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APEA 3P Exam all questions answered 100% correct When performing a visual acuity test the nurse practitioner notes 20/30 in the left eye and 20/40 in the right eye using the Snellen
eye chart. This means:
a) Have the patient return in two weeks for a follow-up vision
screen
b) Dilate the eye and retest
c) Refer the patient to an ophthalmologist
d) Document this as a normal finding
Answer: c) Refer the patient to an ophthalmologist
Rationale: Visual acuity of 20/40 in one eye (and 20/30 in the
other) indicates reduced vision compared to the normal 20/20 standard. This warrants further evaluation by an ophthalmologist to rule out underlying conditions such as refractive errors, cataracts, or retinal issues.
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The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders defines Munchausen
Syndrome By Proxy as:
a) A self-inflicted injury to gain attention
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b) A caregiver making up or causing an illness or injury in a
person under their 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
Answer: b) A caregiver making up or causing an illness or
injury in a person under their care
Rationale: Munchausen Syndrome by Proxy (now termed
Factitious Disorder Imposed on Another in DSM-5) involves a caregiver deliberately fabricating or inducing illness in someone under their care, typically to gain attention or sympathy, distinguishing it from self-inflicted harm or neglect.
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Symptoms of depression are a side effect of which neurotransmitter medication?
a) Dopamine, serotonin, norepinephrine
b) Gabapentin
c) Mil
d) Cortisol
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Answer: a) Dopamine, serotonin, norepinephrine
Rationale: Medications affecting neurotransmitters like
dopamine, serotonin, and norepinephrine (e.g., SSRIs, SNRIs) can have depression as a side effect if imbalances occur during treatment or withdrawal. Gabapentin targets GABA, and "Mil" is incomplete, while cortisol is a hormone, not a medication.
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Which lesion is dark, raised, and asymmetric with an irregular border?
a) Nevus
b) Actinic keratosis
c) Keratoacanthoma
d) Melanoma
Answer: d) Melanoma
Rationale: Melanomas are characterized by the ABCDE criteria: Asymmetry, Border irregularity, Color variation, Diameter >6mm, and Evolving. Dark, raised, asymmetric lesions with irregular borders fit this profile, requiring urgent evaluation, unlike nevi (benign moles), actinic keratosis (precancerous, scaly), or keratoacanthoma (rapidly growing, dome-shaped).
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A 32-year-old woman presents with dull puffiness of the eyes and pronounced non-pitting periorbital edema. This finding is suggestive of which condition?
a) Nephrotic syndrome
b) Myxedema
c) Cushing syndrome
d) Sinusitis
Answer: b) Myxedema
Rationale: Non-pitting periorbital edema is a hallmark of
myxedema, a severe hypothyroidism condition causing mucopolysaccharide accumulation in tissues. Nephrotic syndrome typically causes pitting edema, Cushing syndrome features moon facies, and sinusitis involves pain and discharge, not edema.
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