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APEA Test Questions and Answers with Rationales 2025.
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APEA Pre-Predictor Test Questions and Answers with Rationales 2025.
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APEA Pre-Predictor Test Questions and Answerswith Rationales 2025
1) A 15 years old high school student with a mild sore throat and the low-grade fever has
been haspersistedforabout3weeks. She reports general malaise, fatigue, and loss of appetite.
The NP suspects mono nucleosides. Which of the following is the LEAST appropriate
intervention?
a. Palpate the lymph nodes and spleen
b. Examinetheposteriororopharynxforpetechiae
c. Obtain a CBC, throat culture, and heterophil antibody test.
d. Obtain urinalyses and serum for LFTs and amylase
Explanation: mononucleosis is a symptomatic infection caused by the Epstein-Bar virus.
Common is people 15-24 years of age. Following the incubation period (1-2 months), common
signs and symptoms include fatigue, chills, malaise, anorexia, white tonsillar exudates, and
lymphadenopathy or posterior cervical region. Splenomegaly can be present. A maculopapular or
occasionally petechial rash occurs in less than 15% of patients. A diagnosis is usually made
using the Monospot.In addition,neutropeniaandlymphocytosisareusuallydetectedintheCBC.
2) A 32-year-old male patient complaint of urinary frequency and burning on urination for
three days. Urinalyses reveal bacteriuria and positive nitrites. He denies any past hx. Of urinary
tract infections. The initial treatment should be:
a. trimethoprim-sulfamethoxazole(Bactrim,Sulfatrim)for7-10day
b. ciprofloxacin(Cipro)for3-5days
c. Trimethoprim-Sulfamethoxazolefor3days
d. 750mg ciprofloxacinasa one-timedose
Explanation: trimethoprim-sulfamethoxazole(TMPS)is usually n appropriate medication for
most patients' urinary tract infections.In the case of community resistancetoTMPS
>20%^, another medication should be substituted. In men, the appropriate length of time is 7-10
days.Womenmaybetreatedfor3 days for uncomplicated UTI
3) Which agent is most effective for the treatment of nodulocystic acne?
a. Benzoyl peroxide(Benzac)
b. Retinoic acid(RetinA)
c. Topical
tetracycline
d. Isotretinoin)
Explanation: Isotretinoin (Accutane) is a systemic agent indicated for treating severe
inflammatory acne. The patient must clearly understand the guidelines for its use. A woman of
childbearing age must use an effective method of contraception because isotretinoin is
teratogenic. Many restrictions are in prescribing this medication because of the teratogenic
effects given during pregnancy. Therefore, it is a pregnancy category X.
4) An 18 y/o woman is taking a combined hormonal oral contraceptive. She should be
instructed to use a backup method for the prevention of pregnancy
a. Throughouttheweekofplacebopills
b. If prescribed to piramate(Topamax)for the treatment of migraines.
2
, c. Ifprescribedamoxicillin/clavulanate(Augmentin)for sinus infection
d. if she forgets totakeasingledoseofthecontraceptive
Explanation: Anticonvulsants, including phenytoin (Dilantin), carbamazepine (Tegretol),
primidone (Mysoline), topiramate (Topamax) and oxcarbazepine (Trileptal)reduce the
effectiveness of contraceptives. Depo-medroxyprogesterone acetate injections or levonorgestrel-
releasing intrauterine devices would be a better method of contraception for patients taking
anticonvulsants. Most commonly used antibiotics have not been proven to reduce the
effectiveness of contraceptives. Rifampin is an exception, and additional…. Be used by women
taking this drug and using oral contraceptives, transdermal, or vaginal ring preparations.
Additional backup contraception should be used if taking antifungal agents. No additional
protection is needed thought the week of placebo pills. Missing one contraceptive dose does not
require additional protection; missing more than one dose does.
HEALTH PROMOTION (31)
1- A 58-year-old patient has an annual exam. A fecal occult blood test was used to screen for colon
cancer. Three were ordered on separate days. The first test was positive; the last two were negative.
How should the nurse practitioner proceed?
Rescreen in one year.
Perform a fourth exam.
Refer him for a colonoscopy. Correct
Examine him for hemorrhoids.
Explanation:
A fecal occult blood test is performed multiple times on different days because tumors don’t
consistently excrete blood. The reason multiple are performed is to increase the likelihood of
identifying blood. The patient needs to have a colonoscopy performed for examination of the colon.
The standard of practice is to refer all positive colon cancer screens for colonoscopy.
2 -A criterion for medication choice in an older adult is:
long half-life to prevent frequent dosing.
dosing of 3-4 times daily.
pill color and shape for easy identification.
half-life less than 24 hours. Correct
Explanation:
Many factors go into prescribing for older adults. Some important safety criteria include established
efficacy, low adverse event profile, and half-life less than 24 hours with no active metabolites. Active
metabolites would produce a longer effect of the drug in the patient. Dosing of a medication three to
four times daily invites dosing and medication errors. Once- or twice-daily dosing is ideal. Pill color
and shape is never a criterion for prescribing. Patients who are cognitively able will recognize the
color, shape, and size of pills they take on a regular basis.
