wo weeks for a follow up vision screen b) dilated the eye and retest c) refer the patient to an ophthalmologist d) document this as a normal finding 2. The American psychiatric association’s diagnostic and statistical manual of mental disorder defines Munchausen Syndrome By Proxy a) a self-inflicted injury to gain attention b) a caregiver making up or causing an illness or injury in a person under his or her care c) an abusive behavior that does not involve the caregiver d) a situation in which the abuser is often inattentive and uncaring toward the victim Munchausen syndrome by proxy is a mental illness and a form of child abuse. The caretaker of a child, most often a mother, either makes up fake symptoms or causes real symptoms to make it look like the child is sick. 3. Symptoms of depression are a side effect of which neurotransmitter medication? a) dopamine b) gabapentin c) mil d) cortisol 4. Which lesion is dark raised and asymmetric with irregular border? a) Nevus b) Actinic keratosis c) Keratoacanthoma d) Melanoma 5. A 32 years old woman presents with dull puffiness of the ayes pronounced not pitting periorbital edema this finding is suggestive of this condition? a) Nephrotic syndrome b) Myxedema c) Cushing syndrome d) Sinusitis Myxedema is a deposition of mucopolysaccarides in the dermis. Is commonly found if patients with advanced hypothyroidism. The classic skin changes are: swelling of face, lips, eyelids, and tongue or swelling and thickening of skin anywhere on the body, especially in the lower legs. Myxedema is the hallmark of Grave’s disease, an autoimmune form of hyperthyroidism. Myxedema can also occur in Hashimoto’s thyroiditis a form of hypothyroidism. 6. A 42 years old woman with a past medical history of migraine headaches is requesting prophylactic medication treatment. Which medication should the Nurse practitioner prescribe? a) Sumatriptan (Imitrex) b) Amitriptyline (Elavil) c) Verapamil (verelan) d) Metoprolol (Lopressor) Amitriptyline (Elavil) is a tricyclic antidepresant and is considered offlabel use for prophylactic treatment of migrane. Sumatriptan (Imimtrex) Is aTriptans used to abort migraine 7. A pediatric patient has areas of scaling on the scalp with round patches of alopecia. This clinical finding is consistent with: a) Tinea capitis b) Seborrheic dermatitis c) Trichotillomania d) Alopecia areata 8. What is the appropriate prophylactic medication for an 18 years old woman with a past medical history of migraine headaches? a) Sumatriptan (Imitrex) b) Propanolol (Inderal) c) Ibuprofeno (motrin) d) Dihydroergotamine (DHE) 9. Why would a combined hormonal contraceptive be contraindicated in a 36 year old patient with a past medical history of type 2 diabetes, obesity, chronic smoking and sedentary life a) She is obese b) She has type 2 diabetes mellitus c) Her age and tobacco use d) She leads a sedentary lifestyle Combined oral contraceptive is contraindicated in women older than 45, breastfeeding, smoking, HTN, diabetes or hx of stroke 10. During the breast examination of a perimenopausal woman the NP detects a bloody spontaneous discharge from the right nipple. This indicates further evaluation. a) Fibroadenoma b) Polycystic breast disease Generalized breast pain or tenderness. Green or dark brown nonbloody nipple discharge that tends to leak without pressure or squeezing c) An intraductal papilloma d) Pituitary prolactinoma Intraductal papillomas are usually solitary and smaller than 1 cm. They are located in large lactiferous sinuses or ducts and have a tendency to bleed. Quizlet Nipple Discharge 11. Rh negative women should receive Rho (D) immunoglobulin at what gestational time? a) 6 weeks b) 12 weeks c) 28 weeks d) 35 weeks What happens is the client is Rh negative and has a negative antibody screen? She will need repeat antibody screens and should receive Rho(D) immune globulin (RhoGAM) at 28 weeks' gestation (Quizlet Antepartum Diagnostic Testing Saunders) 12. When interpreting a complete blood count (CBC) lab report which of the following results describes the size of the RBCs? a) Hemoglobin b) Mean corpuscular volume (MCV) c) Red cell distribution width (RDw) d) Hematocrit The mean corpuscle (cell) volume (MCV) is a measurement of the average size of the RBCs. Small-sized RBCs result in a lower MCV, while larger RBCs result in a higher MCV. 13. What medication should be avoided when prescribe prophylactic therapy for headache a) Verapamil b) Propranolol c) Venlataxin (Effexor) d) Nimodipine Serotonin Norepinephrine Reuptake inhibitor have the most serious side effect. Patients should have drug free period for 3-4 weeks after every 6 months of treatment (pharmacology book page 1047) 14. What is the mechanism of action of prostaglandin E1 (PG1) in a patient with transposition of the great arteries a) To maintain equal pressure in the ventricles b) To maintain patency of the great arteries c) To produce vasodilation on ……………. d) To prevent cyanotic episodes by trapping blood in the lower ………… 15. Which of the following complaints best describes lower extremity calf pain associated with peripheral artery disease