APEA 3P Exam Complete Study Guide 2026: 200 Questions &
Rationales, Exams of Nursing ALL QUESTIONS AND
CORRECT ANSWERS | ALREADY GRADED A+ | LATEST
VERSION (JUST RELEASED)
Bacteria - ANSWER//Streptococcus pneumoniae- most common strain
Haemophilus influenzae Neisseria meningitidis Escherichia coli *others
Bacterial meningitis symptoms (Classic Triad) - ANSWER//High fever Nuchal
rigidity rapid change in mental status w/ headache Triad=neck up
erythematous spot-like rash (petechiae) ecchymosis to purple-colored lesions
(purpura) which are non-blanchable Is bacterial meningitis a reportable
disease - ANSWER//yes! Treatment for Bacterial meningitis-patient -
ANSWER//IV Abx ASAP, resp/droplet iso for first 24-48 hrs, hydrate (low
maintenance after initial fluid correction), Maintain ventilation and reduce
increased intra cranial pressure if present (dexamethosone(to reduce
inflammation, mannitol to diurese the brain), low stim environment, tx
complications that may arrive and support family Treatment for bacterial
meningitis-close encounter - ANSWER//Close contacts should be treated w/
rifampin 600 mg q 12 hours x 2 days **Rifampin changes urine color to
reddish orange and can stain contacts **AVOID RIFAMPIN IN PREGNANCY
Brudzinkski sign (meningeal irritation) - ANSWER//Tests for meningeal
irritation Patient supine, raise BACK of head and flex chin towards chest +
result if pt automatically beds both hips --Brudzinski and back of head start
with B as well as bends-- Kernig's sign - ANSWER//Tests for meningeal
irritation patient supine. flex patients hips and knees in a right angle, then
slowly straighten/extend the legs up + result if when the patient complains of
pain during extension of leg MCV4 (meningococcal vaccine) Age 11-19 -
ANSWER//Give one dose of menactra or menveo primary dose given age 12
or younger give a booster at age 16-18 MCV4 (meningococcal vaccine) Age
19-21 - ANSWER//Give one dose of menactra or menveo if never had either
Rocky mountain spotted fever (RMSF) symptoms - ANSWER//Fever chills
N/V myalgia arthralgia 2-5 days later develop petechial rash on forearms,
ankles, and wrists that spreads towards trunk and becomes generalised.
sometimes rash develops on palms and soles **RASH DEVELOPS
INWARDS** RMSF pneumonic (RMSF) - ANSWER//R-Rash M-Muscle aches
(myalgia) S-Stomach aches (nausea and vomiting) F-Fever (>102 F) Rocky
Mountain Spotted Fever (RMSF): Located: - ANSWER//•Think "Rocky"- North
Carolina, Oklahoma, Arkansas, Tennessee, Missouri Spring to Fall (April to
September) Rocky Mountain Spotted Fever (RMSF): DX - ANSWER//PCR
assay by indirect immunofluorescence antibody (IFA) assay for
immunoglobulin G (IgG) for Rickettsia Rickettsii Rocky Mountain Spotted
Fever (RMSF): tx - ANSWER//Doxycycline is always first line for all ages 100
mg every 12 hours x 7-10 days Can be fatal if not treated within the first 5
days Erythema Migrans (early Lyme disease): Symptoms - ANSWER//Usually
appears in 7-14 days after being bitten by a deer tick; range 3-30 days Target
bull's-eye Rash is hot to touch with rough texture. Expanding red rash with
central clearing • Common locations are belt line, axillary area, behind the
knees, and groin area • Positive for flu like symptoms. Lesions and rash
,resolve within a few weeks with or without treatment Erythema Migrans (early
Lyme disease): DX - ANSWER//Dx: • First step is enzyme immunoassay (EIA)
also knows as ELISA if negative no further testing needed. If positive confirm
with Western Blot test (aka indirect immunofluorescence assay (IFA) for
Borrelia Burgdorferi 1. Enzyme immunoassay 2. western blot test
(immunoflurorescence assay/ IFA) Exam Tip: E before I Will have increased
ESR Erythema Migrans (early Lyme disease): TX - ANSWER//Doxycycline is
always first line for all ages 100 mg BID x 10-21 days Remove ticks by
grasping with tweezers or forceps close to the skin and pulling gently with
steady pressure. After removing the tick, clean area with rubbing alcohol,
iodine scrub, or soap and water. Dispose of the tick by flushing it into the toilet
Tick repellant skin use - ANSWER//DEET Tick repellant clothing use -
ANSWER//Permethrin Brown Recluse Spider Bite: SX - ANSWER//• Fever,
chills • Nausea and Vomiting • Located in the arms, upper legs, or the trunk •
Bitten area becomes swollen, red, and tender, or can be painless • Blisters
appear within 24-48 hours • Necrotic in center, which kills the tissue **can be