3- What should the nurse practitioner recommend to any elder taking medications?
Have someone check your medications prior to taking them
Never take your medicine on an empty stomach
Keep a list of all of your medications with you Correct
Have a pharmacist review your list once a year
Explanation:
,A list of current medications should be kept with each patient and carried with him, especially when
healthcare visits are scheduled. Many older adults are capable of taking medications without
supervision. Many medications should be taken without food (thyroid supplementation for example).
A pharmacist can evaluate the list of medications for drug-drug interactions, but the pharmacist will
not know the diagnoses and other reasons for choosing the medications.
Question:
4- What temperature should be set on a water heater in the home of an older adult to prevent burn
injury?
Less than 110 degrees
Less than 120 degrees correct
Less than 130 degrees
Less than 140 degrees
Explanation:
Hot water heaters are common sources of burns in homes of older adults and very young patients.
Many safety organizations in the United States believe that burns can be prevented if hot water heaters
are set to less than 120° F.
Question:
5- What is the recommendation from American Cancer Society for assessment of the prostate gland in
a man who is 45 years old and of average risk for development of prostate cancer? He should have:
screening starting at 50 years of age. Correct
prostate specific antigen (PSA) now.
PSA and digital rectal exam now.
digital rectal exam only.
Explanation:
At age 50 years, males of average prostate cancer risk should have PSA measurement with or without
digital rectal exam (DRE). If they are deemed to be of high risk because of a family history (first-
degree relative with prostate cancer before age 65 years) or race (African American), screening
discussions should take place at age 40-45 years. If initial PSA is > 2.5 ng/mL, annual testing should
take place. If the initial PSA is < 2.5 ng/mL, test every 2 years.
Question:
6 - A 75-year-old adult asks for the pneumonia vaccine. His immunization record indicates that he had
one at age 65 and another a year later. What is the recommendation of the CDC about how the NP
should handle his request?
Revaccination is recommended now
Revaccination is recommended every 5 years after age 65 years
Do not revaccinate this patient at this time Correct
He should have received one at age 70 years
Explanation:
The recommendation of CDC is NOT to revaccinate this patient. After initial vaccination with PCV13
at age 65 years and subsequent vaccination with PPSV23 1 year later, no revaccination is
recommended in this patient.
Question
7- A patient who has been treated for hypothyroidism presents for her annual exam. Her TSH is 4.1
(normal = 0.4- 3.8). She feels well. How should she be managed?
, Continue her current dosage of thyroid replacement.
Increase her replacement.
Decrease her replacement.
Repeat the TSH in 2-3 weeks. Correct
Explanation:
When an abnormal TSH is received, especially when a patient is not symptomatic, it should be
repeated. Sometimes there are periods of transient hypothyroidism, lab error, and missed doses that
can cause changes in TSH levels.
Question:
8 - A 20-year-old student has an MMR titer that demonstrates an unprotective titer for rubella. She is
HIV positive. Her CD4 cell count is unknown. Which statement is true?
She should not receive the MMR immunization because she is low risk for the disease.
MMR is safe to give but she does not need this.
She is at risk for MMR but should not be immunized. Correct
She should receive this. The immunization is not alive.
Explanation:
This patient is at risk for rubella because she does not have a sufficient titer. The MMR immunization
is an attenuated virus. Though an attenuated immunization is weakened, it is still considered live and
so is contraindicated in anyone who may be immunocompromised. Since her CD4 cell count is
unknown, she should not receive this immunization yet. She may be able to receive this immunization
if her CD4 count is normal.
Question:
9- What choice below would be beneficial to a 76-year-old who takes daily oral steroids for COPD
and now takes a daily aspirin for primary prevention of myocardial infarction?
Screen for infection with H. pylori
Daily proton pump inhibitor (PPI) Correct
Antacids PRN heartburn
Daily use of low dose famotidine
Explanation:
Aspirin does increase the risk of gastrointestinal bleeding, especially if it is given in combination with
oral steroids. Most learned authorities and ACOVE (Assessing Care of Vulnerable Elders) agree that
when two or more risk factors for GI bleed are present, aspirin should not be added without some
form of protection for the GI tract (misoprostol or a daily PPI). In considering all the risks for GI
bleed, the most significant ones are age > 75 years, history of GI bleeding, warfarin use, daily NSAID
use, and chronic steroid use.
Question:
10- A patient who is 62 years old asks if she can get the shingles vaccine. She has never had shingles
but states that she wants to make sure she doesn’t get it. What should the nurse practitioner advise?
The immunization will protect you from acquiring shingles.
You are not old enough to receive the immunization.
The immunization is offered only to those who have had shingles.
You are eligible to receive it but you still may get shingles. Correct
Explanation:
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