APEA POST PREDICTOR EXAM NEWEST
2026 UPDATE – 300 QUESTIONS AND 100%
VERIFIED ANSWERS
1. A 65-year-old male with a history of hypertension presents with a blood
pressure of 168/94 mmHg despite lifestyle modifications. What is the most
appropriate initial pharmacologic treatment?
A. Beta-blocker
B. Thiazide diuretic
C. Loop diuretic
D. Alpha-blocker
2. A patient presents with fatigue, weight gain, and cold intolerance.
Laboratory results show elevated TSH and low free T4. What is the
diagnosis?
A. Hyperthyroidism
B. Subclinical hypothyroidism
C. Primary hypothyroidism
D. Secondary hypothyroidism
3. Which of the following is the most appropriate screening test for diabetes
mellitus?
A. Random glucose
B. Oral glucose tolerance test
C. Hemoglobin A1C
D. Fasting insulin
4. A 58-year-old smoker presents with chronic cough and sputum production
for over 3 months each year for 2 consecutive years. What is the diagnosis?
A. Emphysema
B. Asthma
C. Chronic bronchitis
D. Bronchiectasis
5. Which medication is contraindicated in pregnancy due to teratogenicity?
A. Amoxicillin
B. Labetalol
, C. Isotretinoin
D. Metformin
6. A patient presents with acute unilateral facial droop including inability to
close the eye. What is the most likely diagnosis?
A. Stroke
B. Bell’s palsy
C. Trigeminal neuralgia
D. Migraine
7. Which of the following is the best initial treatment for acute otitis media in
children?
A. Azithromycin
B. Amoxicillin
C. Ciprofloxacin
D. Doxycycline
8. A patient presents with burning epigastric pain relieved by eating. What is
the most likely diagnosis?
A. Gastric ulcer
B. GERD
C. Duodenal ulcer
D. Pancreatitis
9. Which lab value is most indicative of iron deficiency anemia?
A. High ferritin
B. Low ferritin
C. High MCV
D. Elevated B12
10.A patient with asthma presents with worsening symptoms and frequent
nighttime awakenings. What step-up therapy is recommended?
A. Short-acting beta agonist only
B. Add inhaled corticosteroid
C. Oral antibiotics
D. Leukotriene inhibitor only
11.A 72-year-old male with sudden onset of severe, tearing chest pain radiating
to the back. Blood pressure is 100/60 mmHg in the right arm and 85/50
mmHg in the left arm. What is the most likely diagnosis?
, A. Acute myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Pericarditis
12.Which finding on urinalysis is most suggestive of a urinary tract infection?
A. Proteinuria
B. Positive nitrites
C. Ketones
D. Glucose
13.A patient presents with sudden, severe headache described as “the worst of
my life,” neck stiffness, and photophobia. What is the initial imaging study
of choice?
A. CT head without contrast
B. MRI brain
C. CT angiography
D. Lumbar puncture (after negative CT)
14.A 45-year-old woman presents with fatigue, joint pain, malar rash, and oral
ulcers. Laboratory shows ANA positive. What is the most likely diagnosis?
A. Rheumatoid arthritis
B. Systemic lupus erythematosus
C. Scleroderma
D. Sjögren’s syndrome
15.Which medication is first-line for stable angina?
A. Nitroglycerin as needed
B. Beta-blocker
C. Calcium channel blocker
D. Ranolazine
16.A 25-year-old woman presents with palpitations, heat intolerance, weight
loss, and a diffuse goiter. What is the most likely diagnosis?
A. Hashimoto’s thyroiditis
B. Subacute thyroiditis
C. Graves’ disease
D. Toxic nodular goiter
, 17.A patient with COPD has an FEV1/FVC ratio of 0.65 and FEV1 45% of
predicted. What is the GOLD stage?
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4
18.Which electrolyte disturbance is most commonly associated with digoxin
toxicity?
A. Hyperkalemia
B. Hypokalemia
C. Hyponatremia
D. Hypercalcemia
19.A 6-month-old infant presents with fever, irritability, and a bulging
fontanelle. What is the most appropriate next step?
A. Antibiotics and observation
B. Lumbar puncture
C. Head CT
D. Blood culture only
20.A patient with known atrial fibrillation on warfarin has an INR of 4.5
without bleeding. What is the appropriate management?
A. Administer vitamin K 10 mg IV
B. Hold warfarin and recheck INR tomorrow
C. Give fresh frozen plasma
D. Increase warfarin dose
21.Which of the following is a classic finding in bacterial meningitis?
A. Kernig sign
B. Babinski sign
C. Brudzinski sign (also correct, but Kernig is classic)
D. Murphy sign
22.A 55-year-old diabetic presents with a painless, non-healing ulcer on the
plantar surface of the foot. What is the most likely diagnosis?
