APEA TEST BANK
A patient with iron deficiency anemia takes iron
supplementation daily. What should he be
advised to avoid within a couple of hours
... [Show More] of
taking iron?
An antacid
Leukemia may have varied clinical
presentations. Which characteristic would
be unusual to find in a patient with
leukemia?
Sickle shaped cells
A 66 year-old African American male
complains of pain in his trunk, especially his
ribs. Cardiovascular disease is ruled out. He
has a normocytic, normochromic anemia
with hypercalcemia. The differential
diagnosis should include:
multiple myeloma.
What hallmark finding is associated with
both B12 and folate deficiencies? Macrocytosis
A patient demonstrates leukocytosis. This
means:
he has an infection of
unknown origin.
What statement is true about anemia in
older adults?
Anemia may have more than one
origin and co-exist in older adults.
A patient has been treated for HIV infection
with anti-retroviral therapy. He is stable.
How often should CD4 counts be repeated?
Every 3-6 months
A patient presents with hematuria, RBC
casts, and proteinuria. What is a likely
explanation?
Glomerulonephritis
A patient demonstrates leukocytosis. This
means:
he has an infection of
unknown origin.
A patient is having an allergic reaction to
seafood. Which white cell will probably be
increased?
Eosinophils
A female patient has been diagnosed with
Glucose-6-phosphate dehydrogenase
deficiency (G6PD). What should be done to
prevent lysis of red cells in this patient?
Avoid aspirin and sulfa drugs
A 75 year-old patient who has multiple
chronic diseases has been in very poor
health for a decade. What type of anemias
is he most likely to exhibit?
Folic acid and pernicious
A patient has been diagnosed with HIV. The
patient’s viral load was ordered. What other
test may be ordered to assess the status of
the patient’s immune system?
CD4 cell count
A 70 year-old male has lymph nodes in his
axillary and inguinal areas that are palpable
but non-tender. He states that he feels well
today. What should be included in a
Lymphoma
differential diagnosis for this patient?
A two year-old with sickle cell anemia (SCA)
should receive which immunizations?
All routine childhood
immunizations at the usual
time
A three year-old child presents with
hematuria, petechiae, and a platelet count
of 50,000 (Normal = 150,000-450,000/ml).
The rest of his CBC is normal. He had an
upper respiratory infection about 2 weeks
ago. On exam today, he is found to have
petechiae and bruises. The most likely
diagnosis is:
idiopathic
thrombocytopenia
purpura (ITP).
A child and father live in an old house. They
both are found to be lead toxic. What type
anemia is typically observed in patients who
are lead toxic?
Iron deficiency anemia
A patient with diarrhea has a stool
specimen positive for WBCs. What does this
indicate?
A viral infection
A 26 year-old female has thalassemia minor.
What should be limited in her diet to avoid
hepatotoxicity?
Multi-vitamin with iron
A patient is found to have eosinophilia. An expected
finding is:
asthma exacerbation.
An African American male complains of pain
in his back and trunk. He is diagnosed with
multiple myeloma. He is probably:
about 65 years old. .
A patient has heavy menses. Which lab
value below reflects an iron deficiency
anemia?
Increased TIBC
An obese 78 year-old male with poorly
controlled hypertension and diabetes has a
normocytic, normochromic anemia. This
anemia is likely:
associated with chronic disease. .
An elderly male diagnosed with a microcytic,
hypochromic anemia: may have a GI bleed.
Which suggestion below is the standard for
treating iron deficiency anemia in infants
and children?
Iron supplementation in
divided doses between meals
with orange juice
A patient with pernicious anemia may be
observed to have: glossitis.
Lead toxicity can be associated with: sideroblastic anemia.
A patient is being treated for iron deficiency
anemia. Iron is better absorbed: on an empty stomach.
What choice below can be attributed to the
two most common causes of iron deficiency
anemia in adults?
Gynecologic losses and
bleeding in the
gastrointestinal tract
The laboratory identifies metamyelocytes in
a 50 year-old patient who had a CBC
performed. What might be an expected
finding in this patient?
Splenomegaly
A patient is found to have an anemia. The
patient’s MCH is normal. The patient’s
anemia can be described as:
normochromic.
Which statement is true about Vitamin B12?
Inadequate amounts can produce
cognitive changes.
A serum ferritin level: demonstrates the amount
of iron in storage.
Which anemias are described as microcytic,
hypochromic anemias?
Iron deficiency anemia and
thalassemia
The nurse practitioner sees a child who
presents with fatigue and purpura on his
lower extremities. His temperature is
normal. The differential includes:
acute leukemia.
An older adult has suspected B12 deficiency.
Which of the following lab indices is most
indicative of a B12 deficiency?
Increased MCV
A patient with anemia of chronic disease
probably has a: normocytic anemia.
A vitamin B-12 deficiency might be
suspected in an older patient with what
complaints?
Memory issues and glossitis
A measure of the degree of variation in red
cell size is indicated by: RDW.
A definitive diagnosis of sickle cell anemia
can be made: by a hemoglobin electrophoresis. .
An example of a macrocytic anemia is: pernicious anemia.
An older adult has suspected B12 deficiency.
