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2024-2025 APEA Nursing Diagnosis 3P Exam With Answers (246 Solved Questions)

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    APEA 3P Exam/ PMHNP 3P exam prep With complete Questions and answers Latest 2024/25 Most ii common ii type ii of ii skin ii cancer ii in ii USA ii - ii ii ii Skin ii cancer ii Most ii common ii type ii of ii skin ii cancer ii - ii ii ii basal ii cell ii carcinoma ii basal ii cell ii carcinoma ii symptoms ii - ii ii ii Appearance ii varies; ii smooth, ii shiny ii bump, ii pink ii to ii pearly ii white ii Basal ii cell ii carcinoma ii common ii locations ii - ii ii ii cheeks, ii nose, ii face, ii neck, ii arms, ii back ii basal ii cell ii carcinoma ii diagnosis ii gold ii standard ii - ii ii ii biopsy. ii if ii not ii an ii option, ii refer ii to ii derm ii Actinic ii keratosis ii - ii ii ii Precursor ii to ii squamous ii cell ii carcinoma numerous ii dry, ii round ii and ii pink ii to ii red ii lesions ii w/ ii rough ii and ii scaly ii texture --> ii does ii not ii heal, ii slow ii growing ii in ii sun ii exposed ii areas ii Actinic ii keratosis ii diagnosis ii gold ii standard ii - ii ii ii Biopsy. if ii not ii an ii option, ii refer ii to ii derm ii Actinic ii keratosis ii treatment ii gold ii standard ii - ii ii ii small- ii cryotherapy large- ii number ii 5-FU ii (5-flouracil ii aka ii efudex). ii 5-FU ii medication ii Causes ii skin ii to ii ooze, ii crust, ii scab ii and ii be ii red ii **5-flouracil/ ii efudex-wear ii sunscreen!!** ii squamous ii cell ii cancer ii - ii ii ii chronic ii red ii scaly ii rough ii textured ii lesion ii w/ ii irregular ii borders crusting ii or ii bleeding ii may ii be ii present ii Squamous ii cell ii carcinoma ii common ii locations ii - ii ii ii rims ii of ii ears, ii lips, ii nose, ii face ii and ii top ii of ii hands ii precursor ii lesion ii to ii squamous ii cell ii cancer ii - ii ii ii actinic ii keratosis ii squamous ii cell ii carcinoma ii diagnosis ii by? ii - ii ii ii biopsy ii gold ii standard. ii if ii biopsy ii is ii not ii an ii option, ii refer ii to ii dermatology ii . ii Risk ii factors ii for ii skin ii cancer(melanoma ii and ii both ii non-melanoma) ii - ii ii ii Blistering ii sunburn ii as ii a ii child, ii history ii of ii sunburns, ii light ii skin, ii chronic ii exposure ii to ii UV ii light ii (sunlight/tanning ii beds), ii moles, ii family ii hx ii for ii skin ii cancer ii Melanoma ii symptoms ii (ABCDE) ii - ii ii ii asymmetry ii (shape/uneven ii texture) border ii (irregular/notched/blurred) color ii (variegated ii colors ii from ii black, ii blue, ii dark ii to ii light ii brown) diameter ii (size ii >6mm ii size ii of ii pencil ii eraser ii or ii larger)

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    evolving ii (changes ii in ii color/size/shape) may ii be ii itchy ii Acral ii lengtiginous ii melanoma ii - ii ii ii Most ii common ii type ii of ii melanoma ii in ii dark ii skinned ii individuals ii (blacks ii & ii asians) --> ii look ii for ii longitudinal ii brown ii to ii black ii bands ii under ii the ii nailbed. ii a ii changing ii spot ii or ii mole ii in ii the ii palms, ii or ii the ii soles ii of ii the ii feet ii seborrheic ii keratosis ii - ii ii ii soft, ii round, ii wart-like ii growth ii that ii is ii light ii tan ii to ii black ii and ii looks ii pasted ii on asymptomatic ii &benign ii Bacterial ii Meningitis ii Bacteria ii - ii ii ii Streptococcus ii pneumoniae- ii most ii common ii strain ii Haemophilus ii influenzae Neisseria ii meningitidis Escherichia ii coli *others ii Bacterial ii meningitis ii symptoms ii (Classic ii Triad) ii - ii ii ii High ii fever Nuchal ii