Download APEA 3P-EXAM PREPS,ASSESSMENTS,PRE & POST TEST MODULES,QUIZZES,STUDY GUIDES|2025|Qs&As. and more Exams Nursing in PDF only on Docsity!
APEA 3P TEST BANK
{COMPLETE GUIDE 2025/2026} ALL YOU NEED IN APEA 3P / EXAM
PREPS, ASSESSMENTS, PRE & POST TEST MODULES, QUIZZES,
STUDY GUIDES, READING, REVIEWS, PRACTICE QUESTIONS AND
T/B QUESTIONS.ALL WITH COMPLETE SOLUTIONS|A+ GRADE
ASSURED. |UPDATED SPRING 2025 |1000+Qs & As|
TABLE OF CONTENTS
APEA 3P Exam Prep- Health Promotion ............................................................ 2
APEA 3P EXAM Prep Neuro… .......................................................................... 14
APEA 3P Exam Prep- Professional Issues/Ethics ............................................ 38
APEA 3P Exam Prep - Sexual Health ................................................................. 50
APEA 3P Exam Prep – Cardiovascular ................................................................ 63
APEA 3P Exam Prep- Women's Health… ......................................................... 97
APEA 3P Exam Prep- Nephrology/GU ............................................................ 115
APEA 3P Exam Prep- GI ....................................................................................... 129
APEA 3P Exam Prep- Men's Health.................................................................... 165
APEA 3P Exam Prep- Dermatology .................................................................... 175
APEA 3P High Stakes Exam Questions .............................................................. 197
APEA 3P Pre Predictor Exam ................................................................................ 224
APEA 3P Test Bank Questions 1 ............................................................................ 306
APEA 3P Test bank Questions 2 ........................................................................... 315
APEA 3P Final Exam Review ................................................................................ 335
APEA 3P Final Exam 2023/2024 .......................................................................... 363
APEA 3P EXAM PREP- HEALTH PROMOTION 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. Examine him for hemorrhoids. Refer him for a colonoscopy. A fecal occult blood test is performed multiple times on different days because tumors don’t consistently excrete blood. The reason multiple tests 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. 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. 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 effectof 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. 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. Have a pharmacist review your list once a year A list of current medications should be kept with each patient and carried with him, especially when healthcare visits are scheduled. Many older adults can take 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. What temperature should be set on a water heater in the home of an older adult to pre vent
be repeated. Sometimes there are periods of transient hypothyroidism, lab error, and missed doses that can cause changes in TSH levels. 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 at 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. She should receive this. The immunization is not alive. 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 CD4count is normal. 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) Antacids PRN heartburn Daily use of low dose famotidine 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. 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. Patients must be at least 50 years old to receive the shingles immunization. It is generally well tolerated but provides protection from shingles in 50-64% of patients. The incidence of postherpetic neuralgia is decreased up to 65% after immunization. The patient still may develop shingles after receiving the immunization. The vaccine may be offered regardless of whether the patient has history of shingles. However, since it is a live vaccine, it may be contraindicated because of steroid use or immune status. Which pharmacokinetic factor is influenced by a decrease in liver mass in an older adult?
