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NR603 Health Assessment APEA Predictor Exam Review Questions Week 4 With Answers (620 Solved Questions)

NR603 Health Assessment APEA Predictor Exam Review Questions Week 4 With Answers provides an in-depth analysis of past exam patterns and topics.

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    APEA Questions 1. A patient report that she is taking kava kava regularly for anxiety with the results. What should the nurse practitioners evaluate? a. Liver function studies 2. A person with 20/80 vision: HAS POORER VISION THAN SOMEONE WITH 20/40 VISION 3. One exception to the recommendation to limit dietary fat intake is CHILDREN UNDER 2 YEARS OF AGE 4. The most effective treatment for anemia of chronic disease is: TREATMENT OF UNDERLYING DISEASE Rationale: The key phrase is “anemia of chronic disease” and with this, the pt’s chronic disease has caused the deficiency so once you correct and or treat the chronic disease, then the anemia will correct itself. 5. Salicylates and other non-steroidal anti-inflammatory agents have all of the following actions EXCEPT- ANTI-EMETIC EFFECTS VIA SUPPRESSION OF GASTRIC ACID SECRETION 6. Which of the following does NOT increase a woman’s risk of developing cervical cancer? NULLIPARITY 7. All of the following principles apply to drug therapy for elders except ENCOURAGE THE ELDERLY TO CONTINUE SELF-MEDICATION ADMINISTRATION TO FACILITATE INDEPENDENCE AND SELF-SUFFIENCY 8. A female patient believes that she was exposed to HIV through sexual intercourse several months ago. She asks for “the test for AIDS.” Which statement is NOT correct? THE ELISA IS USED FOR SCREENING, BUT MAY YIELD A FALSE NEGATIVE THIS SOON AFTER EXPOSURE 9. The nurse practitioner teaches the parents of a 2-month-old infant with GERD that treatment typically includes all of the following interventions except MAINTAINING THE USUAL FEEDING REGIMEN AND BURPING THE INFANT WELL WHEN THE FEEDING IS COMPLETED 10. A widowed 85-year-old was recently moved from her home of 65 years to a bedroom in her daughter’s home. According to reports by family members, she is now

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    “cantankerous” gets “mixed up” easily and cries for no apparent reason. Factors in the client history that are consistent with delirium may include all of the following except a. INSIDIOUS ONSET AND CHRONIC PROGRESSIVE COURSE 11. The two tests that can indicate current infection with hep B are: a. Presents of hep B antigen and IgM 12. A characteristic of elders which affects the pharmacotherapeutics of drug therapy in that population is an increase in PERCENT OF BODY FAT 13. An elder’s caretaker is planning the elder’s menu. The elder is on a bland diet. The nurse practitioner reviews the meal plans and notes that which of the following is NOT appropriate? a. Coffee, tea, carbonated sodas, Orange juice 14. The leading cause of death from injury in childhood is MOTOR VEHICE ACCIDENTS 15. Therapeutic International normalized ratio (INR) for a patient taking warfarin (coumadin) for a chronic atrial fibrillation is expected to be: a. Increased 16. The most accepted recommendation regarding a skin cancer prevention is: a. Avoidance of excessive sun exposure 17. Antibiotic administration has been demonstrated to be of little benefit in the treatment of which of the following disease processes? a. Acute bronchitis 18. An anxious parent brings her three-day old female infant to see the nurse practitioner because of the serosanguineous vaginal discharge. The nurse practitioner tells the mother: a. This is a normal finding in female newborns 19. A common finding associated with temporal arteritis is: a. Severe headache

