APEA FNP PREDICTOR EXAM 2026
– COMPREHENSIVE TOPIC
TEST||Questions And Answers With
Rationales/Graded A+/2026
Update/100% Correct /Instant
Download
Instructions: Select the single best answer. Correct answers are highlighted in
bold. Rationales are provided after each question.
Section 1: Cardiovascular Disorders (Q1–10)
1. A 58-year-old male with HTN and DM presents with substernal chest
pressure radiating to the jaw, occurring at rest for 20 minutes. ECG shows ST-
segment depression. What is the most appropriate next step?
• A) Order troponin and discharge with aspirin
• B) Start heparin, aspirin, and admit for high-risk unstable angina
• C) Refer for stress test in 3 days
• D) Prescribe nitroglycerin PRN and follow up in 1 week
Rationale : Unstable angina requires hospitalization for anti-ischemic therapy and
possible intervention. Discharge or delayed testing is unsafe.
2. On auscultation, you hear a mid-systolic click followed by a late systolic
murmur at the apex. Most likely diagnosis?
• A) Mitral valve prolapse
• B) Aortic stenosis
, • C) Hypertrophic cardiomyopathy
• D) Tricuspid regurgitation
Rationale : Mid-systolic click + late systolic murmur = MVP due to myxomatous
degeneration.
3. Which finding is most specific for heart failure with reduced ejection
fraction (HFrEF)?
• A) Jugular venous distension
• B) Left ventricular ejection fraction ≤40%
• C) BNP 150 pg/mL
• D) Peripheral edema
Rationale : HFrEF defined by LVEF ≤40%. BNP supports but isn’t diagnostic
alone.
4. A 72-year-old with HTN and CKD stage 3 has BP 168/94 despite lisinopril
40 mg daily. Next best agent?
• A) Furosemide
• B) Amlodipine
• C) Spironolactone
• D) Metoprolol
Rationale : Amlodipine (CCB) is effective add-on in CKD/HTN. Spironolactone
risk with CKD; BB not first-line without specific indication.
5. A fib patient on warfarin has INR 4.5 without bleeding. Management?
• A) Give vitamin K 10 mg IM
• B) Hold warfarin, no vitamin K
• C) Give FFP
• D) Increase warfarin dose
Rationale : INR 4.5 – hold dose until INR <3.5. High-dose vitamin K reserved for
bleeding or very high INR (>10).
– COMPREHENSIVE TOPIC
TEST||Questions And Answers With
Rationales/Graded A+/2026
Update/100% Correct /Instant
Download
Instructions: Select the single best answer. Correct answers are highlighted in
bold. Rationales are provided after each question.
Section 1: Cardiovascular Disorders (Q1–10)
1. A 58-year-old male with HTN and DM presents with substernal chest
pressure radiating to the jaw, occurring at rest for 20 minutes. ECG shows ST-
segment depression. What is the most appropriate next step?
• A) Order troponin and discharge with aspirin
• B) Start heparin, aspirin, and admit for high-risk unstable angina
• C) Refer for stress test in 3 days
• D) Prescribe nitroglycerin PRN and follow up in 1 week
Rationale : Unstable angina requires hospitalization for anti-ischemic therapy and
possible intervention. Discharge or delayed testing is unsafe.
2. On auscultation, you hear a mid-systolic click followed by a late systolic
murmur at the apex. Most likely diagnosis?
• A) Mitral valve prolapse
• B) Aortic stenosis
, • C) Hypertrophic cardiomyopathy
• D) Tricuspid regurgitation
Rationale : Mid-systolic click + late systolic murmur = MVP due to myxomatous
degeneration.
3. Which finding is most specific for heart failure with reduced ejection
fraction (HFrEF)?
• A) Jugular venous distension
• B) Left ventricular ejection fraction ≤40%
• C) BNP 150 pg/mL
• D) Peripheral edema
Rationale : HFrEF defined by LVEF ≤40%. BNP supports but isn’t diagnostic
alone.
4. A 72-year-old with HTN and CKD stage 3 has BP 168/94 despite lisinopril
40 mg daily. Next best agent?
• A) Furosemide
• B) Amlodipine
• C) Spironolactone
• D) Metoprolol
Rationale : Amlodipine (CCB) is effective add-on in CKD/HTN. Spironolactone
risk with CKD; BB not first-line without specific indication.
5. A fib patient on warfarin has INR 4.5 without bleeding. Management?
• A) Give vitamin K 10 mg IM
• B) Hold warfarin, no vitamin K
• C) Give FFP
• D) Increase warfarin dose
Rationale : INR 4.5 – hold dose until INR <3.5. High-dose vitamin K reserved for
bleeding or very high INR (>10).