Absorption Distribution Metabolism Elimination As the liver decreases in mass and potentially has a decrease in blood flow, drug metabolism is decreased. Consequently, lower doses of medications in older adults may be as efficacious as higher doses in their younger counterparts. Production of enzymes in the cytochrome P450 system may be decreased, which further impacts metabolism. An older adult has osteopenia. Her healthcare provider has recommended calcium 500 mg three times daily. What is the most common side effect of calcium supplementation? Stomach upset Diarrhea Constipation Mild nausea initially Constipation is the most common side effect of calcium supplementation. To improve tolerance, the nurse practitioner can suggest 500 mg daily for a week, then500 mg twice daily for a week, then three times daily. The patient should be encouraged to increase the intake of fruits, vegetables, fluid, and fiber. Weightbearing exercise and vitamin D intake should be encouraged to improve bone density. Screening for abdominal aortic aneurysm should take place: once for all males aged 65-75 who have ever smoked. once for all men and women who have hypertension. annually after age 75 years for males and females. only if the patient has smoked and has hypertension. The prevalence of abdominal aortic aneurysm (AAA) is greater in men than women. American Heart Association and USPSTF recommend screening males once between the ages of 65-75 years if they have ever smoked. Smoking increases the risk of AAA. The USPSTF does not recommend routinely screening for AAA in women or screening for AAA in men who have never smoked. Screening may be considered in men aged 65-75 years if they have a first-degree relative who required repair of AAA. A 67-year-old patient presents an immunization record that reflects having received the PCV13 immunization when she was 65 years old. She received the PPSV
Over nutrition Malnourishment Vitamin B deficiency Some older adults have great challenges associated with eating and maintaining weight. They may be edentulous or have anorexia. Weight loss is associated with greater mortality in older adults than in patients who have not had recent weight loss. Clinically significant weight loss is usually considered to be about 4-5% of total body weight within 6-12 months. In older patients who do lose weight, they are less likely than younger adults to gain it back. This also increases risk of mortality. A 13-year-old male has exhibited the first sign that he is experiencing sexual maturation. He has: an increase in testicular size. an enlargement of the scrotum. an increase in length of the penis.scrotal and penile changes. A male with Tanner Stage II development will have an increase in testicular volume from 1. mL or less, to up to 6 mL. The skin on the scrotum will begin to thin, redden, and enlarge. The penile length will remain the same. Males begin sexual maturity later than females. In the United States, males begin sexual maturation about 2 years later than females. Maturity begins in girls about 9-12 years. Two common causes of weight loss in older adults are: anorexia and depression. depression and malignancy. malignancy and social isolation. financial limitations and hyperthyroidism. Malignancy is the most common cause of weight loss in the older adults. Depression is the second most common reason. Another reason that contributes to weight loss is social isolation. Many elders live alone and consequently eat alone. Many older adults have financial and mobility limitations that make eating and acquiring foods more difficult. Anorexia is not unusual in older adults, but there are a number of reasons for this. Some are physical, social, and psychosocial.
An octogenarian asks the nurse practitioner if it is OK for him to have an alcoholic beverage in the evenings. There is no obvious contraindication. How should the nurse practitioner respond? Yes, but not more that 4 days per week. Yes, but not more than 1 - 2 drinks per day. No, you will increase your risk of falling and injury. It depends on the type of alcohol you would like to consume. A good rule of thumb for alcohol consumption in older adults is no more than one to two drinks/day after age 65 years. If the patient is cognitively impaired, abstinence is recommended. The type of alcohol is not of great importance. Beer, wine, and hard liquor all contain alcohol, which has the potential to impair older adults. The reason alcohol should be limited or avoided is because of decreased lean body massand decreased total body water in aging bodies. A patient who wrote a living will has changed his mind about the initiation of life- sustaining measures. Which statement is true about this? He cannot change his mind regarding the content of the living will.He can only change the content if he is of sound mind. A healthcare provider is exempt from liability if they provide care outside the living will. An attorney must be consulted if the living will is changed at any time. A living will is intended to allow a patient to provide instructions for his family and healthcare providers about how he would like his care directed if he is unable to make th ese decisions. He can change the content at any time. If, however, he is determined not to be of sound mind, any changes that he attempts to make should not be followed. A healthcare provider is bound to carry out the living will, provided it does not violate any laws or the ethics of the provider. In this case, the provider would be exempt from liability for not carrying these out. In the case of an ethical dilemma, the healthcare provider should identify another healthcare provider who is willing to carry them out. An attorney is not required to be consulted to change the content of a living will. The incidence of osteoporosis in older adults is high. Which characteristics below would increase the risk of osteoporosis in an older adult male patient? Low body weight, age 60 years Smoker, age 65 years
