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NSG 6998 APEA PREDICTOR EXAM 1
LATEST 2025/2026 QUESTIONS AND
CORRECT ANSWERS GRADED A+ SOUTH
UNIVERSITY
Ludwig's angina indicates which of the following?
Submandibular infection
Which of the following is true regarding epistaxis?
Anterior form originates from Kiesselbach's plexus.
A patient with bulging cheeks often described as "chipmunk" facies likely has which of the following diseases?
mumps
A diffusely enlarged and firm thyroid is most suggestive of what diagnosis?
Hashimoto's disease
What does a bruit heard on auscultation over the thyroid suggest?
Graves' disease
What sign associated with hyperthyroidism is found on physical examination?
Lid lag
What physical exam finding is most suggestive of otitis externa?
Pain when pulling on the ear
What is pterygium?
A wing of conjunctival tissue that extends toward the cornea
What is the best way to position a patient for examination with a handheld ophthalmoscope?
Face-to-face with the patient's eyes close to the height of the examiner
What condition may interfere with visualization of the "red reflex?"
Cataracts
What is the normal cup to disc ratio when examining the optic nerve on a fundoscopic exam?
Which type of headaches come with lacrimation and sinus symptoms?
cluster
headaches
How does the parathyroid gland regulate calcium?
when parathyroid hormone is
released, it pulls calcium out of the blood and into the circulation in response to
hypocalcemia. it also increases absorption of calcium from the intestine
How is bursitis treated?
a needle to instill intraarticular steroids and then pull off
fluid
If a patient is on birth control and they miss two pills, what should they do?
double
up for 2 days
What are s/s of Addison's disease?
bronze or discolored skin, salt cravings
What is the biggest side effect of colchicine?
diarrhea
How would you describe the appearance of molluscum contagiosum?
papules that are umbilicated and contain a caseous plug
How do we treat a broken clavicle in an infant?
no treatment; it should heal on it's own
At what week of pregnancy is the uterus palpable just above the pubic symphysis?
week 12
At what week of pregnancy is the fundus palpable halfway between the pubic symphysis and umbilicus?
week 16
At what week of pregnancy is the fundus of the uterus at the umbilicus?
week 20
At what week of pregnancy is the fundus of the uterus halfway between the xiphoid process and umbilicus?
parvovirus aka slapped cheek disease aka erythema infectiosum
Which type of prevention are vaccinations?
primary
When should patients begin antiretroviral therapy for HIV infection?
as soon as it is detected, even if in the acute phase
What are the first generation antihistamines?
diphenhydramine (benadryl) and chlorpeniramine (actifed)
What are s/s of the secondary stage of syphilis?
rash on hands and feet, lymphadenopathy, fever
What is the recommended treatment for chronic bacterial prostatitis?
a fluoroquinolone (cipro or levo) + bactrim
What is the recommended treatment for acute prostatitis?
cipro (if not STI related) or ceftriaxone
What are s/s of an intraductal breast papilloma?
clear to bloody unilateral nipple discharge (bilateral is usually benign), and also a wart like lump palpated in the nipple area
If a patient has GABHS but has an allergy to penicillins, what is the second line option?
first generation cephalosporins, unless the allergy is severe, then you would consider macrolides like a - mycin
PDE5 inhibitors (sildenafil, tadalafil) are contraindicated in which patient populations?
in those who are on any type of nitrate or triptan because it could result in hypotension
What class of drug is sildenafil (viagra)?
a PDE5 inhibitor which can cause hypotension so you should do a full cardiac assessment before starting a patient on this and maybe do an EKG
What are the symptoms of peripheral artery disease?
think P meaning pain, A meaning absent or weak pulses, eschar or shiny legs, intermittent claudication
What is first line treatment for PAD?
