APEA PREDICTOR TEST APRIL #2 Flashcards
The patient who has iron deficiency anemia should be advised that foods high in iron content include:
A.bananas, apples, and oranges.
B.yellow vegetables.
C.organ meats and dark, green leafy vegetables.
D.milk and dairy products.
C
The nurse practitioner suspects migraine in a 6 year old male with a 2 month history of recurrent headache. What finding would support a diagnosis of migraine headache?
A.Family history of migraine headache
B.Localized facial pain and ataxia
C.Problems at home, school, and with peers
D.Ipsilateral weakness and papilledema
A
Eligibility requirements for the ANP or FNP exam include all of the following EXCEPT:
A.clinical preparation in an ANP or FNP educational program.
B.an active RN license in the US.
C.a masters degree in nursing or an area.
D.didactic preparation in an ANP or FNP educational program.
C
Successful management of a patient with attention deficit hyperactivity disorder (ADHD) is best achieved with:
A.stimulant medication along with behavioral and family interventions.
B.methylphenidate (Ritalin®) in conjunction with an antihistamine.
C.treatment by a pediatric psychiatrist.
D.firm discipline and removal of offending foods from the diet.
A
A 20 year old male patient complains of “scrotal swelling.” He states his scrotum feels heavy, but denies pain. On examination, the nurse practitioner notes transillumination of the scrotum. What is the most likely diagnosis?
A.Indirect inguinal hernia
B.Hydrocele
C.Orchitis
D.Testicular torsion
B
The developmental task for the family of an adolescent is to:
A.provide the adolescent with limits and restrictions.
B.encourage the adolescent’s mastery of physical skills.
C.enable the adolescent to form a lasting relationship with another person.
D.allow the adolescent increasing freedom and responsibility.
D
An 8 month old male presents with hemarthrosis of both knees and hematuria. The parents give no history of trauma, but say “he has always bruised easily.” The most likely diagnosis is:
A.physical child abuse.
B.idiopathic thrombocytopenia (ITT).
C.a type of hemophilia.
D.a form of leukemia
C
Which statement below about breastfeeding is NOT accurate?
A.An infant with hyperbilirubinemia should not be breastfed.
B.A mother with flat or inverted nipples may be able to breastfeed.
C.Improper positioning of the infant can result in the mother having sore nipples.
D.A mother with a plugged milk duct should not stop breastfeeding.
A
Babies should begin oral iron supplementation:
A.when they are able to eat iron-enriched cereal.
B.2 months-of-age.
C.4 to 6 months-of-age.
D.anytime after their teeth have erupted.
C
Nurse practitioners are permitted to perform male circumcisions in some states but not in others. This is related to:
A.standards of practice.
B.scope of practice.
C.prescriptive authority.
D.reimbursement.
B
The mother of a 2 week old infant with hypospadias requests circumcision for her infant. The nurse practitioner’s best response to this mother should be to:
A.arrange a surgical consult for the circumcision.
B.explain why an infant with hypospadias should not be circumcised.
C.explain the benefits and risks of infant circumcision.
D.refer her to a physician.
B
A 78 year old man has a diagnosis of emphysema. It is imperative that the nurse practitioner teach him to:
A.use oxygen at home during the night.
B.call the office at the first sign of infection.
C.limit intake of high protein foods.
D.be immunized annually with the polyvalent pneumococcal vaccine.
B
The nurse practitioner is evaluating a 35 year old female nurse. She has a history of hospitalization for hepatitis B infection 2 years ago. Her laboratory tests demonstrate positive HBsAg. The nurse practitioner would most likely diagnose:
A.chronic hepatitis B infection.
B.acute hepatitis B infection.
C.recovered hepatitis B infection.
D.recent hepatitis B vaccination
A
Which of the following is considered a non-inflammatory disease process?
A.Osteoarthritis (OA)
B.Rheumatoid arthritis (RA)
C.Systemic lupus erythematosis (SLE)
D.Psoriatic arthritis
A
Which of the following patients most warrants screening for hypothyroidism?
A.A young adult female with postpartum depression lasting 2 weeks
B.A patient taking a thyroid replacement preparation
C.A 40 year old male with unexplained tremors
D.An elderly female with recent onset of mental dysfunction
D
The nurse practitioner performs a routine physical examination of a 3 year old child. A hard, painless mass is palpated in the abdomen, along with lymph node enlargement and lower limb paresis. Blood and imaging studies provide markers for neuroblastoma. What information is correct to give to the parents?
A.The diagnosis must be confirmed by tissue biopsy or by bone marrow aspiration plus urine or serum catecholamine levels.