Which finding below is considered “within normal limits”?A diastolic murmur in an 18-year-old An INR of 2.0 in a patient taking warfarin Cholesterol level of 205 mg/dL in a 15-year-old Blood pressure of 160/70 mmHg in a 75-year-old An INR (International Normalized Ratio) is considered the best measure of clotting status in outpatients. Depending on the reason for anticoagulation, a common target is 2.0 - 3.0. Diastolic murmurs are always considered abnormal regardless ofage. Cholesterol levels in adolescents should be less than 170 mg/dL (according to National Heart, Lung and Blood institute, NHLBI). Blood pressure of 160/75 mmHg constitutes isolated systolic hypertension, so this is abnormal. A patient is 86 years old and functions independently. He has hypertension, hyperlipidemia, BPH, and flare-ups of gout. His last colonoscopy was at age 76years. What should he be advised about having a colonoscopy? Colonoscopy is the preferred method for screening in older adults Colonoscopy is ill advised in older adults It is not advised in this patient at this time Screening is not necessary after age 80 years Prior to any screening test such as colonoscopy, consideration must be given to the patient’s overall health status, colorectal cancer risk, and desire to pursue treatment if cancer or disease is diagnosed. The United States Preventive Services Task Force, American College of Physicians, and American College of Gastroenterology do not recommend screening an 86- year-old for colorectal cancer.As a general rule, patients with a life expectancy of less than 5- 10 years should forego colorectal cancer screening via colonoscopy. Colonoscopy enables the examiner to visualize the entire colon and is a superior screening tool for colorectal cancer, but there are significant risks of bleeding and perforation in older adults. Additionally, the colon prep can produce massive shifts in electrolytes that can increase the likelihood of arrhythmias, heart failure, weakness, and falls. A 76-year-old patient who is very active has elevated cholesterol and LDLs. He had been treated for hypertension for > 10 years with near normal blood pressures. What is the current recommendation for managing his lipids? No treatment should take place since his age exceeds 75 years.He should be treated with an aspirin only.
He should be treated with a statin. The benefits of treating this patient do not exceed the risk of using a statin oraspirin. Numerous studies (PROSPER, 2006) and learned authorities (including the USPSTF) have found that lipid-lowering drug therapy decreases the incidence of coronary heart disease and vascular events in middle-aged and older adults. The current recommendation is to screen and treat lipid abnormalities in patients who are at risk for a cardiac event. It is unclear whether treatment of middle-aged and older adults at low risk for cardiac events is beneficial. What is true regarding the shingles vaccine given to adults at or after age 50?It is a weakened form of the chickenpox virus. It is the same as the chickenpox virus. It contains significantly more virus than the chickenpox vaccine.It is not related to the chickenpox immunization at all. The shingles (Herpes zoster) vaccine contains 14 times the number of plaque - forming units of virus than the varicella vaccine. The immunization has reduced the incidence of shingles and postherpetic neuralgia in adults who received it. The vaccine is recommended by CDC for all immunocompetent adults who are 60 years or older. It is given once. The FDA has approved use of this vaccine at age 50 years. The vaccine is only used to prevent shingles. It is not used to treat shingles or postherpetic neuralgia. An oral antifungal agent is commonly used to treat tinea unguium. The difficulty in treating an older adult with this is infection is: absorption of the medication. applying the medication twice daily.tolerability of the medication. relative ineffectiveness of oral agents. The most efficacious agents used to treat toenail fungus are oral antifungal agents. They must be taken daily for 8-16 weeks (or longer) for adequate length of treatment. Additionally, the real difficulty lies in the ability of the older adult's liver to handle this medication. Oral antifungal agents require great amounts of the liver’s resources for metabolism. A topical agent or toenail removal may be a betterchoice for an older adult. What is the recommendation for daily multivitamin supplementation in older adults?
APEA 3P EXAM PREP NEURO A patient who is 82 years old is brought into the clinic. His wife states that he was working in his garden today and became disoriented and had slurred speech. She helped him back into the house, gave him cool fluids, and within 15 minutes his symptoms resolved. He appears in his usual state of health when he is examined. He states that although he was scared by the event, he feels fine now. How shouldthe nurse practitioner proceed? Prescribe an aspirin daily. Re- examine him tomorrow. Send him to the emergency department. Order an EKG. This patient likely suffered a transient ischemic attack. He needs urgent evaluation with head CT and/or MRI, ECG, lab work (CBC, PTT, lytes, creatinine, glucose, lipids and sedimentation rate); possible magnetic resonance angiography, carotid ultrasound, and/or transcranial Doppler ultrasonography. He is at increased risk of stroke within the first 48 hours after an event like this one. On initial evaluation, the most important determination to be made is whether the etiology of the stroke or TIA is ischemic or hemorrhagic. After this determination, treatment can begin. Unfortunately, this determination cannot be made in the clinic. The patient needs urgent referral to a center where this evaluation and possible treatment can be performed. The most common presenting sign of Parkinson’s disease is: muscular rigidity. tremor. falling. bradykinesia.