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    20. What information would best help the parent who is concerned about a school age child eating habits? a. Establish a consistent schedule for meals and allow the child to participate in meal planning 21. Which of the following scenarios in a 75-year-old patient would be inappropriately managed in an outpatient setting (i.e. the patient should be referred for hospital admission)? a. UNSTABLE ANGINA 22. A patient with diabetes brings his glucose diary from the past seven days for the nurse practitioner to review and evaluate. What changes should be made? Day one through seven AM 67, 52, 61, 48, 39, 68, 70 PM 138, 161, 148, 168, 121, 142, 176. a. Decreased the PM dose of NPH insulin 23. Appropriate nutritional guidance for the pregnant patient is: a. Increase caloric intake buy 300 cal/day and add iron and folic acid supplementation 24. The most successful patient interview is likely to: a. Be a collaborative process 25. RhoGAM is not administered to an Rh-negative mother with negative anti-d antibodies WITHIN 72 HOURS OF BIRTH OF AN RH-NEGATIVE INFANT 26. The most common presentation of thyroid cancer is A SOLITARY THYROID NODULE 27. A benign thyroid nodule, that’s painless presents as SMOOTH 28. Initial treatment of a child presenting with a severe head injury is: a. Aimed at resuscitation, then maintenance of oxygenation and blood flow 29. Which red blood cell (RBC) index is most useful for differentiating types of anemias? a. Mean corpuscular volume (MCV) 30. A 31-year-old female is informed that her pregnancy test is positive, and she is about three weeks pregnant. The nurse practitioner is very concerned about the patient reported history of alcohol use. She correctly tells the patient that babies born to women who drink alcohol during pregnancy are at risk for all of the following except:

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    a. Post maturity delivery 31. According to Erikson, the developmental task of the early adult is : a. Ego integrity vs. despair 32. The parents of a two-year-old Report that she is not saying any words, but make sounds, babbles, and understand 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 33. Which group is considered to be at high risk for the development of testicular tumors? a. Late adolescence to early adulthood (you need to know the actual age groups) 34. An urgent call is received from a patient’s wife who states that her husband is having chest pain I’m relieved by three nitroglycerin tablets. The nearest hospital is 40 minutes away. Besides having the patient reach the hospital as soon as possible, what intervention can the nurse practitioners suggest might influence a positive outcome? A. Have the patient to an aspirin on the way to the hospital 35. Which of the following postpartum mothers should receive RhoGAM (BayRho-D) to prevent Rh iso-immunization? a. A G1 P1 mother who is Rh negative without Rh antibodies; cord blood is Coombs negative; newborn is Rh positive. 36. A patient with a history of alcohol abuse presents with acute nausea, vomiting, and severe retrosternal pain that radiates to the back. Based on the most probable diagnosis, the nurse practitioner would appropriately order a CBC, chemistry profile, and: a. serum amylase and lipase, and liver function studies 37. A female patient asks, “how do I calculate my ideal body weight?” The nurse practitioner response: a. Start with 100 pounds, and add 5 pounds for every inch in height over 5 feet 38. A 35-year-old woman with prior history of extreme nervousness has been treated with diazepam (valium) for four weeks. She reports improvement. Today her pulse is 112bpm and blood pressure is 130/92 mmHg. She is 5’4” in weighs 105 pounds. What is the most likely diagnosis?

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    a. Hyperthyroidism 39. Which of the following is not a common early sign of benign prosthetic hyperplasia (BPH)? a. Increased force of urine flow 40. Acute idiopathic thrombocytopenia purpura (ITP) is most commonly seen in childhood following: a. Acute infection 41. The nurse practitioner diagnosis epididymitis in a 24-year-old sexually active male patient. The drug of choice for treatment of this patient is: a. Oral doxycycline (Vibramycin) plus intramuscular ceftriaxone 42. A 55-year-old man is diagnosed with basal cell carcinoma. The nurse practitioner correctly tells him: a. It can be cured with surgical excision or radiation therapy. 43. A characteristic of delirium that is typically absent and dementia is: a. Acute onset of confusion in a previously alert and oriented patient 44. A 42-year-old male executive has been diagnosed with depression. He is otherwise healthy. And appropriate initial treatment choice is a: a. Selective serotonin reuptake inhibitor (SSRI) 45. the CAGE/ AUDIT questionnaire is useful to assess: a. alcohol use disorders (but you need to know a little more about 46. A 16-year-old athlete complains of pain underneath his heel every time he walks. There is verrucous surface level with the skin of the heel. What pharmacologic intervention should the nurse practitioner prescribed for this patient? a. Salicylic acid plasters 47. Previously immunized elderly patients should receive a tetanus and diphtheria (Td) booster every: a. 10 years 48. The nurse practitioner is canceling a young woman who desires pregnancy. She discontinued her oral contraceptives for months ago. Her urine pregnancy test is negative. She expresses concern that she might have an infertility problem. The nurse

