APEA- Study Guide well Elaborated 2024

When performing a visual acuity test the nurse practitioner notes 20/30 in the left eye and 20/40 in the right eye using the Snellen eye chart. This means: - ANSWERSRefer the patient to an ophthalmologist The American psychiatric association's diagnostic and statistical manual of mental disorder defines Munchausen Syndrome by proxy: - ANSWERSa caregiver making up or causing an illness or injury in a person under his or her care Symptoms of depression are a side effect of which neurotransmitter medication? - ANSWERSdopamine Which lesion is dark, raised, and asymmetric with irregular border? - ANSWERSMelanoma A 32-year-old woman presents with dull puffiness of the eyes pronounced not pitting periorbital edema this finding is suggestive of this condition? - ANSWERSMyxedema A 42-year-old woman with a past medical history of migraine headaches is requesting prophylactic medication treatment. Which medication should the Nurse Practitioner prescribe? - ANSWERSAmitriptyline (Elavil) A pediatric has areas of scaling on the scalp with round patches of alopecia. this clinical finding is consistent with: - ANSWERSTinea Capitis What is the appropriate prophylactic medication for an 18-year-old woman with a past medical history of migraine headaches? - ANSWERSPropanolol (Inderal) Why would a combined hormonal contraceptive be contraindicated in a 36-year-old patient with a past medical history of type 2 diabetes, obesity, chronic smoking, and sedentary life: - ANSWERSHer age and tobacco use During the breast examination of a perimenopausal woman, the NP detects a bloody spontaneous discharge from the right nipple. This indicates further evaluation. - ANSWERSAn intraductal papilloma Intraductal papilloma are usually solitary and smaller than 1 cm. They are located in large lactiferous sinuses or ducts and have a tendency to bleed. Rh negative women should receive Rho(D) immunoglobulin at what gestational time? - ANSWERS28 weeks When interpreting a complete blood count (CBC) lab report which of the following results describes the size of the RBCs? - ANSWERSMean corpuscular volume (MVC) What medication should be avoided when prescribing prophylactic therapy for headaches? - ANSWERSVenlataxin (Effexor) What is the mechanism of action of prostaglandin E1 (PG1) in a patient with transposition of the great arteries? - ANSWERSTo produce vasodilation and adequate oxygen saturation Which of the following complaints best describes lower extremity calf pain associated with peripheral artery disease: - ANSWERSA dull pain or cramp Which of the following conditions is NOT a typical finding of hyperprolactinemia in a 47-year-old premenopausal woman? - ANSWERSGynecomastia When treating a patient with asthma who is experiencing acute wheezing which medication should be given to relieve the symptom? - ANSWERSShort acting bronchodilator Which immunization reduces a patient's risk for infection with the virus that causes painful localized blistering rash? - ANSWERSShingles (herpes zoster) vaccine Headache warning signs that need prompt investigation include all of the following EXCEPT: - ANSWERSHeadache relieved with mild infrequent use of analgesics The client with iron deficiency anemia should be advised to take the iron supplement: - ANSWERSon an empty stomach between meals Which one of the following statements is true of muchausen syndrome by proxy? - ANSWERSUnder the supervision of adults other than the abuser, the patient does not exhibit symptoms Which of the following is the most common presenting sign of substance abuse in adolescents? - ANSWERSChanges in behavior A woman is 11 weeks pregnant and has a maternity history of one full term vaginal delivery, a set of premature triplets delivered vaginally, and a first trimester abortion. Using her TPAL system to document her maternal status: - ANSWERSGravida 4, Para 1314 Gravida, Term babies, Preterm Babies, Abort and Living Child The nurse practitioner palpates an enlarged right epitrochlear lymph node in a 30 year old patient. The nurse practitioner should assess the patients: - ANSWERSright forearm and hand Anticholinergics are indicated for the treatment of: - ANSWERSUrge incontinence A patient presents with signs of chest pain, the nurse practitioner observes jugular venous distention. Their finding is consistent with: - ANSWERSHeart failure On examination of the neck, a dome shaped lesion in the dermis forming a benign closed firm sac attached to the epidermis is noted on a right lateral side of the neck. The type of lesion is known as : - ANSWERSa cutaneous cyst A dark dot (black-head) may be visible on its usually either an epidermoid cyst, common on the face and neck, or pilar cyst, common in the scalp. Both may be come inflamed. BATES: pg286 Symptoms of heartburn and regurgitation are associated with: - ANSWERSGastroesophageal reflux A 70-years-old man walks 20- minutes most days of the week. He has begun to complain of pain of his left calf when he is walking. The problem has gotten gradually worse and now he is unable to complete his 20 minutes walks without stopping to rest. What choice best describes the pain associated with peripheral artery disease? - ANSWERSa dull pain and cramp Papilledema is cause for concern because it is suggestive of: - ANSWERSIncreased intracranial pressure BATES: pg. 280 A 38-year-old patient with a history of abdominal pain presents to the nurse practitioner. Findings reveal superficial edema and bruising in the subcutaneous fatty tissue around the umbilicus. Hemorrhagic