APEA Pre-Predictor 2025/2026 Exam Test Bank Overview

A disease due to infection with Group A Beta-hemolytic streptococcus, characterized by an acute onset of fever, pharyngitis, headache, cervical lymphadenopathy, and a sandpaper textured rash.

Scarlet fever

A deep, nonblanching rash on the flexor surfaces of the skin associated with scarlet fever.

Pastia lines

The nurse practitioner should check the patient's TSH 6 weeks after starting thyroid hormone replacement therapy.

TSH check timing after thyroid hormone replacement

The half-life of levothyroxine, the treatment of choice for thyroid replacement, is 7 days.

Half-life of levothyroxine

Essential for a patient with a history of cryptorchidism to monitor for increased risk of testicular cancer.

Testicular self-examination

The treatment of choice is a fluoroquinolone twice daily for 3 weeks to 4 months.

Chronic bacterial prostatitis treatment

Diabetes mellitus is a common underlying cause of frequent candidal vaginal infections.

Candidal vaginitis underlying condition

The S3 heart sound is low-pitched and occurs just after the S2 heart sound, produced by rapid ventricular filling.

S3 heart sound characteristics

Normal PSA is 4 ng/ml or less; levels greater than 4 and less than 10 are associated with BPH.

Normal PSA level

A PSA level of 10 or greater suggests prostate cancer.

Prostate cancer PSA level

Positive serum acid phosphatase is associated with malignancy of the prostate gland with bone metastasis.

Positive serum acid phosphatase

Symptoms include fever, pharyngitis, headache, cervical lymphadenopathy, and a sandpaper textured rash.

Acute onset symptoms in a child

The cure rate with Bactrim-DS for chronic bacterial prostatitis is only about 30-40%.

Fluoroquinolone cure rate for CBP

Cryptorchidism is associated with an increased risk for testicular cancer.

Risk factors for testicular cancer

Pregnancy increases the incidence of candidiasis, but is unlikely a factor for a patient in a monogamous relationship with an IUD.

Incidence of candidiasis during pregnancy

It is a common finding with right-sided heart failure, rapid growth, and the last trimester of pregnancy.

Characteristics of S3 heart sound

Meaningful changes in TSH levels will be observed at 4-6 weeks after starting therapy.

Timing for checking TSH after therapy

Frequent infections can be caused by underlying conditions such as diabetes mellitus.

Candidal vaginitis risk factors

Finding abnormalities on DRE necessitates appropriate lab orders and review of PSA levels.

Prostate gland abnormalities

Administered twice daily for a duration of 3 weeks to 4 months.

Fluoroquinolone dosage for prostatitis

Swelling of the cervical lymph nodes often associated with infections such as scarlet fever.

Cervical lymphadenopathy

A characteristic rash associated with scarlet fever that fades with pressure and ultimately desquamates.

Sandpaper textured rash

Finding that most strongly correlates with myocardial infarction.

Elevated Troponin I levels

Not diagnostic of a myocardial infarction (MI); may be elevated from IM injection, surgery, or extensive skeletal muscle trauma.

Elevated creatinine kinase (CK)

Usually indicates ischemic myocardium, but not necessarily post-MI.

ST segment depression on EKG

Reflect myocardial damage.

Elevated ST segments

Specific for myocardial smooth muscle; if elevated, the patient may have had a very recent MI.

MB bands

Most accurate marker of cardiac damage, more specific and sensitive than CK MB.

Troponin measurement

Hypothyroidism is a common secondary cause; TSH should always be checked and corrected before treatment.

Secondary cause of hyperlipidemia

Include pregnancy, excessive weight gain, excessive alcohol intake, insulin resistance or deficiency, obstructive liver disease, and uremia.

Other causes of secondary hyperlipidemia

Include thiazide diuretics, some beta-blockers, oral contraceptives, and corticosteroids.

Medications causing secondary hypothyroidism

Suspected in a patient with low pelvic pain, dysuria, hesitancy, urgency, and reduced flow of stream.

Acute bacterial prostatitis

Would identify only organisms in the bladder and would not differentiate between bladder, kidney, or prostate site infection.

Sterile in-and-out catheter urine specimen

1. Voided urethral urine, 2. Voided mid-stream bladder urine, 3. Voided post-prostate massage urine.

Sequence for obtaining specimens in prostatitis

If 2 pills are missed on consecutive days, double today's dose and tomorrow's dose and use a barrier method for the rest of the month.

Missed oral contraceptive pills

Start Clarithromycin (Biaxin) 500mg 2 times a day for 10 to 14 days.

Outpatient pneumonia treatment for non-smokers

Penicillin is indicated for patients with pneumococcal pneumonia.

Recommended treatment for pneumococcal pneumonia

Ciprofloxacin is recommended.

Legionella species treatment

Most appropriate intervention is to obtain a gynecological consultation.

Heavy vaginal bleeding secondary to uterine leiomyomas

Recommended for a uterus greater than 12 weeks gestational size, significant anemia (hct <30), or failure to respond to hormonal therapy.

Criteria for gynecological consultation

Early HIV detection

Absolute contraindication to breastfeeding

HIV infection and IV drug abuse

Contraindications to breastfeeding

A condition suspected when a patient presents with copious, markedly purulent discharge from the eye.

Gonococcal conjunctivitis

A condition that, along with gonococcal conjunctivitis, requires systemic antibiotic treatment and referral to an ophthalmologist.

Chlamydial conjunctivitis

Should begin at 4-6 months of age.

Oral iron supplementation for babies

Sufficient to last through the first 4-6 months of life.