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    practitioner accurately tells her that a couple is not considered infertile until there has been unprotected intercourse without conception for what period of time? A. One year 49. When a patient presents with symptoms of acute gallbladder disease, what is the appropriate nurse practitioner action? a. Order abdominal ultrasound 50. An eight-year-old female has been brought to the nurse practitioner on five occasions in the past nine weeks with a complaint of abdominal pain. The evaluation each time is negative, but her mother is convinced the child is truly experiencing pain. The most likely diagnosis is: a. Recurrent abdominal pain 51. What is the most common cause of Cushing’s syndrome? a. Administration of a glucocorticoid or ACTH 52. Which of the following maternal situations is considered an absolute contraindication to breast-feeding? a. Early HIV infection 53. A three-year-old male patient is being evaluated by a nurse practitioner for frequent respiratory infections and fatigue. His laboratory test show thrombocytopenia, granulocytopenia, and anemia. Which of the following is consistent with these lab bindings? a. Acute lymphocytic leukemia (ALL) 54. Factors known to be associated with early sexual activity include: a. Lower socioeconomic status, use of tobacco, alcohol or other drugs, and single parent household 55. A 26-year-old female presents with elbow pain that is described as aching in burning. There is point tenderness along the lateral aspect of the elbow and painful passive flexion and extension. She reports she has been playing tennis almost daily for the past month. The most likely diagnosis is: A. Lateral epicondylitis ------tennis elbow

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    56. A two-year-old African-American child is being evaluated by the nurse practitioner. His clinical appearance and history are consistent with sickle cell anemia. What is the appropriate laboratory test to diagnose sickle cell anemia? a. Hemoglobin electrophoresis 57. Which activities are not characteristic of preschool children? a. Always follow rules during playground games 58. What type of question is most useful when opening an interview? a. Open ended 59. All of the following agents/ medication classes are generally contraindicated in pregnancy except: a. Cephalosporins, parenteral insulin, parenteral heparin. 60. A 35-year-old female with a history of mitral valve prolapse is scheduled for routine dental cleaning. According to the 2007 American Heart Association’s guidelines for endocarditis prophylaxis, what would you advise this patient? a. She does not need prophylaxis for any dental procedure 61. What diabetic complications result from hyperglycemia? a. (1) Retinopathy, (3) peripheral neuropathy, (4) accelerated atherogenesis 62. Which of the following diagnostic assessments must be considered before developing any plan of care for a 27-year-old female presenting to a family practice clinic? a. Pregnancy test 63. The process by which a professional association confers recognition that a licensed professional has demonstrated mastery of a specialized body of knowledge and skills is termed: a. Certification 64. A 15-year-old male has a history of cryptorchidism which was surgically repaired. Because of this information, it is essential for a nurse practitioner to teach him about: a. Testicular self-examination

