaccines & Administrations - Influenza
  5. Two types of Influenza Vaccines
  6. LAIV Contraindications
  7. All types of Influenza Vaccine should be avoided if patient has allergic to gelatin (T/F) - verified answer 1. Inactivated and Recombinant vs. Live Attenuated (LAIV)
  8. Pregnancy and chronic pulmonary disease
  9. True Vaccines & Administrations - Tetanus Vaccines (Tdap and Td)
  10. How often do we administer for lifetime?
  11. Infants and children younger than 7 years should receive what form of tetanus vaccine?
  12. For dirty and contaminated wounds, give a ___________ if the last dose was more than how many years ago? - verified answer 1. Every 10 years
  13. DTaP
  14. Tetanus booster; more than 5 years ago Vaccines & Administrations - Pneumococcal Vaccine
  1. Patient Symptoms
  2. What kind of lines are found on the corneal surface?
  3. If infection due to shingles is caused by infection of the trigeminal nerve, what is it called?
  4. Refer to - verified answer 1. Severe eye pain, tearing, photophobia, blurred vision
  5. Fernlike lines
  6. Herpes Zoster Ophthalmicus
  7. ED HEENT - Acute Angle-Closure Glaucoma
  8. Patient symptoms
  9. Patients with this type of glaucoma see ______ of lights.
  10. Cornea appears ______
  11. There is _______ of the optic nerve.
  12. Refer to - verified answer 1. Sudden and acute severe eye pain, Headache, N/V.
  13. Halos
  14. Cloudy
  15. Cupping
  16. ED HEENT - Multiple Sclerosis (Optic Neuritis)
  17. Reports loss of visual acuity over hours to days (T/F)
  18. What two visions are affected?
  19. May be accompanied by other neurological symptoms such as
  20. Complains of daily fatigue that worsens as the day goes on (T/F)
  21. Refer to - verified answer 1. True
  22. Color and Central Vision
  23. Parenthesia, Aphasia
  24. True
  25. Neurologist

HEENT - Orbital Cellulitis

  1. Acute onset of _______ eyelids and ________ eyeballs.
  2. Unable to perform full ROM of ________.
  3. Look for history of ________.
  4. Refer to - verified answer 1. Swollen eyelids and bulging eyeballs
  5. Extraocular muscles
  6. Infection (Rhinosinusitis or upper respiratory infection)
  7. ED HEENT - Retinal Detachment
  8. Sudden onset of _______ associated with looking through a ________-feel.
  9. Sudden flashes of _________.
  10. Refer to - verified answer 1. Floaters; Curtain
  11. Flashes of Light
  12. ED HEENT - Auricular Hematoma
  13. Direct blunt trauma to the ear that can cause bleeding in the __________.
  14. This should be drained as soon as possible (T/F) - verified answer 1. Auricular Cartilage
  15. True HEENT - Acoustic Neuroma (Vestibular Schwannoma)
  16. Presents with unilateral or bilateral hearing loss?
  17. Complains of ___________ movements.
  18. Caused by ________ of the acoustic nerve.
  19. Refer to
  1. Considered a dental __________.
  2. If a young child, determine if the avulsed tooth is a ___________.
  3. Rinse tooth in what solution?
  4. Refer to - verified answer 1. Dental Emergency
  5. Primary Tooth
  6. Normal Saline
  7. Dentist HEENT - Peritonsillar Abscess
  8. Patient symptoms
  9. What kind of voice?
  10. Accompanied by generalized symptoms of
  11. Referral to - verified answer 1. Severe sore throat, and odynophagia (pain on swallowing)
  12. "Hot potato" voice
  13. Fever, malaise and chills
  14. ED HEENT - Diptheria
  15. Patient symptoms
  16. What kind of neck?
  17. Very contagious (T/F)
  18. Refer to - verified answer 1. Sore throat and fever
  19. Bull's Neck
  20. True
  21. ED HEENT Anatomy
  22. Fundi: Veins are smaller than arteries (T/F)
  1. Macula: Responsible for what type of vision?
  2. Tympanic Membrane: What color is the TM supposed to be?
  3. Kiesselbach's Plexus: Where is this located?
  4. Salivary Glands: What are the three?
  5. What is used to measure for presence of fluids in middle ear? - verified answer 1. False, arteries are smaller than veins.
  6. Central vision
  7. Off-white to gray color
  8. Anterior Inferior aspect of nose
  9. Parotid, Submandibular, and Sublingual salivary glands
  10. Tympanogram HEENT - Age-Related Changes
  11. Presbyopia: What is this? - verified answer 1. Decreased ability to read small print at close range. (Poor near vision) HEENT - Noteworthy Abnormal Findings
  12. Blepharitis: What is this? And what is it associated with? How to treat?
  13. Leukoplakia: White to light gray patch on tongue, cheek or mouth. Rule out ________.
  14. Aphthous Stomatitis (Canker Sores): What are these and how are they treated?
  15. Mumps (Parotitis): What is this? - verified answer 1. Inflammation of the edges of the eyelids. Associated with seborrheic dermatitis. Warm compress and Shampoo with warm warter.
  16. Oral Cancer
  17. Painful shallow ulcers; Magic mouthwash
  18. Parotid glands become swollen and tender. HEENT - Papilledema
  19. Optic disc appears ________ with _________ edges due to increased _________.
  1. This is leukoplakia that appears only on the ________.
  2. Pathognomonic for which infection?
  3. Caused by which virus? - verified answer 1. Tongue
  4. HIV Infection
  5. Epstein-Barr Virus HEENT - Cheilosis
  6. Painful skin fissures at the corner of the ______ due to excessive moisture.
  7. Secondary to infection of what two organisms?
  8. Nutritional deficiency of Vitamin ________.
  9. Diagnostic Test
  10. Treatment according to type of organism - verified answer 1. Mouth
  11. Candida and S. Aureus
  12. Vitamin B
  13. Check KOH or C&S
  14. Fungal: Topical anti fungal ointment; Bacterial: Mupirocin ointment HEENT - Terminology
  15. Hyperopia
  16. Myopia
  17. Ambylopia: When does it usually start and who to refer?
  18. Miosis
  19. Ptosis
  20. Entropion
  21. Ectropion - verified answer 1. Farsightedness
  22. Nearsightedness
  23. Lazy eye, starts in infancy.
  24. Excessive construction of pupil
  25. Drooping of upper eyelid
  1. Eyelid turned inward
  2. Eyelid turned outward HEENT - Vision & Hearing Test
  3. Color blindness should be assessed with with chart?
  4. Legal blindness is defined as 20/____.
  5. For children, by age ______ years, visual acuity should be 20/20 bilaterally.
  6. If 20/30 for children by 6 years, refer to __________.
  7. Normal finding for Weber Test
  8. Normal finding for Rinne Test
  9. Weber Test: Lateralization to good ear is __________ loss. Lateralization to bad ear is __________ loss.
  10. Rinne Test: SENSE. L. is AC > BC. Conductive is BC > AC - verified answer 1. Ishihara Chart
  11. 20/
  12. 6 years
  13. Ophthalmologist
  14. No lateralization (Lateralization = hearing sound in only one ear or sound is louder in one ear.)
  15. AC lasts longer than BC. HEENT - Treatment Plan for Corneal Abrasion, Herpes Keratitis and Contact Lens Related-Keratitis
  16. Treatment Plan
  17. Pain prescription (T/F) - verified answer Check visual acuity, flush eye with NS, do not patch eye HEENT - Hordeolum
  18. What is this?
  19. Treatment plan

