APEA PREDICTOR TEST WRONG ANSWERS Flashcards
20.
Which of the following is NOT an appropriate suppression therapy for chronic bacterial prostatitis (CBP)?
Of the following signs and symptoms of congestive heart failure (CHF), the earliest clinical manifestation is:
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A. doxycycline 100 mg qd
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B. nitrofurantoin (Macrobid) 100 mg qd
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C. Bactrim DS (Sulfatrim) qd
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D. erythromycin qd
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An 87 year old patient was placed on low dose amlodipine (Norvasc) for treatment of hypertension and angina. She takes an ASA daily, but, takes no other medications. What side effects might be expected from taking amolodipine?
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A. diarrhea.
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B. orthostatic hypotension.
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C. decreased heart rate.
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D. nocturnal cough.
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5.
Six weeks gestation is confirmed in a 23 year old, moderately overweight, patient. She asks the nurse practitioner, “Should I diet so I won’t gain too much baby fat?” The nurse practitioner appropriately responds:
A. “It is probably a good idea to lose a few pounds in the first trimester since it will be harder to control weight gain later.”
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B. “A weight gain of approximately 25 pounds is ideal for mother and baby.”
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C. “It doesn’t matter how much weight you gain or lose as long as you eat a well-balanced diet.”
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D. “Just try to limit your weight gain as much as you comfortably are able.”
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6.
When, in childhood, do the frontal sinuses usually present?
A. Birth
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B. 2 to 3 years
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C. 4 to 6 years
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D. 10 to 11 years
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7.
A patient presents with sudden onset of “crushing chest pressure,” diaphoresis, pallor, and extreme weakness. Electrocardiogram and serum enzyme changes support a diagnosis of acute myocardial infarction (AMI). The nurse practitioner would expect:
A. widened QRS intervals, AV dissociation, elevated CPK-MP and LDH, and negative troponin.
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B. ST changes, prominent Q wave, elevated CPK-MB and LDH, and cardiac troponin I.
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C. prolonged PR interval, bradycardia, and increased CPK-MB and LDH.
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D. peaked T waves, tachycardia, and elevated CPK-MB and LDH, and cardiac Troponin I.
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Untreated infection with human papilloma virus (HPV-16) increases the female’s risk for:
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A. pelvic inflammatory disease.
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B. ovarian cancer.
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C. infertility
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D. cervical cancer.
.
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Which APRN is the exception to the graduate level preparation requirement for certification for advanced practice registered nurses?
A. Advanced practice registered nurses who have completed an approved educational program prior to implementation of graduate level education are considered to have met the requirements for advanced practice registered nursing.
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B. Advanced practice registered nurses who plan to practice in a hospital or other controlled setting are not required to have graduate education.
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C. Advanced practice registered nurses who can pass both the American Nurses Credentialing Center (ANCC) and the American Academy of Nurse Practitioners (AANP) certification examinations are allowed to practice without graduate level education.
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D. There are no exceptions to the rule requiring graduate education to practice as an advanced practice registered nurse
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11.
Strabismus is observed in a 13 month old child. The most appropriate action for the nurse practitioner to take is to:
A. refer the patient to an ophthalmologist.
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B. patch the child’s affected eye.
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C. follow the child closely for 2 more months.
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D. teach the patient and parent eye muscle exercises.
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13.
The Dubowitz Clinical Assessment is a:
A. standardized scoring system for assessing gestational age of newborns.
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B. scale developed for rating the newborn’s appearance, heart rate, reflexes, activity, and respirations.
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C. system for identifying children who have been sexually or physically abused.
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D. screening system to identify congenital anomalies.
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14.
The nurse practitioner examines a 6 year old who has had 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. prescribe amoxicillin in a weight-appropriate dose.
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B. ask if any other family members have the same symptoms.
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C. encourage supportive and symptomatic care.
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D. prescribe an antihistamine and decongestant.
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The nurse practitioner is counseling a young woman who desires pregnancy. She discontinued her oral ontraceptives four months ago. Her urine pregnancy test (UPT) 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?
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A. 4 months
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B. 8 months
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C. 1 year
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D. 1 ½ years
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16.