rigidity rapid ii change ii in ii mental ii status ii w/ ii headache ii Triad=neck ii up erythematous ii spot-like ii rash ii (petechiae) ii ecchymosis ii to ii purple-colored ii lesions ii (purpura) ii which ii are ii non-blanchable ii Is ii bacterial ii meningitis ii a ii reportable ii disease ii - ii ii ii yes! ii Treatment ii for ii Bacterial ii meningitis-patient ii - ii ii ii IV ii Abx ii ASAP, ii resp/droplet ii iso ii for ii first ii 24-48 ii hrs, ii hydrate ii (low ii maintenance ii after ii initial ii fluid ii correction), ii Maintain ii ventilation ii and ii reduce ii increased ii intra ii cranial ii pressure ii if ii present ii (dexamethosone(to ii reduce ii inflammation, ii mannitol ii to ii diurese ii the ii brain), ii low ii stim ii environment, ii tx ii complications ii that ii may ii arrive ii and ii support ii family ii Treatment ii for ii bacterial ii meningitis-close ii encounter ii - ii ii ii Close ii contacts ii should ii be ii treated ii w/ ii rifampin ii 600 ii mg ii q ii 12 ii hours ii x ii 2 ii days **Rifampin ii changes ii urine ii color ii to ii reddish ii orange ii and ii can ii stain ii contacts **AVOID ii RIFAMPIN ii IN ii PREGNANCY ii Brudzinkski ii sign ii (meningeal ii irritation) ii - ii ii ii Tests ii for ii meningeal ii irritation Patient ii supine, ii raise ii BACK ii of ii head ii and ii flex ii chin ii towards ii chest + ii result ii if ii pt ii automatically ii beds ii both ii hips --Brudzinski ii and ii back ii of ii head ii start ii with ii B ii as ii well ii as ii bends-- ii Kernig's ii sign ii - ii ii ii Tests ii for ii meningeal ii irritation

  4. Page 4
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    patient ii supine. ii flex ii patients ii hips ii and ii knees ii in ii a ii right ii angle, ii then ii slowly ii straighten/extend ii the ii legs ii up ii + ii result ii if ii when ii the ii patient ii complains ii of ii pain ii during ii extension ii of ii leg ii MCV4 ii (meningococcal ii vaccine) ii Age ii 11-19 ii - ii ii ii Give ii one ii dose ii of ii menactra ii or ii menveo primary ii dose ii given ii age ii 12 ii or ii younger ii give ii a ii booster ii at ii age ii 16-18 ii MCV4 ii (meningococcal ii vaccine) ii Age ii 19-21 ii - ii ii ii Give ii one ii dose ii of ii menactra ii or ii menveo ii if ii never ii had ii either ii Rocky ii mountain ii spotted ii fever ii (RMSF) ii symptoms ii - ii ii ii Fever chills N/V myalgia arthralgia 2-5 ii days ii later ii develop ii petechial ii rash ii on ii forearms, ii ankles, ii and ii wrists ii that ii spreads ii towards ii trunk ii and ii becomes ii generalised. ii sometimes ii rash ii develops ii on ii palms ii and ii soles **RASH ii DEVELOPS ii INWARDS** ii RMSF ii pneumonic ii (RMSF) ii - ii ii ii R-Rash ii ii M-Muscle ii aches ii (myalgia) ii ii S-Stomach ii aches ii (nausea ii and ii vomiting) ii ii F-Fever ii (>102 ii F) ii Rocky ii Mountain ii Spotted ii Fever ii (RMSF): ii Located: ii - ii ii ii •Think ii "Rocky"- ii North ii Carolina, ii Oklahoma, ii Arkansas, ii Tennessee, ii Missouri ii ii Spring ii to ii Fall ii (April ii to ii September) ii Rocky ii Mountain ii Spotted ii Fever ii (RMSF): ii DX ii - ii ii ii PCR ii assay ii by ii indirect ii immunofluorescence ii antibody ii (IFA) ii assay ii for ii immunoglobulin ii G ii (IgG) ii for ii Rickettsia ii Rickettsii ii Rocky ii Mountain ii Spotted ii Fever ii (RMSF): ii tx ii - ii ii ii Doxycycline ii is ii always ii first ii line ii for ii all ii ages ii 100 ii mg ii every ii 12 ii hours ii x ii 7-10 ii days ii ii Can ii be ii fatal ii if ii not ii treated ii within ii the ii first ii 5 ii days ii Erythema ii Migrans ii (early ii Lyme ii disease): ii Symptoms ii - ii ii ii Usually ii appears