Approximately 70% of patients with Parkinson’s disease have tremor as the presenting symptom. The tremor typically involves the hand but can involve thelegs, jaw, lips, tongue. It seldom involves the head. Muscular rigidity and bradykinesia are two less common presenting signs. When should medications be initiated in a patient who is diagnosed with Parkinson’s disease? As soon as the disease is diagnosed When symptoms interfere with life’s activities When nonpharmacologic measures have been exhaustedAfter MRI and CT have ruled out stroke or tumor The medications used to treat patients who have Parkinson’s disease do not prevent the progression of the disease. Therefore, it is not necessary to start medications until symptoms interfere with the patient's quality of life. Levodopa is often used initially at the lowest dose that helps a patient manage symptoms. It can be titrated upward as needed. Orthostatic hypotension is a common side effect of levodopa, so blood pressure should be monitored closely. A 72 - year-old patient with history of polymyalgia rheumatica complains of new onset, unilateral headache and visual changes. Her neurologic exam is otherwise normal. Her CT results are WNL. ESR is 75 (Normal: 0 - 29). VS: BP 140/82, HR 67, RR18, T
- What is the most likely reason for her symptoms? Transient ischemic attack Temporal arteritis Meningitis CVA Polymyalgia rheumatica (PMR) is a chronic inflammatory condition that produces morning stiffness in the neck, shoulders, and hips. Its peak incidence is 70-80 years old. PMR is commonly associated with temporal arteritis, also known as giant cell arteritis. Temporal arteritis is a chronic vasculitis of the medium and large vessels. Temporal arteritis is characterized by new onset unilateral temporal headache, abrupt onset of visual disturbances, elevated sedimentation rate, jaw claudication, and unexplained fever. This is best diagnosed by temporal artery biopsy. She should be referred to neurology for evaluation today. What recommendation should be made to an older adult who is diagnosed with mild dementia?
risk of ischemic stroke is reduced. The dosage of aspirin needed to prevent an event is debatable. Most studies found that 75-150 mg daily was as effective in preventing stroke as was higher doses. Lower doses of aspirin are associated with less GI toxicity and fewer side effects. A 75-year-old is diagnosed with essential tremor. What is the most commonly used medication to treat this? Carbidopa Long-acting propanolol Phenobarbital Gabapentin Tremor is the most common of all movement disorders and essential tremor is the most common cause of all tremors. It is characterized by rhythmic movement of a body part, commonly the hands or head. Beta blockers are the most commonly used medication class to treat essential tremor. Propanolol is the most commonly used medication, but other beta blocking agents are used as well. Both gabapentinand phenobarbital are used, but, not nearly as often. Carbidopa is used in patients with Parkinson’s disease. A patient who had an embolic stroke has recovered and is performing all of her activities of daily living. Taking aspirin for stroke prevention is an example of: primary prevention. secondary prevention. tertiary prevention. quaternary prevention. The patient is taking aspirin to prevent recurrent stroke. Research demonstrates that taking an aspirin daily can significantly reduce the risk of subsequent strokes and MI. Secondary prevention means that the intervention is performed to prevent another occurrence of the deleterious event. If she had never had a stroke but tookaspirin daily for prevention of stroke, that would be primary prevention. Taking aspirin at home during the course of having an MI is an example of tertiary prevention. There is no reference in the literature to quaternary prevention. An older adult patient with organic brain syndrome is at increased risk of abuse because she: lives in a nursing home. has multiple caregivers.