A. Arterial ulcer
B. Venous stasis ulcer
C. Neuropathic ulcer
D. Pressure ulcer
2026 UPDATE – 300 QUESTIONS AND 100%
VERIFIED ANSWERS
1. A 65-year-old male with a history of hypertension presents with a blood
pressure of 168/94 mmHg despite lifestyle modifications. What is the most
appropriate initial pharmacologic treatment?
A. Beta-blocker
B. Thiazide diuretic
C. Loop diuretic
D. Alpha-blocker
2. A patient presents with fatigue, weight gain, and cold intolerance.
Laboratory results show elevated TSH and low free T4. What is the
diagnosis?
A. Hyperthyroidism
B. Subclinical hypothyroidism
C. Primary hypothyroidism
D. Secondary hypothyroidism
3. Which of the following is the most appropriate screening test for diabetes
mellitus?
A. Random glucose
B. Oral glucose tolerance test
C. Hemoglobin A1C
D. Fasting insulin
4. A 58-year-old smoker presents with chronic cough and sputum production
for over 3 months each year for 2 consecutive years. What is the diagnosis?
A. Emphysema
B. Asthma
C. Chronic bronchitis
D. Bronchiectasis
5. Which medication is contraindicated in pregnancy due to teratogenicity?
A. Amoxicillin
B. Labetalol
, C. Isotretinoin
D. Metformin
6. A patient presents with acute unilateral facial droop including inability to
close the eye. What is the most likely diagnosis?
A. Stroke
B. Bell’s palsy
C. Trigeminal neuralgia
D. Migraine
7. Which of the following is the best initial treatment for acute otitis media in
children?
A. Azithromycin
B. Amoxicillin
C. Ciprofloxacin
D. Doxycycline
8. A patient presents with burning epigastric pain relieved by eating. What is
the most likely diagnosis?
A. Gastric ulcer
B. GERD
C. Duodenal ulcer
D. Pancreatitis
9. Which lab value is most indicative of iron deficiency anemia?
A. High ferritin
B. Low ferritin
C. High MCV
D. Elevated B12
10.A patient with asthma presents with worsening symptoms and frequent
nighttime awakenings. What step-up therapy is recommended?
A. Short-acting beta agonist only
B. Add inhaled corticosteroid
C. Oral antibiotics
D. Leukotriene inhibitor only
11.A 72-year-old male with sudden onset of severe, tearing chest pain radiating
to the back. Blood pressure is 100/60 mmHg in the right arm and 85/50
mmHg in the left arm. What is the most likely diagnosis?
, A. Acute myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Pericarditis
12.Which finding on urinalysis is most suggestive of a urinary tract infection?
A. Proteinuria
B. Positive nitrites
C. Ketones
D. Glucose
13.A patient presents with sudden, severe headache described as “the worst of
my life,” neck stiffness, and photophobia. What is the initial imaging study
of choice?
A. CT head without contrast
B. MRI brain
C. CT angiography
D. Lumbar puncture (after negative CT)
14.A 45-year-old woman presents with fatigue, joint pain, malar rash, and oral
ulcers. Laboratory shows ANA positive. What is the most likely diagnosis?
A. Rheumatoid arthritis
B. Systemic lupus erythematosus
C. Scleroderma
D. Sjögren’s syndrome
15.Which medication is first-line for stable angina?
A. Nitroglycerin as needed
B. Beta-blocker
C. Calcium channel blocker
D. Ranolazine
16.A 25-year-old woman presents with palpitations, heat intolerance, weight
loss, and a diffuse goiter. What is the most likely diagnosis?
A. Hashimoto’s thyroiditis
B. Subacute thyroiditis
C. Graves’ disease
D. Toxic nodular goiter
, 17.A patient with COPD has an FEV1/FVC ratio of 0.65 and FEV1 45% of
predicted. What is the GOLD stage?
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4
18.Which electrolyte disturbance is most commonly associated with digoxin
toxicity?
A. Hyperkalemia
B. Hypokalemia
C. Hyponatremia
D. Hypercalcemia
19.A 6-month-old infant presents with fever, irritability, and a bulging
fontanelle. What is the most appropriate next step?
A. Antibiotics and observation
B. Lumbar puncture
C. Head CT
D. Blood culture only
20.A patient with known atrial fibrillation on warfarin has an INR of 4.5
without bleeding. What is the appropriate management?
A. Administer vitamin K 10 mg IV
B. Hold warfarin and recheck INR tomorrow
C. Give fresh frozen plasma
D. Increase warfarin dose
21.Which of the following is a classic finding in bacterial meningitis?
A. Kernig sign
B. Babinski sign
C. Brudzinski sign (also correct, but Kernig is classic)
D. Murphy sign
22.A 55-year-old diabetic presents with a painless, non-healing ulcer on the
plantar surface of the foot. What is the most likely diagnosis?
A. Arterial ulcer
B. Venous stasis ulcer
C. Neuropathic ulcer
D. Pressure ulcer