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    65. A 30-year-old female comes into a clinic with classic signs and symptoms of appendicitis. The nurse practitioner fails to refer the patient tree surgeon. D appendix ruptured and the woman dies. This is an example of: a. Malpractice 66. And elderly patient is being seen in the clinic for a complaint of “weak spells” relieved by sitting or lying down. The nurse practitioner checks the patient’s blood pressure while he is lying, sitting, and standing. The nurse practitioner suspects: a. Orthostatic hypertension 67. The nurse practitioner knows that the frail elderly alright high risk for malnutrition. Indicators of malnutrition in this population included all of the following except: a. Hunger and increased appetite 68. The patient reports, “something flew in my eyes” about an hour ago while he was splitting logs. If there was a foreign body in his eye, the nurse practitioner would expect to find all except : a. A purulent discharge 69. Inappropriate initial treatment for external genital warts caused by human papilloma virus (HPV) in a non-pregnant patient is : a. Topical trichloroacetic acid (TCA) 70. A new patient presents to the nurse practitioner clinic stating she wants a second opinion. She started propylthioutacil (PTU, Propyl-Thyracil) 75 mg three times today a week ago as therapy for newly diagnosed Graves’ disease. She still feels irritable and jittery. How should the nurse practitioner respond? a. Inform the patient that improvement requires 2 to 3 weeks 71. What advice should be given to the parents of an infant at risk for SIDS? a. Place the baby in the supine position for sleeping 72. A six-month-old patient with type III metatarsus adductus (i.e., rigid and does not correct to neutral) should be treated with: a. Surgical intervention 73. Patient should be advised to purchase the same brand name for each of the following drugs except:

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    a. Hydrochlorothiazide 74. Which activity during the first trimester could be deleterious to the fetus? a. Dieting 75. The mother of an 18-month-old child is in the office. She is not yet immunized her child because the child’s grandmother “doesn’t believe in that.” The nurse practitioner should: a. Provide education and recommend beginning of the series of vaccines 76. The nurse practitioner is conducting a routine health assessment of a 28- year-old patient. He states he is very “Health conscious” and that he ran 6 miles daily. He denies current Health problems and his past medical history is unremarkable. Routine urinalysis reveals proteinuria. What is the most likely cause of the proteinuria? a. Exercise 77. What is the earliest age that MMR immunization can be administered? a. One year 78. The nurse practitioner examines a six-year-old who has had a 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. Encourage supportive and symptomatic care 79. Physical examination findings consistent with emphysema include all of the following except: a. Pallor and cyanosis of the mucosa nail beds 80. Which choice below is not a contraindication to receiving the diphtheria, pertussis, and tetanus (DPT) vaccine ? a. Current antibiotic use 81. All of the following are included in the differential diagnosis of hyperthyroidism except: a. Plummer’s disease 82. A middle-aged patient has a history of smoking, chronic cough, and sputum production. He reports chronic dyspnea. A diagnosis of COPD should be confirmed with: a. Spirometry

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    83. A patient requests information about foods to include in his diet while vacationing in Mexico to avoid “Montezuma’s revenge.” The nurse practitioner should advise him to ingest only: a. Cooked vegetables in soup, bottled water, and wine 84. An eight-month-old male presents with hemarthrosis of both knees and hematuria. The parents gave no history of trauma but say “he has always bruised easily.” The most likely diagnosis is: a. A type of hemophilia 85. Of the following for malpractice issues for which an APRN may incur liability, which is the most prevalent cause of action? a. Failure to refer when the APRN and skills are exceeded 86. Which of the following factors is (are) associated with increased incidence of cervical cancer? a. Smoking and sexual activity at an early age with multiple partners 87. Following the finding of prostate gland abnormalities on DRE, the nurse practitioner orders appropriate labs. When preparing to view lab reports with the patient, and Nurse practitioner knows all of the following are true except: a. Normal PSA it’s 10ng/ml or less 88. Which characteristic is not indicative of heart failure? a. Purulent sputum 89. A 32-year-old male patient complains of urinary frequency and burning on urination for three days. Urinalysis reveals bacteriuria and positive nitrates. He denies any past history of urinary tract infections. The initial treatment should be: a. Trimethoprim-sulfamethoxazole (Bactrim, sulfatrim) for 7 to 10 days 90. On trans illumination of the scrotum, the nurse practitioner identifies a hydrocele in a three-month-old infant. What course of action should be taken? a. Monitor the infants until 12 months of age 91. Which of the following is an appropriate drug for initial treatment of gastroesophageal reflux disease (GERD) in adults? a. Famotidine (Pepcid)/ You need to know the drug class