Which of the following lab indices is more
indicative of a B12 deficiency?
Macrocytosis
Besides inadequate intake of Vitamin D in
elder adults, what other factor contributes
to deficiencies?
Impaired synthesis of previtamin D
Which white cell should be present in the
greatest number in a patient who is healthy
today?
Neutrophils
A patient has CBC results that indicate a
microcytic, hypochromic anemia. The nurse
practitioner should suspect:
iron deficiency anemia.
A 12 month-old was screened for iron
A patient is found to have an anemia. The
patient’s MCV is normal. The patient’s
anemia can be described as:
normocytic.
A B-12 deficiency can produce: pernicious anemia.
Thalassemia minor can be recognized by: microcytic, hypochromic
red cells.
A patient had a splenectomy after an automobile accident 3 months ago. Patients
who are asplenic are:
An example of a first generation
cephalosporin used to treat a skin
infection is:
cephalexin.
A 4 year-old has been diagnosed
with measles. The nurse
practitioner identifies Koplik’s
spots. These are:
found on the
inside of the
cheek and are
granular.
The main difference between cellulitis
and erysipelas is the:
layer of skin
involvement.
A patient reports that he found a
tick on himself about one month
ago. He reports that there is a red
circle and a white center near
where he remembers the tick bite.
He did not seek treatment at the
time. Today he complains of
myalgias and arthralgias. What
laboratory test can be used to help
diagnose Lyme disease?
ELISA
A patient who is at high risk for
skin cancer should:
examine his
skin monthly
for changes.
A patient has a “herald patch” and
is diagnosed with pityriasis rosea.
Where is the “herald patch” found?
On the chest
Which of the following antibiotics Fluoroquinolones
more
suscep
tible
to
bacter
ial
infecti
on.
may increase the likelihood of
photosensitivity?
A 60 year-old patient is noted to
have rounding of the distal
phalanx of the fingers. What might
have caused this?
Hepatic cirrhosis
A patient exhibits petechiae on
both lower legs but has no other
complaints. How should the NP
proceed?
Order a CBC
When can a child with chickenpox
return to daycare? After all lesions have crusted over
Hand-foot-and-mouth disease and
herpangina:
are viral infections caused by
Coxsackie viruses.
What is the proper technique to
safely remove a tick from a
human?
Pull it off with tweezers
Most cases of atopic dermatitis
exacerbation are treated with: topical steroids.
The primary therapeutic
intervention for patients who
present with hives is:
anti-histamines.
A patient is diagnosed with tinea
pedis. A microscopic examination
of the sample taken from the
infected area would likely
demonstrate:
hyphae.
A patient has been diagnosed with
scabies. What is the medication of
choice to treat this?
Permethrin
An adolescent has acne. The nurse
practitioner prescribed a benzoyl
peroxide product for him. What
important teaching point should
be given to this adolescent
regarding the benzoyl peroxide?
Photosensitivity of the skin can
occur
A patient presents with plaques on
the extensor surface of the elbows,
knees, and back. The plaques are
erythematous and there are thick,
silvery scales. This is likely:
plaque psoriasis.
An infant is diagnosed with diaper
dermatitis. Satellite lesions are
topical anti-fungal agent.
visible. This should be treated with
a:
A key component of the approach
to a patient who has atopic
dermatitis is hydration. Which
agent should be avoided?
Lotions
Patients with atopic dermatitis are
likely to exhibit: Itching.
A 16 year-old has been diagnosed
with Lyme disease. Which drug
should be used to treat him?
Doxycycline
A 28 year-old has thick,
demarcated plaques on her
elbows. Which features are
suggestive of psoriasis?
Silvery scales that are not pruritic
A 71 year-old female presents
with a vesicular rash that burns
and itches. Shingles is diagnosed.
An oral antiviral:
should be started within 72 hours
of the onset of symptoms.
A patient was burned with hot
water. He has several large fluid
filled lesions. What are these
termed?
Bullae
A patient with a primary case of
scabies was probably infected: 3-4 weeks ago.
A patient has a lower leg wound
that appears infected. It is red,
warm to touch and edematous. He
had an acute onset of pain,
symptoms, and low grade fever.
What is this?
Erysipelas
A 15 year-old male has worked
this summer as a lifeguard at a
local swimming pool. He
complains of itching in the groin
area. He is diagnosed with tinea
cruris. The nurse practitioner is
likely to identify:
well marginated half moon macules
on the inner thigh.
A patient has been diagnosed with
MRSA. She is sulfa allergic. Which
medication could be used to treat
her?
Doxycycline
A skin lesion which is a solid mass papule.
is described as a:
Impetigo is characterized by: honey-colored crusts.
A 10 year-old has thick,
demarcated plaques on her
elbows. Which features are
suggestive of psoriasis?
Silvery scales that are not pruritic
The agent commonly used to treat
patients with scabies is
permethrin. How often is it applied
to eradicate scabies?
Once
Which test is NOT suitable to
diagnose shingles if the clinical
presentation is questionable?
Complete blood count (CBC)
A 74 year-old is diagnosed with
shingles. The NP is deciding how
to best manage her care. What
should be prescribed?