ii in ii 7-14 ii days ii after ii being ii bitten ii by ii a ii deer ii tick; ii range ii 3-30 ii days ii Target ii bull's-eye ii Rash ii is ii hot ii to ii touch ii with ii rough ii texture. ii Expanding ii red ii rash ii with ii central ii clearing ii • ii Common ii locations ii are ii belt ii line, ii axillary ii area, ii behind ii the ii knees, ii and ii groin ii area ii • ii Positive ii for ii flu ii like ii symptoms. ii Lesions ii and ii rash ii resolve ii within ii a ii few ii weeks ii with ii or ii without ii treatment ii Erythema ii Migrans ii (early ii Lyme ii disease): ii DX ii - ii ii ii Dx: ii • ii First ii step ii is ii enzyme ii immunoassay ii (EIA) ii also ii knows ii as ii ELISA ii if ii negative ii no ii further ii testing ii needed. ii If ii positive ii confirm ii with ii Western ii Blot ii test ii (aka ii indirect ii immunofluorescence ii assay ii (IFA) ii for ii Borrelia ii Burgdorferi ii

  5. Page 5
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    1. ii Enzyme ii immunoassay 2. ii western ii blot ii test ii (immunoflurorescence ii assay/ ii IFA) ii Exam ii Tip: ii E ii before ii I Will ii have ii increased ii ESR ii Erythema ii Migrans ii (early ii Lyme ii disease): ii TX ii - ii ii ii Doxycycline ii is ii always ii first ii line ii for ii all ii ages ii 100 ii mg ii BID ii x ii 10-21 ii days ii Remove ii ticks ii by ii grasping ii with ii tweezers ii or ii forceps ii close ii to ii the ii skin ii and ii pulling ii gently ii with ii steady ii pressure. ii After ii removing ii the ii tick, ii clean ii area ii with ii rubbing ii alcohol, ii iodine ii scrub, ii or ii soap ii and ii water. ii Dispose ii of ii the ii tick ii by ii flushing ii it ii into ii the ii toilet ii Tick ii repellant ii skin ii use ii - ii ii ii DEET ii Tick ii repellant ii clothing ii use ii - ii ii ii Permethrin ii Brown ii Recluse ii Spider ii Bite: ii SX ii - ii ii ii • ii Fever, ii chills ii • ii Nausea ii and ii Vomiting ii • ii Located ii in ii the ii arms, ii upper ii legs, ii or ii the ii trunk ii • ii Bitten ii area ii becomes ii swollen, ii red, ii and ii tender, ii or ii can ii be ii painless ii • ii Blisters ii appear ii within ii 24-48 ii hours ii • ii Necrotic ii in ii center, ii which ii kills ii the ii tissue **can ii be ii painless ii Brown ii Recluse ii Spider ii Bite ii treatment ii - ii ii ii Treatment: ii • ii Ice ii packs ii to ii wound ii as ii the ii cold ii inactivates ii the ii toxin ii • ii Treat ii like ii cellulitis ii of ii the ii skin ii • ii Antibiotic ii ointment ii at ii first ii and ii watch ii Skin ii lesions ii - ii ii ii primary ii skin ii lesions Macule ii Vesicle ii Papule ii MVP ii Size: ii <1 ii CM ii Macule ii - ii ii ii Flat, ii nonpalpable, ii but ii visually ii distinct ii areas ii on ii the ii skin ii surface ii with ii color ii different ii from ii the ii person's ii normal ii skin; ii less ii than ii 1 ii cm FRECKLE ii Vesicle ii - ii ii ii elevated, ii raised ii lesion ii filled ii with ii serous ii fluid ii (herpetic ii lesions) ii Papule ii - ii ii ii palpable ii solid ii lesion ii (acne, ii moles) ii primary ii skin ii lesions ii >1cm ii in ii size ii - ii ii ii Nodule ii Plaque ii Bullae ii (Blister) ii Pustule ii Wheal ii Nodule ii - ii ii ii raised ii solid ii lesion ii (BCC) ii Plaque ii - ii ii ii solid ii raised ii lesion ii with ii flat ii top ii (psoriasis)

