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APEA Review Questions with Correct
Answers 100% Verified
Black Patient With or Without DM ✔✔Thiazide diuretic Calcium channel blocker Nonblack Patient With or Without DM ✔✔Thiazide diuretic Calcium channel blocker ACE ARB heart murmurs are caused by ✔✔turbulent blood flow through the great vessels or across a heart valve occurs
- Stenotic valves don't ✔✔Stenotic valves don't OPEN properly Regurgitant valves don't ✔✔Regurgitant valves don't CLOSE properly If pravastatin is chosen for Mr. Thibodeaux, how would you manage this? Select all that apply. ✔✔Check liver enzymes prior to initiation of statin. Start him on 40 mg today and recheck lipids/LFTs in 8 weeks. htn stop ✔✔nsaids naproxen
calf pain with walking. What's going on? ✔✔blockage in lower vessels intermittent claudication peripheral artery disease ABI <0.9 or >1.3 is highly suggestive of ✔✔pad What interventions should be initiated to help decrease his triglyceride level (323 mg/dL)? Select all that apply. ✔✔. Decreased carbohydrate consumption. Suppose his triglycerides were 550 mg/dL? How would you treat? ✔✔fibrates lifestyle If Mrs. Boudreaux were to develop heart failure, which medications would be most beneficial to discontinue? Select all that apply ✔✔amlodopine naproxine Heart Failure Clinical Signs and Symptoms ✔✔Crackles S3 and/or S4 • Peripheral edema may be present AAA screening ✔✔-all men 65-75 who have ever smoked
digoxin (Lanoxin) for 10 years. Her EKG is showing a new onset of atrial fibrillation. Her pulse is 64 beats/min ✔✔Order a serum thyroid-stimulating hormone (TSH), digoxin level, and an electrolyte panel Potential complications of mitral valve prolapse (MVP) include all of the following ✔✔ MVP (mitral valve prolapse) ✔✔Severe mitral regurgitation Endocarditis Increased risk of stroke and transient ischemic attack During cardiac murmur assessment, which is the first grade intensity that a thrill can be palpated? ✔✔g Which of the following is correct regarding the best site to listen for mitral regurgitation? ✔✔It is best heard at the apex during S You note a high-pitched and blowing pansystolic murmur while assessing a 70-year-old male patient. It is grade 2/6 and is best heard at the apical area. Which of the following is most likely? ✔✔mr You notice a medium-pitched harsh systolic murmur during an episodic examination of a 37- year-old woman. It is best heard at the right upper border of the sternum. What is most likely? ✔✔Aortic stenosis The S1 heart sound is caused by: ✔✔Closure of the atrioventricular valves A split S2 heart sound is best heard at which of the following areas? ✔✔The pulmonic area mvp ✔✔palpitations
dizziness A systolic murmur that is accompanied by a mid systolic click located at the apical area is a classic finding of mitral valve prolapse (MVP) Which of the following clusters indicates the target organ damage commonly seen in hypertensive patients? ✔✔Arteriovenous (AV) nicking, left ventricular hypertrophy, and stroke HEAVY chest pressure ✔✔call 911 2nd htn ✔✔renal stenosis adrenal tumors A bruit is a murmur heard over the carotid artery in the neck, suggesting arterial narrowing and atherosclerosis. It may increase risk of ✔✔cerebrovascular disease abi ✔✔pad An ABI score of 1.0 to 1.4 is normal. Any value less than 1.0 is abnormal. A score of 0.5 or less is indicative of severe PAD. s2 ✔✔Second intercostal space, left sternal border white ✔✔ace intermittent claudication, he or she would first: ✔✔Check the ankle and brachial blood pressures before and after exercise
