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APEA PREDICTOR EXAM REAL EXAM 2025 LATEST QUESTIONS AND CORRECT ANSWERS GRADE A, Exams of Nursing

APEA PREDICTOR EXAM REAL EXAM 2025 LATEST QUESTIONS AND CORRECT ANSWERS GRADE A

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2024/2025

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APEA PREDICTOR EXAM REAL EXAM 2025
LATEST QUESTIONS AND CORRECT
ANSWERS GRADE A
1) A 15 years old high school student with a mild sore throat
and low-grade fever that has persisted for about 3 weeks. She
reports general malaise, fatigue, and loss of appetite. The NP
suspects mononucleosis. Which of the following is the
LEAST appropriate intervention? a. Palpate the lymph
nodes and spleen
b. Examine the posterior oropharynx for petechiae
c. Obtain a CBC, throat culture, and heterophil antibody test.
d. Obtain an 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.
Common signs and symptoms following incubation period (1-2
months) include fatigue, chills, malaise, anorexia, white
tonsillar exudates and lymphadenopathy or posterior cervical
region. Splenomegaly can be present. A maculopapular or
occasionally a petechial rash occurs in less than 15% of
patients. A diagnosis is usually made using the Monospot. In
addition, neutropenia and lymphocytosis are usually detected in
the CBC.
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Download APEA PREDICTOR EXAM REAL EXAM 2025 LATEST QUESTIONS AND CORRECT ANSWERS GRADE A and more Exams Nursing in PDF only on Docsity!

APEA PREDICTOR EXAM REAL EXAM 2025

LATEST QUESTIONS AND CORRECT

ANSWERS GRADE A

  1. A 15 years old high school student with a mild sore throat

and low-grade fever that has persisted for about 3 weeks. She

reports general malaise, fatigue, and loss of appetite. The NP

suspects mononucleosis. Which of the following is the

LEAST appropriate intervention? a. Palpate the lymph

nodes and spleen

b. Examine the posterior oropharynx for petechiae

c. Obtain a CBC, throat culture, and heterophil antibody test.

d. Obtain an 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.

Common signs and symptoms following incubation period (1- 2

months) include fatigue, chills, malaise, anorexia, white

tonsillar exudates and lymphadenopathy or posterior cervical

region. Splenomegaly can be present. A maculopapular or

occasionally a petechial rash occurs in less than 15% of

patients. A diagnosis is usually made using the Monospot. In

addition, neutropenia and lymphocytosis are usually detected in

the CBC.

  1. A 32 years old male patient complaint of urinary frequency

and burning on urination for 3 days. Urinalyses reveals

bacteriuria and positive nitrites. He denies any past hx. Of

urinary tract infections. The initial treatment should be:

a. trimethoprim-sulfamethoxazole (Bactrim, Sulfatrim) for 7-

10 day

b. ciprofloxacin (Cipro) for 3-5 days

c. Trimethoprim-Sulfamethoxazole for 3 days

d. 750 mg ciprofloxacin as a one-time dose

Explanation: trimethoprim-sulfamethoxazole (TMPS) is

usually n appropriate medication to treat urinary tract infections

in most patients. In the case of community resistance to TMPS

20%^, another medication should be substituted. In men, the

appropriate length of time is 7-10 days. Women may be treated

for 3 days for uncomplicated UTI

  1. Which agent is most effective for the treatment

of nodulocystic acne? a. Benzoyl peroxide

(Benzac) b. Retinoic acid (Retin A)

c. Topical tetracycline

d. Isotretinoin)

Explanation: Isotretinoin (Accutane) is a systemic agent

indicated for treatment with severe inflammatory acne.

Guidelines for its use must be clearly understood by the patient.

A woman of childbearing age must use an effective method of

contraception because isotretinoin is teratogenic. There are

many restrictions in prescribing this medication because of the

c. If prescribed amoxicillin/clavulanate (Augmentin) for a

sinus infection

d. if she forgets to take a single dose of the contraceptive

Explanation: Anticonvulsant 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 contraceptive 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 single dose of contraceptive does not require additional

protection, missing more than one doses does.

  1. A 44 years old female patient has diabetes. Her total

cholesterol (TC) is 250 mg/dl (6.5 mmol/L), LDL= 190 mg/dL

(4.94 mmol/L), HDL= 25 mg/dL (65 mmol/L), and

triglycerides= 344 mg/dL (8.94 mmol/L). What agent have the

greatest effect on improving her lipid profile and reducing

morbidity and mortality associates with dyslipidemia? a.