painless Brown Recluse Spider Bite treatment - ANSWER//Treatment: • Ice
packs to wound as the cold inactivates the toxin • Treat like cellulitis of the
skin • Antibiotic ointment at first and watch Skin lesions - ANSWER//primary
skin lesions Macule Vesicle Papule MVP Size: <1 CM Macule -
Most common type of skin cancer in USA - ANSWER//Skin cancer Most
common type of skin cancer - ANSWER//basal cell carcinoma basal cell
carcinoma symptoms - ANSWER//Appearance varies; smooth, shiny bump,
pink to pearly white Basal cell carcinoma common locations -
ANSWER//cheeks, nose, face, neck, arms, back basal cell carcinoma
diagnosis gold standard - ANSWER//biopsy. if not an option, refer to derm
Actinic keratosis - ANSWER//Precursor to squamous cell carcinoma
numerous dry, round and pink to red lesions w/ rough and scaly texture -->
does not heal, slow growing in sun exposed areas Actinic keratosis diagnosis
gold standard - ANSWER//Biopsy. if not an option, refer to derm Actinic
keratosis treatment gold standard - ANSWER//small- cryotherapy large-
number 5-FU (5-flouracil aka efudex). 5-FU medication Causes skin to ooze,
crust, scab and be red **5-flouracil/ efudex-wear sunscreen!!** squamous cell
cancer - ANSWER//chronic red scaly rough textured lesion w/ irregular
borders crusting or bleeding may be present Squamous cell carcinoma
common locations - ANSWER//rims of ears, lips, nose, face and top of hands
precursor lesion to squamous cell cancer - ANSWER//actinic keratosis
squamous cell carcinoma diagnosis by? - ANSWER//biopsy gold standard. if
biopsy is not an option, refer to dermatology . Risk factors for skin
cancer(melanoma and both non-melanoma) - ANSWER//Blistering sunburn
as a child, history of sunburns, light skin, chronic exposure to UV light
(sunlight/tanning beds), moles, family hx for skin cancer Melanoma symptoms
(ABCDE) - ANSWER//asymmetry (shape/uneven texture) border
(irregular/notched/blurred) color (variegated colors from black, blue, dark to
light brown) diameter (size >6mm size of pencil eraser or larger) evolving
(changes in color/size/shape) may be itchy Acral lengtiginous melanoma -
ANSWER//Most common type of melanoma in dark skinned individuals
(blacks & asians) --> look for longitudinal brown to black bands under the
nailbed. a changing spot or mole in the palms, or the soles of the feet
, seborrheic keratosis - ANSWER//soft, round, wart-like growth that is light tan
to black and looks pasted on asymptomatic &benign Bacterial Meningitis
Bacteria - ANSWER//Streptococcus pneumoniae- most common strain
Haemophilus influenzae Neisseria meningitidis Escherichia coli *others
Bacterial meningitis symptoms (Classic Triad) - ANSWER//High fever Nuchal
rigidity rapid change in mental status w/ headache Triad=neck up
erythematous spot-like rash (petechiae) ecchymosis to purple-colored lesions
(purpura) which are non-blanchable Is bacterial meningitis a reportable
disease - ANSWER//yes! Treatment for Bacterial meningitis-patient -
ANSWER//IV Abx ASAP, resp/droplet iso for first 24-48 hrs, hydrate (low
maintenance after initial fluid correction), Maintain ventilation and reduce
increased intra cranial pressure if present (dexamethosone(to reduce
inflammation, mannitol to diurese the brain), low stim environment, tx
complications that may arrive and support family Treatment for bacterial
meningitis-close encounter - ANSWER//Close contacts should be treated w/
rifampin 600 mg q 12 hours x 2 days **Rifampin changes urine color to
reddish orange and can stain contacts **AVOID RIFAMPIN IN PREGNANCY
Brudzinkski sign (meningeal irritation) - ANSWER//Tests for meningeal
irritation Patient supine, raise BACK of head and flex chin towards chest +
result if pt automatically beds both hips --Brudzinski and back of head start
with B as well as bends-- Kernig's sign - ANSWER//Tests for meningeal
irritation patient supine. flex patients hips and knees in a right angle, then
slowly straighten/extend the legs up + result if when the patient complains of
pain during extension of leg MCV4 (meningococcal vaccine) Age 11-19 -
ANSWER//Give one dose of menactra or menveo primary dose given age 12
or younger give a booster at age 16-18 MCV4 (meningococcal vaccine) Age
19-21 - ANSWER//Give one dose of menactra or menveo if never had either
Rocky mountain spotted fever (RMSF) symptoms - ANSWER//Fever chills
N/V myalgia arthralgia 2-5 days later develop petechial rash on forearms,
ankles, and wrists that spreads towards trunk and becomes generalised.