Licensure is:
A. another term for certification.
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B. contingent on certification.
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C. used to establish minimal competence.
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D. necessary for reimbursement.
.
.
Which class of drugs increases a patient’s risk for developing rhabdomyolysis?
A. Anti-hypertensives
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B. Thiazide diuretics
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C. The “statins”
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D. Anti-coagulants
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18.
Which of the following is the best response to a woman who has just admitted she is a victim of spousal abuse?
A. “What was it you did to make him angry?”
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B. “You must seek refuge immediately.”
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C. “I am concerned about your safety.”
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D. “I am going to call a shelter for you.”
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21.
An example of primary prevention is:
A. routine immunizations for healthy children or adults.
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B. screening for high blood pressure.
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C. cholesterol reduction in a patient with CAD.
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D. a PAP smear to determine degree of cervical dysplasia.
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Flag for Review
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22.
A 30 year old female has varicose veins. These are:
A. due to congenital valve deformities.
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B. usually diagnosed on clinical presentation.
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C. not affected by pregnancy.
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D. more symptomatic during ovulation.
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23.
Which of the following is NOT true about Carpal Tunnel Syndrome?
A. Symptoms present in the first 3 fingers of the affected hand.
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B. Symptoms are absent in the 5th finger.
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C. Median nerve compression can result in decreased strength and impaired fine motor coordination.
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D. Phalen’s and Tinel’s signs are negative.
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24.
The most common breast cancer risk factor is:
A. a family history of breast cancer.
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B. a family history of breast and ovarian cancer.
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C. nulliparity.
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D. advancing age
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25.
Coarctation of the aorta should be suspected in newborns or infants who exhibit any of the following EXCEPT:
A. upper extremity hypertension.
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B. lower extremity hypotension.
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C. diminished lower extremity pulses.
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D. diastolic murmurs.
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26.
The most reliable diagnostic indicator of gout is:
A. monosodium urate (MSU) crystals in the synovial fluid.
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B. tophi visible over joints or in connective tissue.
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C. elevated serum uric acid level.
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D. abrupt onset of single joint inflammation and pain.
.
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- Which of the following is NOT covered by Medicare Part B?
A. Out-patient services
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B. Services in short-stay skilled nursing care facilities
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C. Physician and/or APRN provider services
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D. Lab and x-ray services
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28.
A 15 year old male has a history of cryptorchidism which was surgically repaired. Because of this information, it is essential for the nurse practitioner to teach him about:
A. testicular self-examination.
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B. protection of the testes during sports activities.
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C. risk of testicular torsion.
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D. practicing safer sex.
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29.
A 16 year old patient with Type 2 diabetes mellitus has sporadic blood glucose levels recorded in his glucose diary for the past 3 months. Every reading is between 100 and 140 mg/dL (5.6-7.8 mmol/L). A glycosylated hemoglobin of 14% for this patient would indicate:
A. good overall glucose control.
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B. poor glucose control in the last 2 weeks.
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C. adequate glucose control in the last month only.
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D. poor glucose control for the last 1 to 3 months.
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30.
A 45 year old obese pre-menopausal female complains of indigestion, flatulence, RUQ and epigastric “crampy pain” that radiates to the right scapula. Symptoms are exacerbated by a high-fat meal. What is the most likely diagnosis?
A. Hepatitis
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B. Chronic cholecystitis.
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C. Acute pancreatitis
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D. Myocarditis
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31.
A patient with a past history of documented coronary arterial blockage less than 70% complains of chest pain several times per day (while at rest) which is relieved with nitroglycerin. What is the most appropriate initial action for the nurse practitioner?
A. Refer to a cardiologist as soon as possible.
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B. Prescribe long-acting nitroglycerin.
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C. Order a treadmill stress test.
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D. Prescribe an ACE inhibitor and re-evaluate in 24 to 48 hour
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32.
A mother calls the office reporting that her child has burned his finger by touching a hot pot about 1 hour ago. She describes the burn as red, painful, dry, and without blistering. The child cried at the time of the accident and is complaining of pain now. The nurse practitioner should instruct the mother to:
A. apply cool water compresses and administer ibuprofen.
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B. bring the child to the clinic for evaluation.