Niacin (Niaspan)

Omega 3 fatty acids

Explanation: First and foremost, it is essential to

educate individuals on a heart-healthy lifestyle. LDL-C is one of

the major culprits in the development of atherosclerotic heart

disease. The target level of LDL-C is between 50 to 70mg/dl to

prevent plaque formation in the blood vessels. Guidelines

strongly recommend statin therapy because they primarily lower

LDL-C levels, but they also have the secondary effects of

lowering triglyceride and increasing HDL-C levels.

  1. A 30 years old female comes into a clinic with classic signs

and symptoms of appendicitis. The NP fails to refer the patient

to a surgeon. The appendix ruptures and the woman die. This is

an example of

a. Failure of diligence

b. Professional liability

c. Negligence

d.Malpractice

Explanation : malpractice, a negligence tort, occurs when a

health care professional’s actions fall bellow the appropriate

standard of care and hurts the patient. In this case the patient

came with sings and symptoms indicating appendicitis and the

NP failed to refer the patient..

  1. A NP has recently been hired to work in a fast track facility.

The NP employer asked if she has “a problem prescribing

b.Atorvastatin

c.

d. Fenofibrates

  1. Antidepressant discontinuation syndrome is less likely if the

patient a.

Is male

b. Is less than 35 y/o

c. Has taken an SSRI with a short half life

d. Gradually tapers

SSRI use

Explanation: Antidepressant discontinuation syndrome is most

often seen in the primary care office in association with SSRI

discontinuation, because SSRIs are the most commonly

prescribed class of antidepressant medications. Interruption of

treatment with an anti-depressant medication is sometimes

associated with an antidepressant discontinuation syndrome; in

early reports it was referred to as a “withdrawal reaction.

Symptoms of antidepressant discontinuation syndrome can

include flu-like symptoms, insomnia, nausea, imbalance,

sensory disturbances, and hyperarousal. Tapering is

recommended by experts.

  1. Patient with benign prostatic hyperplasia (BPH) should be

taught to avoid which one of the following drug classes?

a. Alpha adrenergic antagonist

b. Anti-androgen agents

c. Tricyclic antidepressant (TCA)

d. Sulfonamides

Explanation: tricyclic antidepressant should not be used by

men with benign prostatic hyperplasia because of the increased

risk of urinary retention secondary to the anticholigergic

effects of TCAs.

  1. Which of the following is the best response to a woman who

has just admitted she is a victim of spousal abuse?

a. What was if you did to make him angry?

b. You must seek refuge immediately

c. I am concerned about your safety

d. I am going to call a shelter for you

Explanation: The first step is to establish trust in the

therapeutic relationship. without trust future collaboration,

intervention and client outcome cannot be accomplished to

facilitate appropriate and safe behavior. The experience of

abuse is a traumatic psychological crisis that must be addressed

as such. The healthcare providers must emphasize the fact that

the victim has not done anything wrong and they must also

emphasize the fact that the victim's life and the lives of their

children can be in danger if the abuse is not addressed. It will

not disappear with a lack of action. An order of protection

against the perpetrator is often recommended.

  1. For which patient group does the US Preventive Services

Task Force recommend routine screening for asymptomatic

bacteriuria a. pregnant woman

b. Children

c. Patients with diabetes

d. patients over the age of 70

Explanation: Herpangina is a viral infection common in

toddlers and young children caused by Coxsackie virus. The

clinical findings of numerous, small (1-2 mm) ulcerations on the

tonsils and uvula are typical of herpangina. The ulcerations can

be very painful but usually resolve in 7 to 10 days. Treatment is

symptomatic.

  1. A patient has Kawasaki syndrome. Which characteristics

would be UNUSUAL? a.

Age > 15 years

b. Fever > 101 F (38.3 C)

c. Exudative pharyngitis

d. Painful rash explanation: Kawasaki disease is an acute

febrile vasculitis syndrome that evolves inflammation of

the blood vessels. This condition often causes cardiac

complication in children by damaging the coronary arteries

is most prevalent in children of Asian ethnicity. Diagnosis

of Kawasaki disease requires presentation of fever and 4 of

the following criteria: bilateral bulbar conjunctival

injection, oral mucous membrane changes, peripheral

extremity changes, polymorphous rash, and cervical

lymphadenopathy.

  1. According to the JNC 8 guideline hypertension in a 40

y/o can be diagnosed when blood pressure exceeds a.