pancreatic is suspected because of which finding? - ANSWERSA positive Cullen's sign BATES: pg. 208 A 57-year-old post-menopausal female presents with a complaint of vaginal burning, pruritus, and painful intercourse. On examination, the nurse practitioner would be most concern with the findings: - ANSWERSA friable cervix When intervention does the American College of Rheumatology recommend as first line therapy for Osteoarthritis, rheumatoid arthritis or something else: - ANSWERSExercise and weight loss Which of the following drugs is not contraindicated for concurrent use with warfarin (Coumadin)? - ANSWERSAmoxicillin (Amoxil) The lymphatic ducts drain into the: - ANSWERSVenous system Which of the following is the most appropriate treatment for trichomoniasis in a non-pregnant woman? - ANSWERSMetronidazole (Flagyl) Osteosarcoma in a pediatric patient is most often diagnosed when there is: - ANSWERSpain in the affected bone In a patient who has a history of migraine headaches, which characteristics is most common? - ANSWERSFamily history Symptoms associated with small bowel obstruction usually include: - ANSWERSVomiting and pain Unilateral rhinitis could be caused by all of the following except: - ANSWERSDrug induced rhinitis A 7-year-old child has been diagnosed with acute sinusitis. The drug class that should be avoided is: - ANSWERSantihistamines A patient present with a elongated head with bony prominence of the forehead, nose, and lower jaw. These facial features could be suggestive of: - ANSWERSAcomegaly Why would a child diagnosed with beat thalassemia and hemosiderosis received deferoxamine (Desferal)? - ANSWERSTo eliminate excessive iron and prevent organ damage A patient has newly diagnosed hypothyroidism. What are the patients TSH level expected to be? - ANSWERSHigher than normal Which of the following symptoms would be a clinical manifestation noted during the secondary stage of syphilis? - ANSWERSRash marked by red or reddish-brown, penny-size lesions over the palms and soles An 84-year-old male with prostatic hypertrophy is at increased risk of: - ANSWERSUrinary tract infections A characteristic lesion observed in a male with primary syphilis is a: - ANSWERSchancre During an acute attack of gout, the nurse practitioner knows NOT to prescribe: - ANSWERSAllopurinol What two vitamins and minerals should be included in oral multivitamins in women: - ANSWERSFolic acid and iron In a patient with bacterial meningitis, the most common reason for finding of headaches: - ANSWERSIncreased intracranial pressure Janeway lesions, petechiae, and oster nodes are associated with: - ANSWERSInfective endocarditis BATES: pg. 207 A patient presents with decreased hearing related to antibiotic use. Which class of antibiotic is this? - ANSWERSAminoglycosides Aminoglycosides antibiotics, vancomycin and aspirin are some medication that can cause hearing loss BATES: pg. 219 Which antihypertensive would be appropriate to prescribe for a hypertensive patient (B/P) 150/95) that is in her third trimester? - ANSWERSMethyldopa Category B for pregnancy Pharm book: pg.143 A 40-year-old admits to multiple sex partners presents with several lesions over his body Findings reveals hemorrhagic vesiculopustular lesions over the hands and feet. These lesions are most likely associated with: - ANSWERSGonococcemia BATES: pg.207 Purple to grey macules, papules or hemorrhagic pustules distributed over acral and periarticular surfaces Which agent os NOT useful in prophylactic treatment of migraine headaches? - ANSWERSSumatriptan (Imitrex) The right lymph duct drains lymphatic fluid from all the following expect the - ANSWERSRight leg Acute lymphocytic leukemia is usually diagnosed by: - ANSWERSA bone marrow examination The medication that blocks the transportation of glucose across the intestines into the blood stream to target prandial blood glucose is: - ANSWERSAcarbose (Precose) Alpha-Glucosidase Inhibitors Prostate pain is usually located in the: - ANSWERSPerineum A nurse practitioner examines the skin of an elderly patient which finding below is NOT benign lesion associated with the aging process? - ANSWERSDermatophytosis also known as ringworm, is a fungal infection of the skin. Typically it results in a red, itchy, scaly, circular rash. A 65-year-old male presents with findings of symmetric thorax with moderate kyphosis and anterior diameter. Chest expansion is decreased and the diaphragm descending 2 cm bilaterally. These findings related to: - ANSWERSchronic obstructive pulmonary disease Phenazopyridine (Pyridium) is recommended for very short-term use in patients with urinary tract infections (UTIs) because: - ANSWERSOccurrence of hemolytic anemia Estrogen-progestin contraceptives should be avoided in women with: - ANSWERSMigraines with aura Combine contraceptives is a good choice for patients childbearing age younger than 35 with NO aura migraine The addition of benzoyl peroxide to erythromycin for the topical treatment of acne: - ANSWERSImprove the efficacy of erythromycin An elderly male with benign prostate hyperplasia (BPH) should be advised to avoid antihistamines. What is the reason for this? - ANSWERSUrinary retention Examination of the hair reveals a fine silky appearance. This finding may be seen in patients that have: - ANSWERSHyperthyroidism A patient develops a cough secondary to an angiotensin-converting-enzyme (ACE). The most appropriate statement related to ACE-I cough is that the cough typically: - ANSWERSResolves within a week after stopping the ACE inhibitor