is incontinent of stool and urine. has declining cognitive function. Older adults are at increased risk of abuse because of their decline in cognitive function. Caregiver strain, stress, and depression occur at higher rates than in the general population. According to the National Center of Elder Abuse, family members are likely to be abusers of infirm older adults. Healthcare providers shouldremain alert to signs of abuse and caregiver stress. A patient with migraine headaches and hypertension should receive which medication class with caution? Beta blockers Triptans Pain medications ACE inhibitors The class of medications called “triptans” work to eradicate migraine headaches by producing vasoconstriction. This can produce a potentially serious drug - disease interaction in patients with hypertension. An episode of severe hypertension can result. Triptans may be used in patients with well-controlled hypertension, but a hypertensive episode is always possible. A patient who is 60 years old complains of low back pain for the last 5 - 6 weeks. She states that the severity is about 4/10 and that she gets no relief from sitting, standing, or lying. The NP should consider: sciatica. ankylosing spondylitis.disk disease. systemic illness. Systemic illness, like cancer or infection, is a serious consideration when patients report no relief of pain with position change. Additionally, this patient is female, older, and has had pain longer than 4 weeks. These are three risk factors for systemic cause of low back pain. Sciatica presents with pain that radiates down theleg. Ankylosing spondylitis is typical in males in their 40s and produces pain at nighttime that is improved with being upright. Disk disease is a consideration, but, an absence of relief with lying down is unusual.
A 68-year-old smoker with a history of well-controlled hypertension describes an event that occurred yesterday while mowing his lawn. He felt very dizzy and "passed out" for less than 1 minute. He awakened spontaneously. Today, he has no complaints and states that he feels fine. Initially, the NP should: perform a complete neurological and cardiac exam with auscultation of the carotid arteries. order a 12-lead ECG and carotid ultrasound, and perform a physical exam. order a CT of the brain, blood clotting studies, and cardiac enzymes. check blood pressure in three positions, order a 12 - lead ECG, and schedule an exercise stress test. The event described is syncope. Syncope is a brief and sudden loss of consciousness that occurs with spontaneous recovery. This is a significant event but it is especially so in a smoker with hypertension. The assessment of this patient must start with an examination of the cardiac and neurological systems. Based on the findings and tentative diagnosis of syncope, coupled with the patient’s history ofthe event, other tests might be ordered to evaluate arrhythmias, stroke, transient ischemic attack, myocardial infarct, carotid stenosis, other vascular etiologies. A referral to specialty care is indicated after initial workup by the nurse practitioner. Which characteristic is true of tension headaches, but not of cluster headaches? Cluster headaches are always bilateral. Tension headaches are always bilateral. Cluster headaches always cause nausea. Tension headaches cause photosensitivity. Cluster headaches are always unilateral. The affected side produces a red, teary eye with nasal congestion on the affected side. Nausea and photosensitivity are common. Tension headaches are always bilateral with no nausea or photosensitivity associated with them. Which condition listed below does NOT impact an elder’s ability to eat?Stroke Parkinson’s disease Dysphagia Hyperlipidemia
Many, many diseases impact an elder patient’s ability to eat. About 50% of patients who have had stroke have impaired ability to eat. This can include difficulty feeding self as well as difficulty swallowing. Parkinson’s disease and many other neurological diseases have great impact on eating, since coordinated muscle movement is needed for swallowing and feeding. Hyperlipidemia has no significant impact on a patient’s ability to eat. Mr. Williams has moderate cognitive deficits attributed to Alzheimer’s disease and has been started on a cholinesterase inhibitor. The purpose of this drug is to: decrease agitation. increase anticholinergic stimulation of the brain. improve depression. slow progression of his cognitive deficits. This drug is a cholinesterase inhibitor. It will cause more acetylcholine to be available to neurons. Many patients show a slowing of cognitive decline when these medications are used for at least 1 year. A small percentage of patients, 10-25%, show significant improvement in symptoms. An anticholinergic medication would be contraindicated in these patients. There is no direct benefit on agitation or depression in patients who take this class of medications. A neurologic disease that produces demyelination of the nerve cells in the brain and spinal cord is: Parkinson’s disease. late stage Lyme disease. multiple sclerosis. amyotrophic lateral sclerosis. Multiple sclerosis (MS) is a disease of the central nervous system characterized by demyelination of the nerve cells. This produces varied neurological symptoms and deficits. This disease is typical in women between the ages of 16 and 40 years. It is rarely diagnosed after age 50 years. MS can be diagnosed in an adult who has one or more clinically distinct episodes of CNS dysfunction followed by at least partial remission. An older adult patient is at increased risk of stroke and takes an aspirin daily. Aspirin use in this patient is an example of: primary prevention. secondary prevention.
