NR 661-667 Capstone APEA Exam


A 45-year old man presents with malaise and a copper coloured macular rash that covers the trunk ,arms ,legs, palms, and soles of feet. These symptoms began 2 days ago. The nurse practitioner suspects:

  • primary syphilis
  • secondary syphilis
  • early latent syphilis
  • late latent syphilis


A 10 year old infant girl has a history of prematurity and prolonged febrile seizures occurring on two occasions. When discussing the prognosis with the mother, the nurse practitioner informs her that:

  • the child now has two risk factors for developing epilepsy
  • the child already has the following Diagnosis of epilepsy because she has had two seizures
  • febrile seizures are usually benign and alone do not signify epilepsy
  • children with febrile seizures are more likely than general population to develop epilepsy


The diagnostic test to confirm acute lymphoblastic leukemia in a 5 year old child is:

  • chest radiography
  • lumbar puncture
  •  bone marrow biopsy
  • hemoglobin electrophoresis


Ferrous sulfate is initiated in a 24 year old woman with iron deficiency anemia. Which of the following patient statements indicates a need for further patient teaching?

  • “My body absorbs the iron pill better when l take it with my orange juice at breakfast or with my vitamin C pill in the evening”
  • “When l come back to the clinic in a month, that finger stick test will show whether my anemia is getting better.”
  • “l take my iron pill with a glass of milk so it won’t upset my stomach.”
  •  “I take my iron pill in the morning and my milk of magnesia at night.”


A 42 year old man presents with orbital edema, Facial edema , and proteinuria. He states that the symptoms are pronounced in the morning or after lying supine. These findings are likely indicative of :

  • nephrotic syndrome
  • myxedema
  • cushing ‘s syndrome
  • heart failure


At a follow-up visit, a pregnant patient asks for further explanation about inheritance patterns after completing a family history questionnaire . The nurse practitioner explains that X-linked dominant disorders occur.

  • Only in men
  • Through father-to-son transmission.
  • In both men and women, with more severe disease in men.
  • When the man and woman are both carriers.


In a 35 year old man, the symptoms that is most suggestive of testicular cancer is:

  1. testicular swelling
  2. penile warts
  3. testicular pain
  4. erectile dysfunction


Dizziness with activity is the major complained of a 75ear old man with a longstanding history of hypertension and coronary artery disease Initially , the nurse practitioner should:

  • order an echocardiogram
  • order an ultrasound of the carotid arteries
  • obtain blood pressure measurements white the patient is standing, sitting ,and supine
  • order 24 –hour ECG monitoring.


A 30 year old obese woman presents with a small , firm breast nodule .History is significant for fibrocystic breast disease.Axillary lymphadenopathy is palpated on exam .The most appropriate intervention is to:

  • reassure her that the nodule is part of the fibrocystic breast disease
  • inquire about her menstrual cycle
  • order a diagnostic mammogram and ultrasound
  • refer her for biopsy


The history and assessment of 50 year old woman identify stress incontinence .The patient asks what could cause this condition .The most appropriate response is :

  • urinary tract infection
  • constipation
  • aging estrogen deficiency 
  • diabetic neuropathy 


The most common type of dysrhythmia in children is:

  • atrial flutter
  • sinus tachycardia
  • premature atrial contractions
  • paroxysmal supraventricular tachycardia


A 35 year old recently widowed woman experiences her first episode of depression. She is started on an antidepressant .After complete remission of symptoms, the medication should be continued for at least :

  • 2 months
  • 4 months
  • 6 months
  • 12 months


A 32 year old pregnant woman at 32 weeks gestation presents with complications of right upper quadrant pain ,midepigastric tenderness, headache ,and malaise. Blood pressure 135/90 mm Hg .The MOST likely diagnosis is :

  • Preeclampsia 
  • Eclampsia HELLP ;
  • syndrome chronic hypertension 


Lifestyle modifications have not improved interstitial cystitis symptoms in a 38 year old woman .Which oral medication is NOT considered an initial oral medication?

  • hydroxyzine (Vistaril)
  • tramadol (Ultram ER)
  • amitriptyline (Elavil)
  • ibuprofen(Motrin IB)


The sexually transmitted disease that is NOT likely to be transmitted through oral-penile contact in men who have sex with men is:

  • herpes
  • human papillomavirus
  • chlamydia
  • gonorrhea


An 80 year old man with symptoms of depression will benefit from treatment with a selective serotonin reuptake inhibitor (SSRI).Before prescribing, the nurse practitioner should order a (n): CBC fall risk evaluation

  • electrocardiogram(ECG)
  • renal panel


A 24 year old pregnant woman states that she has been experiencing increased mucus formation during her first trimester .This is most likely :

  • trichomoniasis
  • candidiasis
  • physiologic leukorrhea
  • bacterial vaginosis


The mechanism of action of medication used to treat overactive bladder include selective stimulation of beta-3 adrenergic receptors, which relax the smooth muscle of the bladder .The medication that falls in this category is:

  • finasteride (Proscar)
  • dutasteride (Avodart)
  • tamsulosin(Flomax)
  • mirabegron(Myrbetriq)


A 22 year old woman is in the clinic with genital warts. Appropriate treatment for genital warts does NOT include: cryotherapy

  • podofilox (Condylox)0.5%gel
  • salicylic acid (Virasal)
  • electrodessication


The nurse practitioner is evaluating the patient’s understanding of Chlamydia trachomatis treatment with mycin. Which statement demonstrates proper understanding of the medication?