sometimes rash develops on palms and soles **RASH DEVELOPS
INWARDS** RMSF pneumonic (RMSF) - ANSWER//R-Rash M-Muscle aches
(myalgia) S-Stomach aches (nausea and vomiting) F-Fever (>102 F) Rocky
Mountain Spotted Fever (RMSF): Located: - ANSWER//•Think "Rocky"- North
Carolina, Oklahoma, Arkansas, Tennessee, Missouri Spring to Fall (April to
September) Rocky Mountain Spotted Fever (RMSF): DX - ANSWER//PCR
assay by indirect immunofluorescence antibody (IFA) assay for
immunoglobulin G (IgG) for Rickettsia Rickettsii Rocky Mountain Spotted
Fever (RMSF): tx - ANSWER//Doxycycline is always first line for all ages 100
mg every 12 hours x 7-10 days Can be fatal if not treated within the first 5
days Erythema Migrans (early Lyme disease): Symptoms - ANSWER//Usually
appears in 7-14 days after being bitten by a deer tick; range 3-30 days Target
bull's-eye Rash is hot to touch with rough texture. Expanding red rash with
central clearing • Common locations are belt line, axillary area, behind the
knees, and groin area • Positive for flu like symptoms. Lesions and rash
resolve within a few weeks with or without treatment Erythema Migrans (early
Lyme disease): DX - ANSWER//Dx: • First step is enzyme immunoassay (EIA)
also knows as ELISA if negative no further testing needed. If positive confirm
with Western Blot test (aka indirect immunofluorescence assay (IFA) for
Borrelia Burgdorferi 1. Enzyme immunoassay 2. western blot test
Rationales, Exams of Nursing ALL QUESTIONS AND
CORRECT ANSWERS | ALREADY GRADED A+ | LATEST
VERSION (JUST RELEASED)
Bacteria - ANSWER//Streptococcus pneumoniae- most common strain
Haemophilus influenzae Neisseria meningitidis Escherichia coli *others
Bacterial meningitis symptoms (Classic Triad) - ANSWER//High fever Nuchal
rigidity rapid change in mental status w/ headache Triad=neck up
erythematous spot-like rash (petechiae) ecchymosis to purple-colored lesions
(purpura) which are non-blanchable Is bacterial meningitis a reportable
disease - ANSWER//yes! Treatment for Bacterial meningitis-patient -
ANSWER//IV Abx ASAP, resp/droplet iso for first 24-48 hrs, hydrate (low
maintenance after initial fluid correction), Maintain ventilation and reduce
increased intra cranial pressure if present (dexamethosone(to reduce
inflammation, mannitol to diurese the brain), low stim environment, tx
complications that may arrive and support family Treatment for bacterial
meningitis-close encounter - ANSWER//Close contacts should be treated w/
rifampin 600 mg q 12 hours x 2 days **Rifampin changes urine color to
reddish orange and can stain contacts **AVOID RIFAMPIN IN PREGNANCY
Brudzinkski sign (meningeal irritation) - ANSWER//Tests for meningeal
irritation Patient supine, raise BACK of head and flex chin towards chest +
result if pt automatically beds both hips --Brudzinski and back of head start
with B as well as bends-- Kernig's sign - ANSWER//Tests for meningeal
irritation patient supine. flex patients hips and knees in a right angle, then
slowly straighten/extend the legs up + result if when the patient complains of
pain during extension of leg MCV4 (meningococcal vaccine) Age 11-19 -
ANSWER//Give one dose of menactra or menveo primary dose given age 12
or younger give a booster at age 16-18 MCV4 (meningococcal vaccine) Age
19-21 - ANSWER//Give one dose of menactra or menveo if never had either
Rocky mountain spotted fever (RMSF) symptoms - ANSWER//Fever chills
N/V myalgia arthralgia 2-5 days later develop petechial rash on forearms,
ankles, and wrists that spreads towards trunk and becomes generalised.