140/90 b. 130/

c. 125/

d. 150/

Explanation: According to JNC 8 guidelines, hypertension is a

sustained elevation of systolic BP greater than or equal to 140

mmHg or diastolic BP greater or equal than 90mmHg, taken

from 2 or more readings on 2 different occasions after an initial

screening.

  1. A 48 y/o female complains of pain and stiffness in her

right hip and knee that is mild on awakening in the morning,

get worse as the day progresses and is relived with hot baths

and ibuprofen. Crepitus is palpated on range of motion of the

knee. Signs of inflammation are notably absent. What is the

most likely diagnosis? a. Rheumatoid arthritis (RA) b.

Gout

c. Osteoarthritis (OA)

d. Osteoporosis

Explanation: Rheumatoid arthritis is characterized by several

joint deformities, usually bilaterally symmetrical. RA is

characterized by inflammatory processes, while OA is not. RA

and OA are chronic conditions. Gout is characterized by acute

exacerbations related to a defect in purine metabolism,

increased uric acid production, or decreased uric acid excretion.

  1. A 7-year old female patient presents with severe injuries

that are inconsistent with the explanation given for them. The

nurse practitioner questions the mother about abuse. She admits

that her husband, the child’s father, beat the child. How should

the nurse practitioner proceed? a. Inform the mother that

the abuse must be reported to child protection authorities.

portion of the intestine which telescopes into a more distal

intestinal segment. The classic triad of intussusception

include crampy

(intermittent, also known as colicky) abdominal pain, vomiting,

and bloody stools. The patient may pull up his knees with

crying. The patient may develop vomiting with bilious emesis.

Progressive lethargy/altered level of consciousness and pallor is

common. The etiology of this lethargic presentation is not

known, but it tends to occur in younger infants. As

intussusception progresses, a palpable, sausage-shape mass may

develop. Some hypothesize that this is due to release of

endogenous opioids or endotoxins released from ischemic

bowel. Intussusception in a child presenting with lethargy is

often difficult to diagnose since other causes of lethargy such as

dehydration, hypoglycemia, sepsis, toxic ingestion, post-ictal

state, etc., must also be considered. Ultrasound is the preferred

diagnostic test. Enemas is considered the first line of treatment

prior surgery. Volvulus occurs more frequently in middle-aged

and elderly men. Cronos’s is most often diagnosed between 13

  • 30 years of age.
  1. A middle-aged female complains of insomnia, night sweats,

feeling intensely hot, emotional lability, extreme nervousness

and impatience. The LEAST likely cause of her symptoms is a.

Thyrotoxicosis

b. Menopausal vasomotor instability

c. Alcohol or another drug withdrawal

d. New onset type 2

diabetes mellitus

Explanation: New onset diabetes produces elevated serum

glucose levels less than 200 mg/dL (7.0 mmol/L) and usually no

clinical signs or symptoms. At higher levels, the patient may

report lethargy, fatigue, weakness, weight loss, and polydipsia,

polyuria, and/or polyphagia. Complaints of insomnia, night

sweats, feeling intensely hot, emotional lability, and extreme

nervousness may be caused by thyroxine excess, menopausal

instability, or withdrawal from alcohol or other drugs of

addiction.

  1. Which of the following indicated need for further

evaluation? a.

A 7 y/o girl with vaginal bleeding

b. A 7 years old girl with no true pubic hair

c. A 12 years old boy with sparse, slightly pigmented pubic

hair

d. A 12-year-old girl with breast buds explanation: In

newborn girls, withdrawal bleeding may occur as a normal

response to maternal estrogen leaving the infant’s uterine

lining. Vaginal bleeding after the first few weeks of life and

before puberty is considered abnormal. Early vaginal

bleeding can indicate trauma, foreign bodies (toilet paper is

the most common), vulvovaginitis, hemangiomas, benign

polyps, precocious puberty, or sexual abuse.

d. Prescribe an ACE inhibitor and re-evaluate in 24 to 48

hours

Explanation: The patient has at least a 70% occlusion of a

major coronary artery. For a patient to be considered for

CABG, the coronary arteries to be bypassed must have

approximately a 70% occlusion (60% if in the left main

coronary artery).