a) A sharp stabbing pains b) A dull pain or cramp c) An electric shock d) A pulsating pain Peripheral artery disease signs and symptoms include: Painful cramping in one or both of your hips, thighs or calf muscles after certain activities, such as walking or climbing stairs (claudication) Leg numbness or weakness. Coldness in your lower leg or foot, especially when compared with the other side. (Mayoclinic) APEA 3P Actual Exam Test Bank (APEA Question Bank) 16. Which of the following conditions is NOT a typical finding of hyperprolactinemia in a 47- year-old premenopausal woman? a) Hirsutism b) Gynecomastia c) Oligomenorrhea d) Acne Hyperprolactinemia causes typical symptoms in premenopausal women and in men, but not in postmenopausal women. Premenopausal women — Hyperprolactinemia in premenopausal women causes hypogonadism, with symptoms that include infertility, oligomenorrhea, or amenorrhea and less often galactorrhea. ( 17. When treating a patient with asthma who is experiencing acute wheezing which medication should be given to relieve the symptom? a) Short acting bronchodilator b) Long acting bronchodilator c) Inhaled corticosteroid d) Combination of methylxanthine and long acting bronchodilator Short-Acting Beta Agonist (SABA) inhalers; used for acute asthma attacks; quickly reduce airway constriction & restore normal airflow; agonists/stimulators of adrenergic receptors in SNS (sympathomimetics); albuterol (Ventolin), levalburterol (Xopenex), pirbuterol (Maxair), terbutaline (Brethine), metaproterenol (Alupent). (Quizlet Pharm Ch 37 Respiratory drugs) 18. Which immunization reduces a patient’s risk for infection with the virus that causes painful localized blistering rash? a) Smallpox vaccine b) Varicella vaccine (chicken Pox) c) Shingles (herpes zoster) vaccine d) Meningococcal vaccine Shingles (herpes zoster) is an extremely painful skin rash caused by the varicella zoster virus, the same virus that causes chickenpox. In people who have had chickenpox, the virus is never fully cleared from the body; instead, it remains dormant in the nerve tissues. ( 19. Headache warning signs that need prompt investigation include all of the following EXCEPT: a) new onset after age 50 b) aggravated or relieved by change of position c) precipitated by Valsalva maneuver d) Headache relieved with mild infrequent use of analgesics 20. The client with iron deficiency anemia should be advised to take the iron supplement a) With milk to avoid stomach upset b) With milk of magnesia at bedtime to avoid constipation APEA 3P Actual Exam Test Bank (APEA Question Bank) c) On an empty stomach between meals APEA 3P Actual Exam Test Bank (APEA Question Bank) d) For 30 days to 5 weeks Because iron is best absorbed on an empty stomach, patients should be advised to take the supplement an hour before meals. Most patients can use the less expensive, more standard forms of ferrous sulfate (Quizlet Hematology Cht 33) 21. Which one of the following statements is true of Munchausen syndrome by proxy? a) The injury is self-inflicted as the patient is seeking attention from others b) Under the supervision of adults other than the abuser, the patient does not exhibit symptoms c) The caregiver is usually not involver in the abusive behavior d) The abuser is often inattentive and uncaring towards the victim Munchausen syndrome by proxy (MSP) is a mental illness. It is also a form of child abuse. It affects caregivers, especially caregivers of children. It is also known as factitious disorder by proxy. Mothers of small children are most often affected by this condition. Fathers or other caregivers can have it as well. 22. Which of the following is the most common presenting sign of substance abuse in adolescents? a) Poor school performance b) change in sleep habits c) increased blood pressure d) changes in behavior 23. A woman is 11 weeks pregnant and has a maternity history of one full term vaginal delivery, a set of premature triplets delivered vaginally, and a first trimester abortion. Using her TPAL system to document her maternal status a) Gravida 4 para 1114 b) Gravida 4, para 1314 4 is the number of living children GTPAL c. Gravida 3, para 1114 c) Gravida 3, para 1112 Gravida, Term babies, Preterm babies, Abort and Living child 24. The nurse practitioner palpates an enlarged right epitrochlear lymph node in a 30 years old patient. The Nurse Practitioner should asses the patents a) Throat, face, and right ear b) Neck and supraclavicular region c) Right forearm and hand d) Right groin and abdomen Lower arm and hand for erythema and swelling 25. Anticholinergics are indicated for the treatment of a) Asymptomatic bacteriuria APEA 3P Actual Exam Test Bank (APEA Question Bank) b) Renal insufficiency APEA 3P Actual Exam Test Bank (APEA Question Bank) c) Urge incontinence d) Overflow incontinence Anticholinergics are drugs that block the action of acetylcholine. Anticholinergics can treat a variety of conditions, including: urinary incontinence, overactive bladder, COPD, They also help block involuntary muscle movements associated with certain diseases such as Parkinson’s disease.