Symogi effect v dawn phenomenon: ✔✔Symogi: hypoglycemia causes hyperglycemia Dawn phenomen: increase in insulin due to growth hormones, cortisol etc The Somogyi effect is characterized by ✔✔high fasting blood glucose in the morning that is caused by the secretion of glucagon The Somogyi phenomenon or Somogyi effect occurs when nocturnal hypoglycemia (2 a.m.- 3 a.m.) stimulates the pancrease to secrete glucagon, which causes the liver to convert glycogen to glucose. Fasting blood glucose then becomes elevated. It is also known as the "rebound effect." ✔✔ tsh 10 check ✔✔Check the thyroid profile Hashimoto's thyroiditis? ✔✔Anti-thyroid peroxidase and anti-thyroglobulin antibodies symogi is what kind of effect ✔✔reboun hyperglycemia Type 2 diabetes mellitus screening tests include fasting plasma glucose level (>126 mg/dL), random plasma glucose level (>200 mg/dL), and oral glucose tolerance testing (2-hour blood glucose level >200 mg/dL) with a 75-g glucose load. Normal A1C levels are less than 6%. ✔✔ A UTI is defined as the presence of 100,000 organisms per milliliter of urine in asymptomatic patients or greater than 100 organisms per milliliter of urine with pyuria (>7 WBCs/mL) in a symptomatic patient ✔✔
Synthroid starting dose ✔✔25 mcg check in 6 weeks TSH (thyroid stimulating hormone) value ✔✔1.0 and 3. The classic triad of symptoms of Meniere's disease are episodic vertigo, tinnitus, and sensorineural hearing loss (low frequency). Tinnitus is usually low pitch (like listening to a conch shell). ✔✔ Patients who exercise vigorously in the afternoon may have hypoglycemic episodes in the evening or at night if they do not eat ✔✔ Statin medications, such as rosuvastatin (Crestor), can affect liver function and increase liver enzymes as well as cause the patient to feel weak, fatigued, and have muscle aches. Therefore, checking the liver function profile is recommended. ✔✔ Diverticulosis/diverticulitis ✔✔Diverticulosis may lead to Diverticulitis DIVERTICULOSIS: pouch-like herniations of colon into muscularis layer, esp. sigmoid colon; symptoms minimal, possible rectal bleeding DIVERTICULITIS: inflammation of diverticula, may cause abscess; pain, cramping of lower left Q, nausea/vomiting, slight fever, increased WBC; complications - bowel obstruction, perforation with peritonitis, hemorrhage Red flag: back pain Which of the following laboratory values may be elevated on the liver function panel of patients who are alcohol abusers?
If left untreated, Zollinger-Ellison syndrome can cause which of the following? Severe ulceration of the stomach or duodenum ✔✔ Extreme tenderness and involuntary guarding at McBurney's point is a significant finding for possible: ✔✔Acute appendicitis Which of the following laboratory tests is the most sensitive test for evaluating an active Helicobacter pylori infection of the stomach or duodenum: ✔✔Urea breath test A 40-year-old White woman with a body mass index (BMI) of 32 complains of colicky pain in the right upper quadrant of her abdomen that gets worse if she eats fried food. During the physical exam, the nurse practitioner presses deeply on the left lower quadrant of the abdomen and the patient complains of pain on the right side of the lower abdomen. What is the name of this finding? ✔✔Rovsing's sign The Rovsing sign is right lower quadrant pain intensified by left lower quadrant abdominal pressure. It is associated with peritoneal irritation and appendicitis. ✔✔ Symptoms of ulcerative colitis include bloody diarrhea mixed with mucus, nausea/vomiting, abdominal pain, and possible weight loss with long-term diarrhea. ✔✔ Cdiff 1st line ✔✔Vancomycin https: The most important clue for ulcerative colitis is bloody stools that are covered with mucus and pus along with the systemic symptoms (fatigue, low-grade fever). ✔✔ When performing an abdominal exam, what is the best method to differentiate an abdominal wall mass from an intra-abdominal mass? ✔✔lift her head off the table while tensing her abdominal muscles to visualize any masses and then palpate the abdominal wall
