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NURS 634 APEA PRACTICE TEST BANK FINAL
EXAM 2024 -2025 UPDATED QUESTIONS AND
ACCURATE DETAILED ANSWERS COMPLETE
DOCUMENT FOR STUDY
Mrs. T. comes for her regular visit to the clinic. She is on your schedule
because her regular provider is on vacation, and she wanted to be
seen. You have heard about her many times from your colleague and
are aware that she is a very talkative person. Which of the following is
a helpful technique to improve the quality of the interview for both
the provider and the patient?
A. Allow the patient to speak uninterrupted for the duration of the
appointment.
B. Briefly summarize what you heard from the patient in the first 5
minutes and then try to have her focus on one aspect of what she told
you.
C. Set the time limit at the beginning of the interview and stick with it,
no matter what occurs in the course of the interview.
D. Allow your impatience to show so that the patient picks up on your
nonverbal cue that the appointment needs to end.
ANS: B
Feedback: You can also say, “I want to make sure I take good care of this
problem because it is very important. We may need to talk about the
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others at the next appointment. Is that okay with you?” This is a
technique that can help you to change the subject but, at the same
time, validate the patient's concerns; it also can provide more structure
to the interview
You feel a small mass that you think is a lymph node. It is mobile in
both the up-and-down and side-to-side directions. Which of the
following is most likely?
A. Cancer
B. Lymph node
C. Deep scar
D. Muscle
ANS: B
Feedback: A useful maneuver for discerning lymph nodes from other
masses in the neck is to check for their mobility in all directions. Many
other masses are mobile in only two directions. Cancerous masses may
also be “fixed,” or immobile
A 77-year-old retired bus driver comes to your clinic for a physical
examination at his wife's request. He has recently been losing weight
and has felt very fatigued. He has had no chest pain, shortness of
breath, nausea, vomiting, or fever. His past medical history includes
colon cancer, for which he had surgery, and arthritis. He has been
married for over 40 years. He denies any tobacco or drug use and has
not drunk alcohol in over 40 years. His parents both died of cancer in
their 60s. On examination his vital signs are normal. His head, cardiac,
and pulmonary examinations are unremarkable. On abdominal
examination you hear normal bowel sounds, but when you palpate his
liver it is abnormal. His rectal examination is positive for occult blood.
What further abnormality of the liver was likely found on
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examination?
A. Smooth, large, nontender liver
B. Irregular, large liver
C. Smooth, large, tender liver
D. Irregular, small, nontender
ANS: B
Feedback: With his past history of colon cancer and with recent weight
loss and fatigue, a relapse of his colon cancer would be expected. Colon
cancer usually metastasizes to the liver, creating hard, irregular nodules,
which can sometimes be palpated on examination. A smooth, large liver
which is tender is often seen in hepatitis.
A 21-year-old college senior presents to your clinic, complaining of
shortness of breath and a nonproductive nocturnal cough. She states
she used to feel this way only with extreme exercise, but lately she
has felt this way continuously. She denies any other upper respiratory
symptoms, chest pain, gastrointestinal symptoms, or urinary tract
symptoms. Her past medical history is significant only for seasonal
allergies, for which she takes a nasal steroid spray but is otherwise on
no other medications. She has had no surgeries. Her mother has
allergies and eczema and her father has high blood pressure. She is an
only child. She denies smoking and illegal drug use but drinks three to
four alcoholic beverages per weekend. She is a junior in finance at a
local university and she has recently started a job as a bartender in
town. On examination she is in no acute distress and her temperature
is 98.6. Her blood pressure is 120/80, her pulse is 80, and her
respirations are 20. Her head, eyes, ears, nose, and throat
examinations are essentially normal. Inspection of her anterior and
posterior chest shows no abnormalities. On auscultation of her chest,
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there is decreased air movement and a high-pitched whistling on
expiration in all lobes. Percussion reveals resonant lungs. Which
disorder of the thorax or lung does this best describe?
A. Spontaneous pneumothorax
B. Chronic obstructive pulmonary disease (COPD)
C. Asthma
D. Pneumonia
ANS: C
Feedback: Asthma causes shortness of breath and a nocturnal cough. It
is often associated with a history of allergies and can be made worse by
exercise or irritants such as smoke in a bar. On auscultation there can be
normal to decreased air movement. Wheezing is heard on expiration
and sometimes inspiration. The duration of wheezing in expiration
usually correlates with severity of illness, so it is important to document
this length (e.g., wheezes heard halfway through exhalation). Realize
that in severe asthma, wheezes may not be heard because of the lack of
air movement. Paradoxically, these patients may have more wheezes
after treatment, which actually indicates an improvement in condition.
Peak flow measurements help to discern this.
A 17-year-old high school senior presents to your clinic in acute
respiratory distress. Between shallow breaths he states he was at
home finishing his homework when he suddenly began having right-
sided chest pain and severe shortness of breath. He denies any recent
traumas or illnesses. His past medical history is unremarkable. He
doesn't smoke but drinks several beers on the weekend. He has tried
marijuana several times but denies any other illegal drugs. He is an
honors student and is on the basketball team. His parents are both in
good health. He denies any recent weight gain, weight loss, fever, or