If a patient on coumadin's INR is 3.1-4 ,what should you do?
decrease the weekly dose by 5-10%
If a patient on coumadin's INR is 4.1-5.0, what should you do?
hold one dose then decrease the weekly dose by 10%
If a patient's INR is greater than 5, what should you do?
consult cards, likely would hold two doses then decrease the weekly dose
An anorexic patient will have a BMI of what?
less than 18
What is primary amenorrhea?
when the patient has never gotten their period before (there is an absence of menarche) but they have all of their secondary sex characteristics
Secondary amenorrhea is a lack of menses after _________ of not having a period; but you have had one before
3 months
What do we need to do first when a patient comes in with secondary amenorrhea?
rule out pregnancy
Anorexia can put you at risk for what?
osteoporosis, amenorrhea, cardiac damage
Amenorrhea is considered a risk factor for what?
osteoporosis
What is the best indication of an anorexic patient doing better? They tell you they are eating more, they have weight gain, or they get their period back?
they get their period back
If a pregnant woman has syphilis, what should we do?
treat it with penicillin while she is pregnant because there is risk for spontaneous abortion
What is the causative organism of mastitis?
staph
What is the first line treatment for mastitis?
If a patient's Coomb's test is positive, what do we do?
nothing, she is RH positive so we do not need to treat
If a patient's Coomb's test is negative, what do we do?
give rhogam at 28 weeks and 72 hours after birth
What is the only form of non-hormonal contraception other than barrier methods such as condoms?
IUD
The vaginal ring for contraception must be taken out how often?
every 3 weeks
If a patient is on birth control and is currently having breakthrough bleeding, then what do we do?
increase the progesterone
How do we treat temporal arteritis?
steroids
If a patient is on birth control and they miss one pill, what should they do?
double up
If a patient is on birth control and they miss two pills, what should they do?
double up for 2 days
If any woman comes in with painless vaginal bleeding between periods (esp if she is postmenopausal), what should you do?
do a pregnancy test and then refer for endometrial biopsy to rule out endometrial cancer
In terms of the breasts, _____________ is used for screening and _____________ is used for diagnosis.
mammogram; ultrasound
When do we screen for group B strep in pregnancy?
weeks 35-
When do we perform alpha fetoprotein screening in pregnancy?
15-20 weeks
What is the recommended treatment for polymyalgia rheumatica?
steroids
Patients with SLE are going to have what abnormal labwork?
elevated ESR and CRP
How do we treat lupus flares?
steroids
What are common sequelae of fibromyalgia?
insomnia and depression
What is a great treatment option for fibromyalgia?
amitriptyline (a TCA) because it helps with chronic pain, sleep, and depression
How is fibromyalgia diagnosed?
when at least 8 out of 11 points bilaterally are tender to touch and the symptoms have lasted longer than 3 months
What is slipped capital femoral epiphysis?
when the femoral head of the hip is out of place
What is the trendelenburg sign and when is it positive?
when the patient is standing straight and the pelvis on the unaffected side drops; this is a sign of a slipped capital femoral epiphysis
What is the main characteristic of a slipped capital femoral epiphysis?
walking with a limp
SCFE is most common in which patient population?
adolescents
What is legg-calve-perthe disease?
avascular necrosis of the femoral head due to a lack of blood supply
Legg-calve-perthes disease is most common in which patient population?
young children
What is the radiographic study of choice for the knee?
What is myasthenia gravis?
an autoimmune disorder that causes muscle weakness of the voluntary muscles
Genu valgum is caused by a problem with what?
the medial collateral ligament; think valgum as in gum makes your knees stick together
Genu varum is caused by a problem with what?
the lateral collateral ligament
What are shin splints?
a medial tibial syndrome caused by overuse of the muscles
How do we treat shin splints?
rest and avoidance of exercise until the pain resolves
What is the tell-tale difference between a herniated disc and sciatica?
sciatica feels better when you stand, a herniated disc feels better when you sit down
When will spinal or lumbar stenosis feel better?
when the patient sits down
What is Korsakoff syndrome?
a deficiency in thiamine and folate caused by alcoholism
What changes to the vagina occur with aging?
dryness, loss of rugae, less pubic hair
What is a navicular fracture?
also known as a scaphoid fracture; this impacts the snuff box and causes tenderness there. This will have to be casted to stabilize the fracture
Heberden and bouchard's nodes are indicative of what disease process? What about swan neck deformities?
osteoarthritis; rheumatoid arthritis
What is Morton's neuroma?
a mass between the 3rd and 4th toes that feels like a pebble; most common in women who wear high heels or tight shoes