An abdominal wall mass will become more prominent when the abdominal wall muscles are tense. ✔✔ Evidence of blood in the urine can be seen with kidney stones, bladder cancer, and acute pyelonephritis. ✔✔ bag of worms ✔✔varicocele You palpate a tender and warm cystic mass on the lower edge of the left labia minora, which is red. ✔✔Bartholin's glands are located in the base of the labia minora at about the 4 o'clock and 8 o'clock positions. Their function is to provide moisture for the vestibule. They are small (about pea sized) unless they become clogged or infected. If this occurs, an abscess may form and glands will enlarge and become painful. dysuria ✔✔Order a urinalysis and urine for culture and sensitivity (C&S), and treat the patient with antibiotics BPH prostate ✔✔Symmetrically enlarged, firm, and smooth Prostate feels rubbery and uniformly enlarged sensitive test for evaluating renal function? ✔✔Estimated glomerular filtration rate (eGFR) The most common cause of nongonococcal urethritis is Chlamydia trachomatis, ✔✔ 1 - week history of fever and pain over the left scrotum. It is accompanied by frequency and dysuria. The scrotum is edematous and tender to touch. He denies flank pain, nausea, and vomiting. He reports that the pain is lessened when he uses scrotal-support briefs. The urinalysis shows 2+ blood and a large number of leukocytes. What is the most likely diagnosis? ✔✔Acute epididymitis
Vertigo with nausea and vomiting Nystagmus While performing a funduscopic exam, the nurse practitioner notices arteriovenous (AV) nicking on the patient's retina. What causes AV nicking? It is caused by an arteriole crossing a venule, which compresses the venule and causes it to bulge on each side ✔✔ cones ✔✔color Hypocalcemia ✔✔Chvostek's sign i The cover/uncover test screens for strabismus. ✔✔ A normal result in the Rinne test is air conduction (AC) greater than bone conduction (BC). When there is a conductive hearing loss (i.e., ceruminosis, otitis media), the result will be BC greater than AC. The reason is that the sound waves are blocked (i.e., cerumen, fluid in middle ear). Therefore, the patient cannot hear them as well as through bone conduction. ✔✔ The red reflex examination is used to screen for: Cataracts ✔✔ Microaneurysms are seen with diabetic retinopathy. Arteriovenous (AV) nicking, copper wire arterioles, and flame hemorrhages are seen with uncontrolled hypertension. ✔✔ Which of the following eye findings is seen in patients with diabetic retinopathy? ✔✔Neovascularization
Arteriovenous nicking (AV nicking), copper wire arterioles, and flame hemorrhages are associated with hypertensive retinopathy. ✔✔ Pterygium is a triangular growth on the white part of the eye that also extends onto the cornea. ✔✔ The best test for diagnosing glaucoma is ✔✔Tonometry 10 22 Which bacterium is the most common pathogen seen in otitis externa infections? Pseudomonas aeruginosa ✔✔ What is the best procedure for evaluating a corneal abrasion ✔✔Fluorescein stain The gold standard for diagnosis of thalassemia (or sickle cell anemia) is the hemoglobin electrophoresis. ✔✔ Koilonychia is also known as spoon-shaped nails. The finger nails are thin and have a concave shape. Koilonychia is associated with severe iron-deficiency anemia. ✔✔ Vitamin B12-deficiency adversely affects myelin, leading to neuropathy. ✔✔ Myeloma is a cancer of the plasma cells (or mature B-cells/ lymphocytes) that affects the bone marrow. Plasma cells produce antibodies and reside mainly in the bone marrow. Signs and symptoms are bone pain, fractures, hypercalcemia, depressed immunity, and anemia. The bone marrow produces white blood cells (neutrophils, lymphocytes, eosinophils, basophils), red blood cells, and platelets. The typical patient is an adult who is age 60 years or older. ✔✔ Of the primary hepatitis viruses, only B and C are associated with hepatocellular cancer ✔✔
Heart disease and endometrial cancer ✔✔ Which of the following laboratory tests is a sensitive test for evaluating renal function? ✔✔Estimated glomerular filtration rate (eGFR)