An oral antiviral agent
The term caput succedaneum
refers to: scalp edema.
A pregnant mother in her first
trimester has a 5 year-old who has
Fifth Disease. What implication
does this have for the mother?
There is a risk of fetal death if she
becomes infected.
A topical treatment for basal cell
carcinoma is: 5-fluorouracil.
The most common form of skin
cancer is: basal cell carcinoma.
A skin disorder has a hallmark
finding of silvery scales. What
word below describes this
common condition?
Chronic
The most common place for basal
cell carcinoma to be found is the: face.
A low potency topical
hydrocortisone cream would be
most appropriate in a patient who
has been diagnosed with:
atopic dermatitis.
A patient with a positive history of
a tick bite about 2 weeks ago and
erythema migrans has a positive
ELISA for Borrelia. The Western
blot is positive. How should he be
managed?
He should receive doxycycline for
Lyme disease.
A 16 year-old male has
nodulocystic acne. What might
have the greatest positive impact
in managing his acne?
Isotretinoin (Accutane®)
A patient who has been in the sun
for the past few weeks is very
tanned. He has numerous 3-6 mm
light colored flat lesions on his
trunk. What is the likely etiology?
Tinea versicolor
A skin lesion fluoresces under a
Wood’s lamp. What microscopic
finding is consistent with this?
Hyphae
An example of a premalignant
lesion that develops on sundamaged skin is:
actinic keratosis.
A 9 year-old female has presented
to your clinic because of a rash on
the left, upper area of her anterior
trunk. She is embarrassed and very
reticent to lift her blouse because
her nipple will be exposed. How
should the NP proceed?
Examine all other areas of the trunk,
then ask the child to lift her blouse
A patient reports to the minor care
area of the emergency department
after being bitten by a dog. The
patient states that the dog had a
tag around his neck and had been
seen roaming around the
neighborhood. The dog did not
exhibit any odd behavior. How
should this be managed?
Report the bite to animal control
and administer appropriate medical
care.
A patient has seborrheic
dermatitis. Which vehicle would be
most appropriate to use in the
hairline area to treat this?
Foam
A 68 year old female adult with
pendulous breasts complains of
“burning” under her right breast.
The nurse practitioner observes a
malodorous discharge with mild
maceration under both breasts.
What is this?
Intertrigo
A patient is found to have
koilonychia. What laboratory test
would be prudent to perform?
Complete blood count
Which of the following areas of the
body has the greatest
percutaneous absorption?
Genitalia
A patient calls your office. He
states that he just came in from the
woods and discovered a tick on his
upper arm. He states that he has
removed the tick and the area is
slightly red. What should he be
advised?
No treatment is needed.
A patient will be taking oral
terbinafine for fingernail fungus.
The NP knows that:
Terbinafine is a potent inhibitor of
the CYP 3A4 enzymes.
An elderly patient has been
diagnosed with shingles on the
right lateral aspect of her trunk. It
appeared initially yesterday. It is
very painful. How should she be
managed?
An oral antiviral agent and pain
medication.
A young child has developed a
circumferential lesion on her inner
forearm. It is slightly raised, red
and is pruritic. It is about 2.5 cm in
diameter. This is probably related
to:
the child’s new cat.
Which chronic skin disorder
primarily affects hairy areas of the
body?
Seborrheic dermatitis
A microscopic examination of the
sample taken from a skin lesion
indicates hyphae. What type
infection might this indicate?
Fungal
A 40 year-old female patient
presents to the clinic with
multiple, painful reddened nodules
on the anterior surface of both
legs. She is concerned. These are
probably associated with her
history of:
ulcerative colitis.
What advice should be given to a A parent may experience joint
parent who has a child with Fifth
Disease? aches and pains.
What finding characterizes
shingles? Unilateral dermatomal rash
A 70 year-old is diagnosed with
multiple cherry angiomas. The
nurse practitioner knows that:
these may bleed profusely if
ruptured.
A patient with diabetes has a right
lower leg that has recently become
edematous, erythematous, and
tender to touch over the anterior
shin. There is no evidence of pus,
but the leg is warm to touch. What
is the most likely diagnosis to
consider?
Cellulitis
The American Cancer Society uses
an ABCDE pneumonic to help
patients develop awareness of
suspicious skin lesions. What does
the “B” represent?
Border
A 9 year-old has been diagnosed
with chickenpox. A drug that
should be avoided in him is:
aspirin.
Mr. Johnson is a 74 year old who
presents with a pearly-domed
nodular looking lesion on the back
of the neck. It does not hurt or itch.
What is a likely etiology?
Basal cell carcinoma
A 3 year-old female had a fever of
102 degrees F for 3 days. Today
she woke up from a nap and is
afebrile. She has a maculopapular
rash. Which statement is true?
The rash will blanch.
The lesions seen in a patient with
folliculitis might be filled with: pus.
A child has 8-10 medium brown
café au lait spots > 1 cm in
diameter. The differential
diagnosis should include:
neurofibromatosis.
A patient presents with small
vesicles on the lateral edges of his
fingers and intense itching. On
close inspection, there are small [Show Less]