sometimes rash develops on palms and soles **RASH DEVELOPS
INWARDS** RMSF pneumonic (RMSF) - ANSWER//R-Rash M-Muscle aches
(myalgia) S-Stomach aches (nausea and vomiting) F-Fever (>102 F) Rocky
Mountain Spotted Fever (RMSF): Located: - ANSWER//•Think "Rocky"- North
Carolina, Oklahoma, Arkansas, Tennessee, Missouri Spring to Fall (April to
September) Rocky Mountain Spotted Fever (RMSF): DX - ANSWER//PCR
assay by indirect immunofluorescence antibody (IFA) assay for
immunoglobulin G (IgG) for Rickettsia Rickettsii Rocky Mountain Spotted
Fever (RMSF): tx - ANSWER//Doxycycline is always first line for all ages 100
mg every 12 hours x 7-10 days Can be fatal if not treated within the first 5
days Erythema Migrans (early Lyme disease): Symptoms - ANSWER//Usually
appears in 7-14 days after being bitten by a deer tick; range 3-30 days Target
bull's-eye Rash is hot to touch with rough texture. Expanding red rash with
central clearing • Common locations are belt line, axillary area, behind the
knees, and groin area • Positive for flu like symptoms. Lesions and rash
,resolve within a few weeks with or without treatment Erythema Migrans (early
Lyme disease): DX - ANSWER//Dx: • First step is enzyme immunoassay (EIA)
also knows as ELISA if negative no further testing needed. If positive confirm
with Western Blot test (aka indirect immunofluorescence assay (IFA) for
Borrelia Burgdorferi 1. Enzyme immunoassay 2. western blot test
(immunoflurorescence assay/ IFA) Exam Tip: E before I Will have increased
ESR Erythema Migrans (early Lyme disease): TX - ANSWER//Doxycycline is
always first line for all ages 100 mg BID x 10-21 days Remove ticks by
grasping with tweezers or forceps close to the skin and pulling gently with
steady pressure. After removing the tick, clean area with rubbing alcohol,
iodine scrub, or soap and water. Dispose of the tick by flushing it into the toilet
Tick repellant skin use - ANSWER//DEET Tick repellant clothing use -
ANSWER//Permethrin Brown Recluse Spider Bite: SX - ANSWER//• Fever,
chills • Nausea and Vomiting • Located in the arms, upper legs, or the trunk •
Bitten area becomes swollen, red, and tender, or can be painless • Blisters
appear within 24-48 hours • Necrotic in center, which kills the tissue **can be
painless Brown Recluse Spider Bite treatment - ANSWER//Treatment: • Ice
packs to wound as the cold inactivates the toxin • Treat like cellulitis of the
skin • Antibiotic ointment at first and watch Skin lesions - ANSWER//primary
skin lesions Macule Vesicle Papule MVP Size: <1 CM Macule -
Most common type of skin cancer in USA - ANSWER//Skin cancer Most
common type of skin cancer - ANSWER//basal cell carcinoma basal cell
carcinoma symptoms - ANSWER//Appearance varies; smooth, shiny bump,
pink to pearly white Basal cell carcinoma common locations -
ANSWER//cheeks, nose, face, neck, arms, back basal cell carcinoma
diagnosis gold standard - ANSWER//biopsy. if not an option, refer to derm
Actinic keratosis - ANSWER//Precursor to squamous cell carcinoma
numerous dry, round and pink to red lesions w/ rough and scaly texture -->
does not heal, slow growing in sun exposed areas Actinic keratosis diagnosis
gold standard - ANSWER//Biopsy. if not an option, refer to derm Actinic
keratosis treatment gold standard - ANSWER//small- cryotherapy large-
number 5-FU (5-flouracil aka efudex). 5-FU medication Causes skin to ooze,
crust, scab and be red **5-flouracil/ efudex-wear sunscreen!!** squamous cell
cancer - ANSWER//chronic red scaly rough textured lesion w/ irregular
borders crusting or bleeding may be present Squamous cell carcinoma
common locations - ANSWER//rims of ears, lips, nose, face and top of hands
precursor lesion to squamous cell cancer - ANSWER//actinic keratosis
squamous cell carcinoma diagnosis by? - ANSWER//biopsy gold standard. if
biopsy is not an option, refer to dermatology . Risk factors for skin
cancer(melanoma and both non-melanoma) - ANSWER//Blistering sunburn
as a child, history of sunburns, light skin, chronic exposure to UV light
(sunlight/tanning beds), moles, family hx for skin cancer Melanoma symptoms