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C. apply cooking oil.
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D. apply moisturizing lotion
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33.
An autosomal recessive disorder such as cystic fibrosis is expressed in the offspring when:
A. neither parent carry the gene.
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B. both parents carry the gene.
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C. 1 parent has the disease.
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D. 1 parent carries the gene.
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34.
Which symptom is NOT typical in a female during the peri-menopausal period?
A. Vasomotor instability
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B. Paresthesias
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C. Increased vaginal lubrication
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D. Disturbed sleep patterns
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35.
A 6 year old patient presents to the nurse practitioner’s health clinic with a 1 x 1 inch (2.5 cm x 2.5 cm) honey-colored crust on his right shin. The nurse practitioner diagnoses impetigo. Following debridement with soap and water, the most appropriate pharmacological treatment is:
A. erythromycin 250 mg orally 4 times a day for 10 days.
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B. mupirocin (Bactroban®) ointment applied to the lesion 4 times a day for 10 days.
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C. ciprofloxacin (Cipro®) 500 mg 2 times a day for 10 days.
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D. miconazole nitrate (Monistat®) ointment applied to the lesion 4 times a day for 10 days.
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36.
A 6 year old presents with 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
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B. Herpangina
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C. Epiglottitis
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D. Tonsillitis
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37.
The most appropriate first-line drug treatment for African American patients diagnosed with hypertension is:
A. a calcium channel blocker (CCB), demonstrated by research to be the most effective anti-hypertensive drug class for this population.
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B. an angiotensin converting enzyme inhibitor (ACE-I), because African-Americans are typically high renin producers.
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C. an angiotensin converting enzyme inhibitor (ACE-I), because African-Americans are typically low renin producers.
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D. a beta-adrenergic blocker (beta-blocker), demonstrated by research to be the most effective first-line treatment for all ethnic populations.
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38.
A good sunscreen lotion or sunblock may contain all of the following components. Which provides the LEAST protection against the sun’s harmful rays?
A. Zinc oxide
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B. Benzophenones
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C. Para-aminobenzoic acid (PABA)
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D. Lanolin
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39.
The parents of a 2 year old report that she is not saying any words, but makes sounds, babbles, and understands 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.”
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B. “Your child should be saying a few words by this time. We will wait another 3 to 6 months and observe her progress.”
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C. “Your child’s language skills are not as developmentally advanced as we would expect. She will need speech therapy.”
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D. “Your child should be referred to an ear, nose, and throat specialist to assess her hearing.”
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40.
Which lymph node characteristics should raise concern if palpated by the examiner?
A. Enlarged and mobile
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B. Tender and 0.5 cm in diameter
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C. Firm and non-tender
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D. Warm and 1.0 cm
.
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- Given appropriate patient education by the primary care provider, poor compliance with medical recommendations is most often due to:
A. willful disobedience.
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B. vision and/or hearing deficits.
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C. anxiety.
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D. limited cognitive ability
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42.
A 74 year old widowed male, who lives alone, tells the nurse practitioner “I get enough to eat. I don’t need much.” He does not prepare food for himself at home, preferring to eat a noon meal at a neighborhood restaurant. He says he might have a bowl of cereal in the morning or in the evening if he is hungry at home. Which of the following is the most sensitive indicator of this patient’s nutritional status?
A. Absence of 3 well-rounded daily meals
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B. Fatigue and weight loss
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C. Serum pre-albumen level
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D. Elevated serum BUN and RBCs
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43.
Why is it important that a post-menopausal woman with an intact uterus receive combined estrogen-progestin hormone replacement therapy rather than estrogen alone?
A. Taken without progestin, estrogen is less effective in relieving vulvovaginal atrophy.
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B. The beneficial effect of estrogen on high-density lipoprotein cholesterol levels is increased with the addition of progestin.
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C. Prolonged use of unopposed estrogens increases the risk of endometrial cancer.
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D. Risk of breast cancer is increased for women using unopposed estrogen.
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44.