Iron stores in full-term infants

Many systemic diseases like diabetes, hypo/hyperthyroidism, and medications can result in ED.

Erectile dysfunction (ED) causes

Not implicated in erectile dysfunction (ED).

Urinary tract infection (UTI)

Increased total lung capacity (TLC).

Expected spirometry readings in chronic emphysema

Pallor and cyanosis is typical of chronic bronchitis, while emphysema is not associated with these symptoms.

Chronic bronchitis vs. emphysema

A physical exam finding associated with increased anterior-posterior diameter in emphysema.

Barrel chest

Serial quantitative beta-human chorionic gonadotropin levels are useful for diagnosis.

Diagnosis of spontaneous abortion

Avoidance of excessive sun exposure is the most accepted recommendation.

Skin cancer prevention recommendation

Fair-skinned individuals >65 years, those with atypical moles, and those with >50 moles have a substantially increased risk.

Risk factors for melanoma

Prophylaxis medication recommended for patients under 35 years of age with a positive PPD to prevent progression from latent infection to active infection.

Isoniazid (INH)

Based on the exclusion of other pathologies, as most cases are idiopathic.

Meniere's disease diagnosis

Should be avoided because they may mask symptoms of hypoglycemia.

Beta-adrenergic blockers in diabetes

Using the height-weight formula, a female who is 5 feet 7 inches tall has an ideal body weight of 135 lbs.

Ideal body weight for a female

Oral ferrous sulfate is the appropriate initial treatment for iron deficiency anemia secondary to heavy menstrual bleeding.

Initial treatment for iron deficiency anemia

Usually not needed, but may be required in cases of malabsorption disorder, inflammatory bowel disease, intolerance to oral iron, or excessive blood loss.

Intramuscular iron dextran

Patients should report all issues to their healthcare provider except for one missed dose, as the effect of warfarin lasts beyond 24 hours.

Warfarin (Coumadin) monitoring

Warfarin has a narrow therapeutic index, meaning fluctuations in its level can cause significant changes in its therapeutic effect.

Warfarin therapeutic index

Meclizine (Antivert) does NOT have dizziness or vertigo as potential adverse side effects.

Medication class without dizziness as side effect

A sensation of body movement when there is no body movement occurring.

Dizziness

The sensation that the person is still and the room is spinning.

Vertigo

A long-acting antihistamine which is used to treat chronic vertigo.

Meclizine

Considered positive for confirmed or suspected HIV infection, injecting drug users, close contacts of a TB case, persons with a chest X-ray suggestive of TB.

PPD positive at 5 mm

Considered positive for injecting drug users known to be HIV negative, occupants of long-term care facilities, age less than 4 years, groups with a high prevalence for TB, the medically underserved, and healthcare workers.

PPD positive at 10 mm

Considered positive in those with no known risk factors.

PPD positive at 15 mm

The first focus of education targeted toward the adolescent age group considering mortality statistics.

Alcohol abuse

About 90% of adolescents have used alcohol by 16 years of age.

Alcohol use in adolescents

The leading cause of death in the 15-24 year old age group related to driving under the influence of alcohol.

Motor vehicle accidents

Best managed with daily inhaled steroids and long acting bronchodilators.

Moderate persistent asthma management

The biggest side effect is diarrhea.

Colchicine side effect

Papules that are umbilicated and contain a caseous plug.

Molluscum contagiosum appearance

No treatment; it should heal on its own.

Broken clavicle in an infant

The uterus is palpable just above the pubic symphysis.

Uterus palpable at week 12

The fundus is palpable halfway between the pubic symphysis and umbilicus.

Uterus palpable at week 16

The fundus of the uterus is at the umbilicus.

Uterus palpable at week 20

The fundus of the uterus is halfway between the xiphoid process and umbilicus.

Uterus palpable at week 28

The fundus is just below the xiphoid process.

Uterus palpable at week 34

A sign of hyperthyroidism.

Increased sweat production

Localized increased bone turnover and blood flow resulting in the breakdown of bone and replacing it with weakened and highly vascular bone, putting the individual at increased risk of fractures.

Paget's disease

Bisphosphonates.

Treatment for Paget's disease

Should wear the shoulder strap like a normal person and then the groin strap below the belly and across the hips.

Pregnant women seatbelt use

Another name for fifth disease is not provided in the notes.

Fifth disease

aka slapped cheek disease aka erythema infectiosum

parvovirus

primary prevention

vaccinations

as soon as it is detected, even if in the acute phase

antiretroviral therapy for HIV infection

diphenhydramine (benadryl) and chlorpeniramine (actifed)

first generation antihistamines

rash on hands and feet, lymphadenopathy, fever

s/s of the secondary stage of syphilis

a fluoroquinolone (cipro or levo) + bactrim

treatment for chronic bacterial prostatitis

cipro (if not STI related) or ceftriaxone

treatment for acute prostatitis

clear to bloody unilateral nipple discharge (bilateral is usually benign), and also a wart like lump palpated in the nipple area

s/s of an intraductal breast papilloma

first generation cephalosporins, unless the allergy is severe, then consider macrolides like a - mycin

second line option for GABHS with penicillin allergy

in those who are on any type of nitrate or triptan because it could result in hypotension

PDE5 inhibitors contraindications

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

sildenafil (viagra) class

think P meaning pain, A meaning absent or weak pulses, eschar or shiny legs, intermittent claudication

symptoms of peripheral artery disease

walking and physical activity to improve circulation. second line is an aspirin or anti-platelet

first line treatment for PAD

do not elevate the feet; keep them down

advice for patients with PAD