REAL APEA FINAL EXAM QUESTION AND ANSWERS LATEST SOLUTIONS (CORRECT ANSWERS HIGHLIGHTED IN GREEN)

REAL APEA FINAL EXAM QUESTION AND ANSWERS LATEST SOLUTIONS (CORRECT ANSWERS HIGHLIGHTED IN GREEN)

1-What characteristic should make the nurse practitioner suspect that a
pneumonia is secondary to DRSP?
Your answer is incorrect
Recent airplane travel
Exposure to another patient who has DRSP
Adolescence
Recent antibiotic exposure
2-What characteristic best distinguishes asthma from COPD?
Your answer is incorrect
Severity of shortness of breath
Need for rescue medicine
Use of steroids for exacerbations
Presence of inflammation
3- A 70 year old smoker presents with right unilateral wheezing. A chest x-ray
demonstrates right enlarged hilar nodes. What should be done next?
Your answer is incorrect
Refer to oncology
Order CT chest with contrast
Order pulmonary function tests
Order CBC, CMP
4- A 74 year old patient has symptoms of depression. Treatment with
sertraline is being considered. Which studies might be most important to
order?
Your answer is incorrect
EKG, B12, TSH
B12, folate, TSH
CBC, B12, folate
EKG, B12, folate, TSH
5- A patient who was on Lisinopril developed a cough. What finding in this
patient supports a diagnosis of ACE inhibitor related cough?
Your answer is correct
It is accompanied by a wheeze.
It is a productive cough.
He has shortness of breath.
Cough started 4 days after lisinopril was begun.
6- A 24 year old college student (otherwise healthy, non-smoker) has
community acquired pneumonia. She has taken amoxicillin with clavulanate
for the past 3 days. Her fever persists. How should she be managed?
Your answer is correct
Continue amoxicillin with clavulanate for 2 more days.
Stop amoxicillin with clavulanate and start levofloxacin.
Start doxycycline.
Stop amoxicillin with clavulanate and start azithromycin.
7- A young adult who has asthma has used low dose steroid inhaler twice
daily with good control for the past 3 months. In the last two weeks, he has
had daily symptoms of cough and chest tightness. What plan would help
alleviate his symptoms?
Your answer is incorrect
Add oral steroid once daily for 5 days
Add a LABA twice daily
Add a long acting anticholinergic medication
Discontinue the steroid, add a LABA
8- What patient is most likely to harbor an atypical pathogen?
Your answer is incorrect
A 19 year old type 1 diabetic
A 27 year old with asthma, recent sinus infection treated with
amox/clav
A 39 year old smoker of 1 PPD
A 48 year old who has teenagers in the household
9- A patient who has moderate persistent asthma takes fluticasone twice daily
but is still having symptoms. What medication listed below will be of little
benefit in management of this patient’s wheezing and cough? Select all that
apply.
Your answer is incorrect
Theophylline
Albuterol
Tiotropium
Salmeterol
10- Mr. Boudreaux, a 78 year old male smoker, has Stage II COPD. He has
received a prescription for ipratropium. What problem is likely after he begins
the ipratropium? Medical History: Dysrhythmias, Cataracts, Osteoporosis,
Glaucoma, HTN, Pre-DM
Your answer is incorrect
Hypertension
Urinary retention
Pathologic fracture
Increased intraocular pressure
11- A 30 year old female patient with moderate persistent asthma has a
temperature of 102°F, bilateral wheezes, mild SOB, and purulent sputum.
How should she be managed today? Meds: Fluticasone/salmeterol BID,
Albuterol PRN, Amlodipine 5 mg, levothyroxine 88 mcg daily, metformin 1000
mg BID
Your answer is correct
Order nebulized albuterol, treat with doxycycline
Treat with ciprofloxacin, nebulized albuterol every 4-6 hours as
needed
Treat as acute bronchitis, use oral steroids only
Treat as pneumonia with levofloxacin, use nebulized albuterol
every 4-6 hours as needed for wheezing
12- A pregnant 30 year old female patient with moderate persistent asthma
has a temperature of 102°F, bilateral wheezes, mild SOB, and purulent
sputum. How should she be managed today? Meds: Fluticasone/salmeterol
BID, Albuterol PRN, Amlodipine 5 mg, levothyroxine 88 mcg daily, metformin
1000 mg BID
Your answer is correct
Continue with same plan.
Do not use albuterol.
Do not use levofloxacin.
Use azithromycin.
13- What might be the significance of white cell casts?
Your answer is incorrect
Urinary tract infection
No clinical significance
Inadequate hydration
Pyelonephritis
14- What inhaled medication combo creates the greatest risk of sudden death
in an asthma patient?
Your answer is correct
Fluticasone, salmeterol, albuterol
Formoterol, albuterol
Albuterol, salmeterol, budesonide
Albuterol, fluticasone
15- An 80 year old patient with COPD has been diagnosed with pneumonia.
She is allergic to ciprofloxacin. What is the most appropriate antibiotic for his
treatment?
Your answer is incorrect
Clarithromycin plus doxycycline
Azithromycin plus Amoxicillin-clavulanate
Doxycycline
Levofloxacin

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