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    92. The major health risk associated with oral contraceptive therapy is? a. Cardiovascular events 93. The most effective treatment of primary and secondary encopresis focuses on: a. Establishment of a regular bowel routine 94. A 55-year-old male patient complains of blood in his urine for the past two weeks. He denies dysuria. Urinalysis is positive for red blood cells and negative for leukocytes and nitrates. The initial evaluation of this patient should include: a. Renal ultrasonography 95. A 50-year-old non-smoker with no comorbidities presents to the clinic an is diagnosed with community acquired pneumonia. His vital signs are normal except for temperature 101.6°F. a sputum specimen is collected and sent for culture and sensitivity. What action should the nurse practitioner take today? a. Start Clarithromycin (Biaxin) 500 mg BID for five days 96. ??????? a. Influenza vaccine should be given annually to all persons 65 years or older, anti- persons six months or older who are And chronic care facilities, or who suffer chronic cardiopulmonary disorders, metabolic disorders, hemoglobinopathies, or immunosuppression. 97. Simple cases of impetigo and folliculitis are usually successfully treated with: a. Topical antibiotics 98. A patient on oral contraceptives reports that she has forgotten to take her pill the last two days in A row. What should you advise her? 1-take two tablets daily for the next two days, then resumed a regular schedule. 2-begin a new compact of tablets starting the first day of the next cycle. 3-use an additional method of contraception for the rest of the pill pack.4-take one tablet, discard the second, and continue as scheduled. a. 1 and 3 99. A three-year-old has enlarged, warm, tender cervical lymph nodes, indicating: a. Infection proximal to the nodes

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    100. A 62-year-old female has been diagnosed with osteoporosis. She refuses hormone replacement therapy as well as new medication shown to increase bone density. Important education for this patient should include: a. The benefits of increasing calcium daily and daily weight bearing exercises 101. The tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) have demonstrated efficacy in the treatment of each of the following conditions except: a. Gastroesophageal reflux 102. Which finding below would be unusual and patient with diabetic retinopathy? a. Papilledema 103. A two-year-old child is diagnosed with hemophilus influenza type B. The child’s parents will not allow any of their children to be immunized. There are two other children in the home, ages one year and three years, how should the nurse practitioner manage contacts? a. Rifampin prophylaxis should be given to all household contacts, including the adults. 104. Atenolol (Tenormin) should be avoided in: a. A 43-year-old female with asthma 105. The results of the Weber tuning fork test is the lateralization of sound to the right ear. This finding indicates : a. Conduction problem in the right here 106. A male patient with chronic atrial fibrillation takes a generic brand of Coumadin (warfarin). He should report all of these to his healthcare provider except : a. One missed dose of warfarin 107. The side effect of the medroxyprogesterone (depo-Provera) that often leads women to discontinue use is : a. Weight gain 108. The mother of a two-week-old infant with hypospadias request circumcision for her infant. The nurse practitioner’s best response to this mother should be :

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    a. Explain why an infant with hypospadias should not be circumcised 109. 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 110. Enlargement of the scrotum and testes with little change in size of the penis characterizes which tanner stage of sexual development? a. Tanner 2 111. Which of the following ecchymotic lesions in a four-year-old patient most likely represents a possible bleeding disorder: a. 7 cm on the abdomen 112. The mother of a six-month-old infant asked about the use of an infant walker. The most appropriate response is to : a. Discourage the use of walkers and encourage parental holding and floor play 113. The developmental task for the family of an adolescent is to: a. Allow the adolescent increasing freedom and responsibility 114. Which of the following diseases is not acquired trans placentally? a. Tuberculosis 115. A two-year-old has iron deficiency anemia and has not had an increase in hemoglobin for the past three months despite Iron supplementation. The nurse practitioner should : a. Consider referral to a hematologist for further assessment 116. A 38-year-old penicillin allergy patient has folliculitis on A bearded part of his face. The nurse practitioner prescribes erythromycin and tells the patient: a. Erythromycin may upset his stomach, so it should be taken with food. 117. A 45-year-old male is diagnosed with hypertension. His blood pressures have been gradually increasing overtime, with a reading today of 152/98. Diagnostic studies are normal. The most likely diagnosis for this patient is: a. Essential hypertension 118. Which of the following signs and symptoms are typical of hypothyroidism? a. Constipation