(ABCDE) - ANSWER//asymmetry (shape/uneven texture) border
(irregular/notched/blurred) color (variegated colors from black, blue, dark to
light brown) diameter (size >6mm size of pencil eraser or larger) evolving
(changes in color/size/shape) may be itchy Acral lengtiginous melanoma -
ANSWER//Most common type of melanoma in dark skinned individuals
(blacks & asians) --> look for longitudinal brown to black bands under the
nailbed. a changing spot or mole in the palms, or the soles of the feet
, seborrheic keratosis - ANSWER//soft, round, wart-like growth that is light tan
to black and looks pasted on asymptomatic &benign Bacterial Meningitis
Bacteria - ANSWER//Streptococcus pneumoniae- most common strain
Haemophilus influenzae Neisseria meningitidis Escherichia coli *others
Bacterial meningitis symptoms (Classic Triad) - ANSWER//High fever Nuchal
rigidity rapid change in mental status w/ headache Triad=neck up
erythematous spot-like rash (petechiae) ecchymosis to purple-colored lesions
(purpura) which are non-blanchable Is bacterial meningitis a reportable
disease - ANSWER//yes! Treatment for Bacterial meningitis-patient -
ANSWER//IV Abx ASAP, resp/droplet iso for first 24-48 hrs, hydrate (low
maintenance after initial fluid correction), Maintain ventilation and reduce
increased intra cranial pressure if present (dexamethosone(to reduce
inflammation, mannitol to diurese the brain), low stim environment, tx
complications that may arrive and support family Treatment for bacterial
meningitis-close encounter - ANSWER//Close contacts should be treated w/
rifampin 600 mg q 12 hours x 2 days **Rifampin changes urine color to
reddish orange and can stain contacts **AVOID RIFAMPIN IN PREGNANCY
Brudzinkski sign (meningeal irritation) - ANSWER//Tests for meningeal
irritation Patient supine, raise BACK of head and flex chin towards chest +
result if pt automatically beds both hips --Brudzinski and back of head start
with B as well as bends-- Kernig's sign - ANSWER//Tests for meningeal
irritation patient supine. flex patients hips and knees in a right angle, then
slowly straighten/extend the legs up + result if when the patient complains of
pain during extension of leg MCV4 (meningococcal vaccine) Age 11-19 -
ANSWER//Give one dose of menactra or menveo primary dose given age 12
or younger give a booster at age 16-18 MCV4 (meningococcal vaccine) Age
19-21 - ANSWER//Give one dose of menactra or menveo if never had either
Rocky mountain spotted fever (RMSF) symptoms - ANSWER//Fever chills
N/V myalgia arthralgia 2-5 days later develop petechial rash on forearms,
ankles, and wrists that spreads towards trunk and becomes generalised.
sometimes rash develops on palms and soles **RASH DEVELOPS
INWARDS** RMSF pneumonic (RMSF) - ANSWER//R-Rash M-Muscle aches
(myalgia) S-Stomach aches (nausea and vomiting) F-Fever (>102 F) Rocky
Mountain Spotted Fever (RMSF): Located: - ANSWER//•Think "Rocky"- North
Carolina, Oklahoma, Arkansas, Tennessee, Missouri Spring to Fall (April to
September) Rocky Mountain Spotted Fever (RMSF): DX - ANSWER//PCR
assay by indirect immunofluorescence antibody (IFA) assay for
immunoglobulin G (IgG) for Rickettsia Rickettsii Rocky Mountain Spotted
Fever (RMSF): tx - ANSWER//Doxycycline is always first line for all ages 100
mg every 12 hours x 7-10 days Can be fatal if not treated within the first 5
days Erythema Migrans (early Lyme disease): Symptoms - ANSWER//Usually
appears in 7-14 days after being bitten by a deer tick; range 3-30 days Target
bull's-eye Rash is hot to touch with rough texture. Expanding red rash with
central clearing • Common locations are belt line, axillary area, behind the
knees, and groin area • Positive for flu like symptoms. Lesions and rash
resolve within a few weeks with or without treatment Erythema Migrans (early
Lyme disease): DX - ANSWER//Dx: • First step is enzyme immunoassay (EIA)
also knows as ELISA if negative no further testing needed. If positive confirm
with Western Blot test (aka indirect immunofluorescence assay (IFA) for
Borrelia Burgdorferi 1. Enzyme immunoassay 2. western blot test