  • l should abstain from sexual intercourse for 24 hours after starting the medication
  • I can have sexual intercourse f72 hours after completing the medication
  • My partner should use a condom if we are going to have sexual intercourse within the next 5 days
  • I should abstain from sexual intercourse for 7 days


A-68-year-old man has a history of long-term tobacco use, uncontrolled hypertension, and hyperlipidemia. He presents with sudden, intense left lower abdominal pain that radiates to the backs and has a tearing sensation. A pulsation is palpated in the mid abdomen. The MOST appropriate step should be to:

  • order an outpatient abdominal CT scan 
  • refer the patient to the emergency department.
  • order an abdominal ultrasound. refer the patient for angiography.


The class of antihypertensive agents that should be avoided as initial therapy for a 38-year-old woman with uncomplicated hypertension is:

  • Angiotensin-converting enzyme (ACE) inhibitors.
  • Beta blockers.
  • Calcium channel blockers (CCBs).
  • Angiotensin receptor blockers (ARBs).


A 60-year-old man is experiencing paroxysmal nocturnal dyspnea. This condition typically occurs in combination with:

  • Chest palpitations.
  • Left ventricular hypertrophy.
  • Nocturnal asthma attacks.


The MOST appropriate initial treatment of idiopathic facial nerve palsy (Bell’s palsy) for a patient who began to notice a facial droop 2 days prior is:

  • Acyclovir (Zovirax).
  • Botox injections.
  •  Oral glucocorticoids.
  • Gabapentin (Neurontin). 


A 32-year-old man presents with a 24-hour history of fever, diarrhea, nausea, and dehydration. The symptom most suggestive of infection with an invasive organisms:

  • Dehydration


A 38-year-old man has polycythemia vera and is scheduled for phlebotomy. The goal of therapy is to reduce blood viscosity .It is at bringing which compound of the CBC into normal range?

  • Hemoglobin
  • Hematocrit
  • Platelets
  • Mean corpuscular volume (MCV)


Which statement about the glomerular filtration rate (GFR)is true?

  • The GFR correlates exactly to the loss of functioning nephrons
  • GFR is used as the sole of chronic kidney disease
  • A stable GFR implies stable rental disease
  • An increase in GFR may indicate a compensatory hyperfiltration response


A16 Year old girl presents with a sore throat. Mononucleosis and streptococcal pharyngitis are suspected. Which medication should be avoided?

  • Cephalexin (Keflex).
  • Amoxicillin (Amoxil).
  • Doxycycline (Vibramyclin).
  • Azithromycin (Zithromax).


A 6-year-old boy exhibits nuchal rigidity. In children, this finding is indicative of.

  • Seizure activity.
  • Meningeal irritation.
  • Mono paresis.
  • Central nervous system damage.


A 20-years-old man has a history of testicular fixation due to testicular torsion. The nurse practitioner should make the patient aware that he:

  • Remains at risk for recurrent torsion, even many years later.
  • Should have testosterone levels drawn annually.
  • Is at risk for benign prostatic hypertrophy.
  • Is at increased risk for urinary reflux syndrome.


Which of the following is NOT considered a potential trigger of migraine headaches?

  • Nitrites
  • Folic acid
  • Tyramine
  • Monosodium glutamate


Routine self-monitoring of capillary blood glucose is not required when taking:

  • Basal insulin.
  • Glipizide (Glucotrol XL).
  • Metformin (Glucophage).
  • Rapid-acting insulin


When evaluating a patient for postpartum depression, which tool is the most appropriate?

  • The Hamilton Depression Rating Scale(HDRS)
  • The beck depression inventory scale (EPDS)
  • The Edinburgh Postnatal Depression(EPDS)
  • The Patient Health Questionnaire(PHQ)


A 35 year old woman complains of fatigue and weight gain over the past 6 months. Which thyroid study should be ordered?

  • Thyroid panel
  • Thyroid-stimulating hormone
  • Free T4 and Free T3
  • T4 uptake


A 58 Year old woman is being treated with basal insulin for type 2 diabetes mellitus. In planning, the dietary component that directly determines postprandial blood sugar is the intake of:

  • Carbohydrate
  • Fiber
  • Proteins
  • polyunsaturated fats


A repeat knee X-ray on a 60 year old woman with a previous right knee sprain revealed no evidence of a fracture. However, moderate osteopenia was noted. The most appropriate test to order at this time is:

  • an MRI of right knee
  • a CT scan of both knees
  • bone densitometry
  • an MRI of the spine