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    ii Bulla/Bullae ii - ii ii ii elevated ii superficial ii blister ii filled ii with ii serous ii fluid ii (2nd ii degree ii burn, ii impetigo) ii Pustule ii - ii ii ii circumscribed ii elevated ii lesion ii containing ii pus ii (acne ii pustules) ii Secondary ii Skin ii Lesions-Lichenification ii - ii ii ii thickening ii of ii the ii epidermis ii with ii exaggeration ii of ii normal ii skin ii due ii to ii chronic ii skin ii itching ii (eczema) ii Secondary ii skin ii lesions- ii Scale ii - ii ii ii flaking ii skin ii (psoriasis) ii Secondary ii skin ii condition-crust ii - ii ii ii dried ii exudate ii (impetigo) ii Secondary ii skin ii condition-ulceration ii - ii ii ii eroding ii of ii epidermis ii and ii dermis ii (if ii deep ii can ii involve ii subcutaneous ii tissue) ii Secondary ii skin ii condition-scar ii - ii ii ii permanent ii fibrotic ii change ii following ii damage ii to ii dermis ii (surgical ii scars) ii Secondary ii skin ii condition-keloids/hypertrophic ii scars ii - ii ii ii overgrowth ii of ii scar ii tissue ii (more ii common ii in ii Black ii and ii Asian ii descent) ii Rule ii of ii 9's ii - ii ii ii Head ii and ii neck ii = ii 9% Upper ii Ex ii = ii 9% ii each ii Lower ii Ex ii = ii 9% ii each Front ii trunk ii = ii 18% Back ii trunk ii = ii 18% ii Rule ii of ii 9's ii =-child ii leg ii - ii ii ii Chlid ii one ii leg=13.5% One ii leg ii adult ii =18% ii Rule ii of ii 9's ii =child ii head ii - ii ii ii Child ii head- ii 18% ii (half ii of ii adult ii %) ii First ii degree ii (superficial): ii - ii ii ii Red ii to ii bright ii red ii skin ii and ii tenderness/pain ii second-degree ii (partial-thickness) ii burns ii - ii ii ii Painful ii red ii skin, ii bullae ii (blisters), ii reddened/weepy ii skin --> ii BLISTERS ii START ii AT ii SECOND ii DEGREE ii third-degree ii (full-thickness) ii burns ii - ii ii ii Pain ii sensation ii absent. ii Pale/white ii color, ii charred ii skin, ii leather-like ii texture ii Criteria ii for ii Burn ii Center ii Referral: ii - ii ii ii Face, ii hands, ii feet, ii genitals, ii major ii joints ii ii Electrical ii burns, ii lightning ii burns ii ii Partial ii thickness ii burns ii >10% ii of ii total ii body ii surface ii area ii ii Third ii degree ii burns ii in ii any ii age ii group

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    ii If ii pt. ii has ii a ii Sulfa ii allergy ii and ii can't ii use ii Silvadene ii what ii is ii the ii alternative? ii - ii ii ii Bacitracin, ii Polysporin/Triple ii antibiotic ii cream ii or ii ointment ii Cellulitis ii - ii ii ii Bacteria ii (Gram ii Positive): ii Streptococcus ii (beta ii hemolytic ii strep), ii Staph ii aureus ii (MRSA) ii Cellulitis ii Symptoms: ii - ii ii ii Diffused ii pink ii to ii red ii colored ii skin, ii warm ii to ii touch, ii and ii may ii become ii abscessed ii ii If ii red ii streaks ii radiating ii from ii infection ii it ii has ii spread ii to ii lymph ii nodes ii (lymphangitis) ii Usually ii within ii the ii deep ii dermis ii and ii is ii poorly ii demarcated ii (poor ii boundaries) Most ii common ii location ii is ii the ii lower ii legs -->If ii pt. ii has ii DM ii and ii develops ii cellulitis ii watch ii for ii osteomyelitis ii Cellulitis ii treatment ii - ii ii ii First ii line: ii Abscess/cellulitis ii is ii I&D ii (if ii <5 ii cm ii no ii PO ii antibiotic ii needed) ii • ii Check ii for ii tetanus ii vaccine ii status ii ii Nonpurulent: ii Cephalexin ii (Keflex) ii 500 ii mg ii or ii Dicloxacillin ii q ii 6 ii hours ii for ii 5-10 ii days ii ii Purulent ii (MRSA): ii Wound ii culture ii o ii Follow ii up ii in ii 48 ii hours ii Bactrim ii BS ii BID ii x ii 10 ii days ii o ii If ii you ii suspect ii osteomyelitis ii order ii an ii MRI ii If ii allergic ii to ii Penicillin: ii Azithromycin ii (Z-Pack ii x ii 5 ii days) ii Erysipelas: ii - ii ii ii Bacteria: ii Group ii A ii Streptococcus Located: ii • ii Involves ii upper ii dermis ii and ii superficial ii lymphatics ii • ii Found ii on