B.Neuroblastoma is the final diagnosis based on physical examination and blood and imaging markers.
C.Signs and symptoms, along with the blood imaging markers, define the tumor as stage D, metastasis beyond lymph nodes.
D.The prognosis is poor, based on the likelihood that there is metastasis to the bone.
A
Group A Beta-hemolytic streptococcal (GABHS) pharyngitis is most common in which age group?
A.Under 3 years-of-age
B.Preschool children
C.6 to 12 years-of-age
D.Adolescents
C
The most appropriate therapy for an elderly patient with pernicious anemia is:
A.increased dietary intake of vitamin B-12.
B.oral vitamin B-12 supplementation.
C.intramuscular injections of vitamin B-12.
D.oral multivitamin supplementation.
C
An important measure to prevent complications in children with sickle cell anemia is:
A.tight restriction of physical activity.
B.trace mineral supplementation.
C.staying well-hydrated.
D.home schooling for infection control.
C
Alkaline phosphatase (ALP) is usually elevated in all of the following except:
A.adolescents and children.
B.pregnant women in the third trimester.
C.Paget’s disease.
D.nephrotic syndrome.
D
It is recommended that the therapeutic management of children with juvenile rheumatoid arthritis (JRA) should include:
A.avoidance of exercise.
B.immunosuppressant agents.
C.ophthalmologist examination at least annually.
D.avoidance of aspirin therapy.
C
A 24 year old male patient diagnosed with Hodgkin’s lymphoma is concerned about long-term survival. The most accurate response by the nurse practitioner would be:
A.”The 5-year survival rate is about 80%.”
B.”Non-Hodgkin’s lymphoma has a better prognosis.”
C.”With radiation and chemotherapy, there is almost a 100% cure rate.”
D.”With surgical treatment, there is a 95% cure rate.”
A
Which of the following statements concerning informed consent is FALSE?
A.The risks, benefits, and alternatives must be written and explained in words the patient understands.
B.It ensures the patient’s right to choose or refuse an intervention.
C.It is not legally binding if the patient cannot write his or her name.
D.It may be signed by a surrogate decision-maker who has power of attorney for medical decisions.
C
A 59 year old postmenopausal woman has atrophic vaginitis. She has a history of breast cancer at age 40 years. What is the appropriate initial treatment for this patient?
A.Oral conjugated estrogens
B.Oral medroxyprogesterone acetate
C.Topical medroxyprogesterone acetate
D.Topical conjugate estrogen cream
D
Which activities are NOT characteristic of preschool children?
A.Social, cooperative, and shared play
B.Independent toileting with occasional accidents
C.Always follow rules during playground games
D.Use of security objects
C
A 2 year old presents with sudden onset of respiratory distress with unilateral wheezing. What is the likely cause?
A.Pneumonia
B.Foreign body aspiration
C.Asthma exacerbation
D.Epiglottitis
B
The mechanism by which nurses are held accountable for practice, based on the quality of nursing care in a given situation in accordance with established standards of practice, is:
A.outcome criteria.
B.process criteria.
C.peer review.
D.quality assurance.
C
A 26 year old female presents with vaginal itching and a malodorous vaginal discharge. Wet prep is positive for budding hyphae and flagellated protozoa and negative for WBCs and clue cells. KOH is positive. Based on these lab and microscopy findings, the most likely diagnoses are:
A.Gonorrhea and genital herpes.
B.Trichomoniasis and vaginal candidiasis.
C.Genital herpes and trichomoniasis.
D.Vaginal candidiasis and bacterial vaginosis.
B
Which of the following is the most common presenting sign of substance abuse in adolescents?
A.Poor school performance
B.Change in sleep habits
C.Increased blood pressure
D.Changes in behavior
D
Initial treatment of a child presenting with a severe head injury is:
A.aimed at prevention of seizure activity with prophylactic anticonvulsant medication.
B.prevention of coma, which is the most important determinant of neurologic recovery.
C.aimed at resuscitation, then maintenance of oxygenation and blood flow.
D.normalization of intracranial pressure, followed by intracranial pressure monitoring.
C
Your 45 year old patient with diabetes asks about the medications you have prescribed. You respond:
A.”A daily 81 mg of aspirin daily will help reduce the risk of cardiovascular complications from diabetes.”
B.”ACE inhibitors are no longer venoprotective after albuminuria is present.”
C.”Every diabetic should take a lipid-lowering drug to protect the blood vessels from damage.”
D.”As long as your blood pressure is normal, you’ll never need an ACE inhibitor.”
A
Which of the following statements is true regarding asymptomatic bacteriuria in institutionalized older women?
