3P APEA CERTIFICATION EVALUATION
2026 TEST PAPER QUESTIONS AND
SOLUTIONS
●● A patient has poorly controlled hypertension for more than 10 years.
Indicate the most likely position of his point of maximal impulse (PMI).
Answer: 5th ICS, left of MCL
●● A 43 year old Hispanic male has an audible diastolic murmur best
heard in the mitral listening point. There is no audible click. His status
has been monitored for the past two years. This murmur is probably.
Answer: mitral stenosis
●● A patient who has diabetes presents with pain in his lower legs when
he walks and pain resolution with rest. When specifically asked about
his pain in his lower leg, he likely will report pain.
Answer: in the calf muscle
●● A patient with hypertension describes a previous allergic reaction to
a sulfa antibiotic as "sloughing of skin" and hospitalization. Which
medication is contraindicated in this patient?.
Answer: hydrochlorothiazide
,●● A 75 year old patient who has aortic stenosis wants to know what
symptoms indicate worsening of his stenosis. the NP replies:.
Answer: shortness of breath and syncope
●● A 74 year old patient has PAD. Which item listed below is an
important nonmodifiable risk factor for PAD?.
Answer: diabetes
●● Benazepril should be d/c immediately if.
Answer: pregnancy occurs
●● aortic regurgitation characteristics.
Answer: long asymptomatic period follow by exercise intolerance, then
dyspnea at rest
●● DVT classic symptoms.
Answer: swelling, pain, and discoloration of lower extremity
●● Characteristic of ACE-induced cough is that?.
Answer: usually begins two weeks of starting therapy
●● Valve most commonly involved in chronic rheumatic heart disease.
Answer: mitral
, ●● Medication that can exacerbate HF.
Answer: naproxen
●● Patient taking ACE inhibitors should avoid?.
Answer: potassium supplements
●● Grade 3 murmur indication for a referral.
Answer: a fixed split
●● Group of meds used to treat HF.
Answer: fosinopril, HCTZ, verapamil
●● Mr. Smith is a 72-year-old patient who takes warfarin for chronic A-
fib. INR today is 4.0. the NP should:.
Answer: stop the warfarin today and repeat INR tomorrow
●● According to the NHLBI, which characteristic is a coronary heart
disease risk equivalent, that is, which risk factor places the pt. as a CHD
risk similar to a hx of CHD.
Answer: diabetes mellitus
●● good drug to reduce morbidity and mortality in mild HF.
2026 TEST PAPER QUESTIONS AND
SOLUTIONS
●● A patient has poorly controlled hypertension for more than 10 years.
Indicate the most likely position of his point of maximal impulse (PMI).
Answer: 5th ICS, left of MCL
●● A 43 year old Hispanic male has an audible diastolic murmur best
heard in the mitral listening point. There is no audible click. His status
has been monitored for the past two years. This murmur is probably.
Answer: mitral stenosis
●● A patient who has diabetes presents with pain in his lower legs when
he walks and pain resolution with rest. When specifically asked about
his pain in his lower leg, he likely will report pain.
Answer: in the calf muscle
●● A patient with hypertension describes a previous allergic reaction to
a sulfa antibiotic as "sloughing of skin" and hospitalization. Which
medication is contraindicated in this patient?.
Answer: hydrochlorothiazide
,●● A 75 year old patient who has aortic stenosis wants to know what
symptoms indicate worsening of his stenosis. the NP replies:.
Answer: shortness of breath and syncope
●● A 74 year old patient has PAD. Which item listed below is an
important nonmodifiable risk factor for PAD?.
Answer: diabetes
●● Benazepril should be d/c immediately if.
Answer: pregnancy occurs
●● aortic regurgitation characteristics.
Answer: long asymptomatic period follow by exercise intolerance, then
dyspnea at rest
●● DVT classic symptoms.
Answer: swelling, pain, and discoloration of lower extremity
●● Characteristic of ACE-induced cough is that?.
Answer: usually begins two weeks of starting therapy
●● Valve most commonly involved in chronic rheumatic heart disease.
Answer: mitral
, ●● Medication that can exacerbate HF.
Answer: naproxen
●● Patient taking ACE inhibitors should avoid?.
Answer: potassium supplements
●● Grade 3 murmur indication for a referral.
Answer: a fixed split
●● Group of meds used to treat HF.
Answer: fosinopril, HCTZ, verapamil
●● Mr. Smith is a 72-year-old patient who takes warfarin for chronic A-
fib. INR today is 4.0. the NP should:.
Answer: stop the warfarin today and repeat INR tomorrow
●● According to the NHLBI, which characteristic is a coronary heart
disease risk equivalent, that is, which risk factor places the pt. as a CHD
risk similar to a hx of CHD.
Answer: diabetes mellitus
●● good drug to reduce morbidity and mortality in mild HF.