HEENT - Primary Open-Angle Glaucoma

  1. Acute or Gradual onset?
  2. Increased IOP of how many mmHg?
  3. Usually asymptomatic in early stages (T/F)
  4. Treatment plan: Check IOP using _____________.
  5. Normal range of IOP is?
  6. If IOP is greater than 30 mmHg, refer to ______________ immediately!
  7. Medications
  8. Contraindications to Medications - verified answer 1. Gradual Onset
  9. Greater than 22 mmHg
  10. True
  11. Tonometer
  12. 8-21 mmHg
  13. ED
  14. Beta-blocker eye drops and Latanoprost
  15. BBs have contraindications to those who have COPD, asthma, and Heart failure due to bronchoconstriction HEENT - Primary Angle-Closure Glaucoma
  16. Gradual or Acute?
  17. If not treated immediately, can lead to permanent damage of which cranial nerve?
  18. Symptoms of glaucoma
  19. Treatment plan - verified answer 1. Acute Onset
  20. Permanent damage of CN II
  21. Cloudy pupil, dilated pupil, sever eye pain with headache and N/V.
  22. Refer to ED HEENT - Age-Related Macular Degeneration
  1. Loss of _________ vision.
  2. Painful or painless?
  3. Refer to - verified answer 1. Central Vision
  4. Painless
  5. Ophthalmologist HEENT - Sjögren's Syndrome
  6. Chronic autoimmune disorder characterized by decreased function of which two glands?
  7. This can occur alone or with _____________ disorder.
  8. Treatment plan
  9. Referral to - verified answer 1. Lacrimal and salivary glands
  10. Autoimmune
  11. Eye drops
  12. Rheumatologist HEENT - Allergic Rhinitis
  13. Treatment plan - First-Line
  14. If only partial relief from first-line treatment, what do you administer?
  15. What do you use if the patient is congested?
  16. Sudafed is contraindicated for which patient population?
  17. Non-sedating once daily antihistamines are recommended (T/F)
  18. To prevent Rhinitis Medicamentosa, what do you do? - verified answer 1. Topical nasal steroid sprays
  19. Antihistamines
  20. Decongestants (Sudafed)
  21. Infants and young children
  22. True
  23. Stop using nasal decongestants before three days.