The Patient Self-Determination Act of 1991 requires all health care agencies receiving Medicare or Medicaid funds to give patients written information about their rights to make decisions regarding their medical care. A document which declares in advance what type of medical care a person wants to be provided or withheld should he or she be unable to express his or her wishes is called:
A. an advanced directive.
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B. a durable power of attorney.
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C. informed consent.
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D. a right to die statement.
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45.
A patient complains of “an aggravating cough for the past 6 weeks.” Which medication is most likely to be causing the cough?
A. methyldopa (Aldomet®)
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B. enalapril (Vasotec®)
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C. amlodipine (Norvase®)
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D. hydrochlorothiazide
.
46.
The obesity associated with Type 2 diabetes mellitus is:
A. a lower body (gynecoid) distribution.
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B. defined as BMI 30% or greater.
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C. defined as waist-to-hip ratio 0.5 or less.
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D. a truncal (android) distribution.
.
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- Which agent is most effective for the treatment of nodulocystic acne?
A. benzoyl peroxide (Benzac)
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B. retinoic acid (Retin-A®)
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C. Topical tetracycline
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D. isotretinoin (Accutane®
.
48.
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
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B. Oral medroxyprogesterone acetate
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C. Topical medroxyprogesterone acetate
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D. Topical conjugate estrogen cream
.
49.
An 83 year old man has a resting hand tremor. What disease process is this type of tremor is most commonly associated with?
A. Multiple sclerosis (MS)
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B. Parkinson’s disease
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C. Diabetic neuropathy
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D. Huntington’s chorea
.
50.
Primary prevention of human papilloma virus (HPV) infection requires educational efforts directed toward:
A. receiving annual screening examinations.
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B. self-examination to detect the signs of infection.
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C. receiving a vaccination on an annual basis.
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D. delaying the onset of sexual activity and using barrier methods of contraception.
.
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- Which of the following is a secondary cause of hyperlipidemia?
A. Osteoporosis
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B. Hypothyroidism
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C. Recent dietary excess and weight gain
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D. Lack of exercise
.
52.
Which of the following is NOT a risk factor for sudden infant death syndrome (SIDS)?
A. Maternal age < 19 years
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B. Winter months
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C. Low birth weight
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D. Female gender
.
53.
What is the most frequent cause of death in patients with anorexia nervosa?
A. Renal failure
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B. Suicide
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C. Hepatic failure
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D. Cardiac arrest
.
54.
Which of the following is NOT true regarding the diagnosis of scoliosis in children?
A. Scoliosis is most apparent during the pre-adolescent growth spurt.
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B. Scoliosis may be evidenced by unequal shoulder, scapula, or iliac crest height with the child standing.
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C. Kyphosis in the adolescent indicates scoliosis.
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D. Routine screening for scoliosis should begin at 10 to 12 years-of-age, with forward bending touching the toes, and unclothed examination of the spine.
.
55.
Which of the following must be present for the diagnosis of bacterial vaginosis?
A. Presence of clue cells
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B. Vaginal pH < 4.0
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C. Presence of pseudohyphae on HPF
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D. Negative amine test
.
56.
Which of the following is appropriate to teach a patient who is using a daily nitrate agent for treatment of chronic angina?
A. Continuous 24-hour coverage is necessary for maximum protection.
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B. A daily 12-hour nitrate-free period is important to prevent tolerance.
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C. A daily 6-hour nitrate-free period is important to prevent tolerance.
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D. Nitrate-free periods present a potential for developing nitrate intolerance.
.
57.
Microscopic examination of expressed prostatic secretions (EPS) and post-prostate massage urine is positive for WBCs > 10 to 20/HPF and negative for bacteria. The most likely diagnosis is:
A. chronic nonbacterial prostatitis.
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B. benign prostatic hyperplasia (BPH).
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C. acute bacterial prostatitis.
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D. carcinoma of the prostate gland.
.
58.
The infant 1 to 6 months-of-age with a diagnosis of developmental hip dysplasia is correctly treated with:
A. closed reduction of the hips.
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B. surgical open reduction followed by pelvic and/or femoral osteotomy.
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C. a variety of adduction orthoses.
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D. the Pavlik harness.
.