A.Treatment has not been shown to decrease mortality.
B.Treatment has been shown to decrease morbidity.
C.Screening should be done at least every 3 months.
D.Treatment will usually eradicate the organisms.
A
A patient complains of “stomach pains” on and off for the past month. In distinguishing between a gastric and duodenal ulcer, what question is least important to ask?
A.Have you been out of the country in the past several months?
B.Have you had dark, tarry, or bloody stools?
C.Is your stomach pain made worse by eating?
D.Does your stomach pain wake you up in the early morning?
A
Persons of Mediterranean descent have an increased incidence of which of the following?
A.Thalassemia
B.Pernicious anemia
C.Sickle cell anemia
D.Leukemia
A
A patient presents with a furuncle in his right axilla. The nurse practitioner should prescribe an oral antibiotic and:
A.frequent warm moist compresses.
B.benzoyl peroxide.
C.topical mupirocin ointment (Bactroban®).
D.topical hydrocortisone cream.
A
Which of the following is the most prevalent skeletal problem in the United States?
A.Osteomyelitis
B.Stress fracture
C.Osteoporosis
D.Rheumatoid arthritis
C
The daughter of a 75 year old patient reports that her mother roams the house at night saying she cannot fall asleep. She has fallen twice. Of the following choices, which would be the most appropriate to treat her insomnia?
A.doxepin (Sinequan®)
B.trazodone (Desyrel®)
C.diazepam (Valium®)
D.zolpidem (Ambien®)
D
A patient has Kawasaki syndrome. Which characteristic would be UNUSUAL?
A.Age > 15 years
B.Fever > 101F (38.3C)
C.Exudative pharyngitis
D.Painful rash
A
An 8 year old is sent home from school with a mucopurulent discharge from his eye. He is brought to the nurse practitioner for treatment. What is the most appropriate intervention?
A.Cromolyn sodium (Opticrom, Nalcrom) ophthalmic solution for 4 days
B.Doxycycline (Vibramycin) orally for 10 days
C.Bacitracin/polymyxin (Polysporin) ophthalmic solution for 7 to 10 days
D.No pharmacologic intervention is needed because this will resolve overnight without treatment.
C
The leading causes of morbidity and mortality in postmenopausal American women are cardiovascular disease, osteoporosis, and cancer. What intervention has the greatest impact on prevention of these disorders?
A.Hormone replacement therapy
B.Early screening for hyperlipidemia
C.Vitamin supplementation
D.Exercise
A
An important factor to consider when interviewing the geriatric patient is that:
A.elders are less skilled than young adults at decision-making.
B.the capacity to learn, re-learn, synthesize, and problem-solve diminishes in old age.
C.there is considerable variation in general health, mental status, and functional ability among elders.
D.abstract reasoning and conceptual skills decrease with advanced age.
C
What is the recommendation of the U.S. Department of Health and Human Resources regarding nicotine replacement therapy?
A.Encourage the use of nicotine replacement except in the presence of serious medical conditions.
B.Offer nicotine replacement only to those smokers who are unsuccessful after 3 attempts to stop smoking.
C.Discourage the use of nicotine replacement.
D.Offer nicotine replacement only to select populations of heavy smokers with a long history of smoking.
A
After hearing the news that she is pregnant, an overweight patient remarks, “I’m not in good enough shape to have a baby. How can I get in shape?” The nurse practitioner would appropriately advise her to:
A.join an aerobic exercise class.
B.begin walking about 3 times per week with a family member or friend.
C.take yoga or tai-chi lessons for mental and physical relaxation.
D.avoid exertion, as adequate rest is more important.
B
The diagnosis of Meniere’s disease is based on:
A.magnetic resonance imaging (MRI) findings.
B.exclusion of other pathologies.
C.the presence of high frequency hearing loss.
D.the presence of central vertigo.
B
An individual with a positive surface antibody and positive core would have developed immunity from having the disease, not the immunization. A nurse practitioner palpates a nodule during a prostate exam. What other clues may indicate prostate cancer?
A.Elevated PSA and hematuria
B.Urinary retention and scrotal pain
C.Urethral discharge and elevated PSA
D.Freely movable cystic mass and nonviable sperm
A
A 25 year old overweight patient presents with a complaint of dull achiness in his groin and history of a palpable lump in his scrotum that “comes and goes.” On physical examination, the nurse practitioner does not detect a scrotal mass. There is no tenderness, edema, or erythema of the scrotum and the scrotum does not transilluminate. Considering these findings, what is the most likely diagnosis?
A.Testicular torsion
B.Epididymitis
C.Inguinal hernia
D.Varicocele
C