ii the ii cheeks ii and ii shins ii Erysipelas: ii Symptoms ii - ii ii ii Symptoms: ii • ii Bright ii red ii plaque ii or ii induration ii with ii sharp ii or ii elevated ii margins ii on ii the ii face ii or ii lower ii legs ii • ii If ii fever ii and ii chills ii present ii pt. ii is ii septic ii (hospitalization ii is ii recommended) ii Erysipelas: ii Treatment ii - ii ii ii If ii treating ii facial ii erysipelas ii assume ii MRSA ii is ii present. ii Use ii appropriate ii antibiotics ii or ii refer ii to ii ER ii if ii septic ii ii Dicloxacillin ii QID, ii Cephalexin ii or ii Clindamycin ii x ii 10 ii days ii ii If ii allergic ii to ii Penicillin: ii Azithromycin ii (Z-Pack ii x ii 5 ii days) ii MRSA: ii Treatment ii - ii ii ii Bactrim ii ii Doxycycline ii ii Minocycline ii Clindamycin ii --> ii If ii patient ii is ii allergic ii to ii Sulfa ii do ii not ii use ii Bactrim ii Human ii bites ii - ii ii ii "Dirtiest" ii bite ii of ii all. ii Watch ii for ii closed-fist ii injuries ii of ii the ii hands ii (may ii involve ii joint ii capsule ii and ii tendon ii damage). ii Eikenella ii corrodens ii & ii numerous ii bacteria ii may ii be ii involved

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    ii Animal ii bites: ii - ii ii ii Cat ii bites ii have ii a ii higher ii risk ii of ii infection ii that ii dog ii bites ii Redness, ii swelling, ii pain ii Systemic ii symptoms ii may ii develop ii within ii 12-24 ii hours ii Treatment ii for ii human ii bites ii and ii animal ii bites ii - ii ii ii •Augmentin ii 875/125 ii mg ii BID ii x ii 10 ii days ii or ii IV ii antibiotics ii in ii ER ii Penicillin ii Allergy ii § ii Doxycycline ii BID ii or ii Bactrim ii DS ii BID ii PLUS ii Flagyl ii BID ii or ii Clindamycin ii TID ii ii Also ii give ii Tetanus ii booster ii if ii needed ii Evaluate ii for ii rabies ii prophylaxis ii Tetanus ii Vaccination ii - ii ii ii Initial ii series ii (3 ii doses) ii DTaP ii (infants ii to ii age ii 6): ii 5 ii doses ii Ages ii 7 ii and ii older ii Td ii or ii Tdap ii Need ii every ii 10 ii years ii for ii lifetime ii Common ii reaction: ii pain ii at ii injection ii site ii in ii 24- 48 ii hours ii Contaminated ii wounds: ii give ii one ii dose ii if ii last ii dose ii was ii more ii than ii 5 ii years ii ago ii or ii is ii due ii Impetigo ii - ii ii ii Bacteria ii (Gram ii Positive): ii Beta ii Streptococcus ii or ii Streptococcus ii aureus Most ii common ii bacterial ii skin ii infection ii in ii young ii children ii ages ii 2-5 ii Impetigo ii symptoms ii - ii ii ii Itchy ii pink-red ii lesions, ii evolve ii into ii vesiculopustules ii that ii rupture ii easily, ii honeycolored ii crusts ii (from ii dried ii serous ii exudate) ii ii Very ii pruritic ii and ii contagious ii Impetigo ii Treatment ii - ii ii ii Order ii C&S ii of ii fluid Severe ii Case= ii Keflex ii or ii Dicloxacillin ii QID ii x ii 10 ii days Penicillin ii Allergy ii o ii Give ii Azithromycin ii 250 ii mg ii x ii 5 ii days ii or ii o ii Clindamycin ii x ii 10 ii days **If ii no ii blisters- ii topical ii mupirocin ii ointment ii (bactroban) ii 2% ii x ii 10 ii days ii Acne ii Vulgaris ii (common ii acne): ii treatment ii - ii ii ii First ii line ii is ii always ii topical ii retinoid ii such ii as ii tretinoin ii cream ii (Retin-A) ii Acne: ii Mild ii treatmetn ii - ii ii ii open ii comedones ii blackheads/closed ii comedones ii (whiteheads) ii w/ ii or ii w/o ii papules topical ii retinoid ii (Retin-A) **Acne ii will ii worsen ii during ii first ii 4-6 ii weeks** IF ii no ii improvement ii in ii 8-12 ii weeks, ii increase ii dose ii or ii ADD ii benzoyl ii peroxide ii and/or ii erythromycin

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