  1. A 3 y/o has enlarged, warm, tender cervical

lymph nodes, indicating: a. Infection proximal to

the nodes b. A possible cancer diagnosis

c. Shorty nodes, a common normal variant in children

d. An infectious process distal to the nodes explanation: size

of lymph nodes is important. Nodes > 1 cm are significant

and should be asses carefully. Nodes > 5 cm are almost

always neoplastic. Tenderness of a node usually suggest

inflammation. Cancerous nodes frequently are larger, non-

tender, and stone-like in consistency. Nodes are pea-sized,

nontender, mobile, discrete and reflect pre-existent

infection.

  1. The NP examines a 2-month-old with unequal gluteal and

thigh skin folds. What should the NP do next?

a. Send the infant for x-ray of the hips

b. Send the infant for ultrasound of the hips

c. Perform Ortolani and Barlow test

d. Examine the infant for unequal arm length

Explanation: Gluteal and thigh skin fold asymmetry may

indicate congenital hip dysplasia. X- ray studies are not useful

before 3 months-of-age because the femoral head has not

completely ossified.

  1. A very active 35 years old male has painful hemorrhoid, but

he does not want hemorrhoidal surgery at this time. His diet has

been indiscriminate as his job requires frequent travel. The most

appropriate recommendation is for him to select food that are: a.

Low in fiber such as milk and other dairy products

b. High in simple carbohydrates such as white bread and

mashed potatoes

c. High in fiber such as bran, complex carbohydrates and fresh

fruit

d. High protein such a meat, poultry and fish

Explanation : Hemorrhoid disease is the most common reason

patients seek evaluation by a colon and rectal surgeon. The

majority of hemorrhoids can be managed nonoperatively with

medical management or office-based procedures. Patients

should benefit from minimizing straining and avoiding

constipation. Bulking of the stool facilitates this and can be

accomplished by increasing dietary fiber and fluid intake. Stool

softeners may also be used.

  1. Correct instructions to give new parent who are transporting

their newborn infant is

a.

b. The infant car set may be secured in the back or front seat,

but must rear-facing

A rear-facing infant car seat secured in the backseat is

required until the infant weight 20

lbs.

  1. A 20 y/o male patient complains of “scrotal swelling”. He

states his scrotum feels heavy but denies pain. On examination,

the NP notes transillumination of the scrotum. What is the most

likely diagnosis? a. Hydrocele

b. Orchitis

c. Testicular torsion

d. Indirect inguinal hernia

Explanation: Hydrocele is common in newborns and usually

disappears without treatment within the first year. Older men

can develop hydroceles, sometimes due to inflammation or

injury. Hydroceles are usually painless, but may become large

and inconvenient. An ultrasound may be needed to diagnose the

condition.

30 ) A 15 y/o male has a hx of cryptorchidism which was

surgically repaired. Because of this information, it is essential

for the NP to teach him about a. Testicular self-examination

b. Protection of the testes during sports activities

c. Risk of testicular torsion

d. Practicing safer sex

Explanation: Cryptorchidism, even with surgical repair, is

associated with increased risk for testicular cancer.

  1. A pt. present with classic symptoms of gastroesophageal

reflux diseases’ (GERD). He is instructed in lifestyle

modification, and drug initialed. Two month later, he returns and

report that he still has symptoms. The next steps are to.

a) Refer for surgical interventions such as partial or complete

fundoplication.

b) Refer for endoscopy, namometry, and/or PH testing

c) Repeat the 8*-week course of drug therapy while

continuing lifestyles modifications.

d) Review proper proton pump inhibitor dosing time and

adherence with the patient. Explanation: poor adherence

is an importance cause of inadequate acid suppression and

refractory GERD. Determining adherence to proton pump

inhibitor (PPI) therapy and superficially timing in relation

to meals, should be sought first alarm features such as iron

deficiency anemia, unexplained weight loss, and persistent

vomiting would precipitate the need for further diagnostic

testing. Diagnostic testing procedures should proceed any

surgical intervention like fundoplication.

  1. A 51 – year- old post-menopausal female, request

guidance regarding osteoporosis risk. The NP would be

correct to recommend all of the following EXCEPT a.

Moderate weight bearing exercise 3 times per week b.

1200 – 1500 mg calcium daily

c. Avoidance of alcoholic beverages

d. Weight loss

Explanation: the recommended calcium intake is 1,200 mg –

1500 mg a day. Regular weightbearing and muscle-

strengthening exercise reduce the risk of falls and fractures.

Moderate alcohol intake has no known negative effect on bone

and may even be associated with slightly higher bone density

and lower risk of fracture in postmenopausal women. However,

alcohol intake of more than two drinks per day for women or

three drinks a day for men may be detrimental to bone health,