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    119. The most commonly recommended method for prostate cancer screening in a 55-year-old man is: a. prostate specific antigen (PSA) testing alone 120. An obese 43-year-old has recurrent superficial fungal skin infections over the past two years. Today, she presents with intertriginous candida. Her skin is macerated from frequent rubbing and scratching. The plan of care should include: a. Recommended screening for diabetes myelitis and HIV infection 121. If 37-year-old female patient with A history of a single episode of depression and frequent complaints of PMS is being treated for hypothyroidism. Today she complains of poor concentration and fatigue. The nurse practitioner should: a. Question her further 122. Which of the following drugs has a beneficial effect on benign prosthetic hyperplasia? a. Doxazosin (Cardura) 123. A patient that has 20/80 Visual acuity can see: a. At 20 feet what a person with normal vision can see it 80 feet 124. The goals of treatment for patients with alcohol abuse disorder are: a. Abstinence or reduction in use, relapse prevention, and rehabilitation 125. The nurse practitioner correctly teaches the patient with diabetes mellitus that if blood glucose is less than 100mg/dl (5.6 mmol/L) prior to exercise, the patient should first consume 15 g of carbohydrates, such as: a. Once slice of bread 126. Characteristics of prescription and OTC drug use in the elder population include all of the following except: a. Increased tolerance to drug effects 127. Acute lymphocytic leukemia (ALL) is usually diagnosed by: a. A bone marrow examination 128. Subsequent to successful completion of the nurse practitioner certification exam, the candidate is considered to be: a. CERTIFIED

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    129. An obese hyperlipidemic patient, newly diagnosed with type II diabetes mellitus has fasting blood glucose values 180 to 250 mg/dL (10.1-14 mmol/L). What is the most appropriate initial treatment to consider? a. A sulfonylurea and /or metformin (Glucophage-XR) 130. All of the following are typical of toddlers except: a. Increased appetite 131. Interest practitioner has treated an infant for the last three weeks for thrush with nystatin (Mycostatin) oral suspension. What diagnostic test could the nurse practitioner platform which might quickly confirm a diagnosis of oral candidiasis? a. A potassium hydroxide (KOH) slide preparation 132. Which of the following physical findings is consistent with a diagnosis of Beta-thalassemia major? a. Bronze skin color 133. An adult female patient is seeking information about her ideal weight. She is 5’7” tall using the” height weight formula”, what is her ideal body weight? a. 135 pounds 134. The most appropriate therapy for an elderly patient with pernicious anemia is: a. Intramuscular injection of vitamin B 12 135. Which of the following patients is most likely to have a diagnosis of type II diabetes mellitus? a. A 49-year-old male with impotence and HBA1C 10.0% 136. The recent Beta-adrenergic blockers should be avoided in patients with diabetes is because they may: a. Mask symptoms of hypoglycemia 137. The nurse practitioner is initiating levothyroxine (Synthroid) for primary hypothyroidism in a 71-year-old female. The usual starting dose of levothyroxine is 50 to 100 micrograms per day. What would be the most appropriate initial therapy in this patient? a. 25 μg per day 138. Nurse practitioner is evaluating a 35-year-old female nurse. She has a history of hospitalization for hepatitis B infection two years ago. Her laboratory tests

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