APEA 3P EXAM NEWEST 2026/ 2027 ACTUAL EXAM
TEST BANK| 2 VERSIONS (VERSION A & B) WITH
COMPLETE 450 REAL EXAM QUESTIONS AND
CORRECT VERIFIED ANSWERS/ ALREADY GRADED
A+| APEA 3P PREDICTOR MAIN EXAM (MOST
RECENT!!)
1. A 45-year-old male presents with sudden onset of severe,
sharp chest pain that worsens with inspiration and improves
when leaning forward. He reports a low-grade fever and
malaise for one week. What is the most likely diagnosis?
A. Acute myocardial infarction
B. Unstable angina
C. Acute pericarditis
D. Pulmonary embolism
Correct Answer: C
Rationale: Acute pericarditis classically presents with sharp,
pleuritic chest pain that improves with sitting up and leaning
forward. The pain worsens with inspiration and lying supine.
Fever and malaise suggest an inflammatory or viral prodrome.
1
,An MI typically presents with pressure-like pain that does not
change with position.
2. A 28-year-old woman reports 3 months of heavy menstrual
bleeding, fatigue, and dyspnea on exertion. Labs: Hb 8.5
g/dL, MCV 72 fL, ferritin 6 ng/mL. What is the most
appropriate next step?
A. Oral ferrous sulfate 325 mg daily
B. Blood transfusion
C. Parenteral iron infusion
D. Colonoscopy
Correct Answer: A
Rationale: The patient has iron deficiency anemia from
menorrhagia. Oral iron is first-line for mild to moderate anemia
without hemodynamic instability. Transfusion is for severe
symptoms or Hb <7. Colonoscopy is not indicated without GI
bleeding symptoms.
3. A 72-year-old man with hypertension and diabetes
presents with a 1-hour history of difficulty speaking and right
arm weakness. Symptoms resolved completely after 30
2
,minutes. NIHSS is 0. What is the most appropriate next step?
A. Aspirin 325 mg and discharge home
B. Urgent CTA of head and neck
C. Tissue plasminogen activator (tPA)
D. Carotid endarterectomy
Correct Answer: B
Rationale: This is a transient ischemic attack (TIA). Urgent
neuroimaging (CTA or MRA) is indicated to identify carotid
stenosis or intracranial pathology for secondary prevention. tPA
is for acute ischemic stroke. Aspirin is indicated but after imaging.
4. A 55-year-old woman reports a 3-day history of right knee
pain, swelling, and erythema. She denies trauma or fever.
Aspiration reveals 65,000 WBC/mm³ with 90% neutrophils,
no crystals. What is the most likely diagnosis?
A. Gouty arthritis
B. Osteoarthritis exacerbation
C. Septic arthritis
D. Pseudogout
Correct Answer: C
Rationale: Septic arthritis is suspected with WBC >50,000/mm³
3
, with high neutrophil percentage and absence of crystals. This
requires emergent joint drainage and antibiotics.
Gout/pseudogout crystals would be present.
5. A 34-year-old woman presents with 4 weeks of
progressive fatigue, arthralgias, malar rash, and oral ulcers.
Labs: ANA positive, anti-dsDNA positive, C3 low. What is the
most appropriate treatment for active lupus without major
organ involvement?
A. Hydroxychloroquine
B. Prednisone 60 mg daily
C. Cyclophosphamide
D. Methotrexate
Correct Answer: A
Rationale: Hydroxychloroquine is first-line for mild to moderate
systemic lupus erythematosus (SLE). Prednisone is for moderate-
severe flares. Cyclophosphamide is for lupus nephritis.
Methotrexate is not first-line.
6. A 68-year-old man with a 50-pack-year smoking history
presents with new-onset hoarseness for 6 weeks. Direct
4
TEST BANK| 2 VERSIONS (VERSION A & B) WITH
COMPLETE 450 REAL EXAM QUESTIONS AND
CORRECT VERIFIED ANSWERS/ ALREADY GRADED
A+| APEA 3P PREDICTOR MAIN EXAM (MOST
RECENT!!)
1. A 45-year-old male presents with sudden onset of severe,
sharp chest pain that worsens with inspiration and improves
when leaning forward. He reports a low-grade fever and
malaise for one week. What is the most likely diagnosis?
A. Acute myocardial infarction
B. Unstable angina
C. Acute pericarditis
D. Pulmonary embolism
Correct Answer: C
Rationale: Acute pericarditis classically presents with sharp,
pleuritic chest pain that improves with sitting up and leaning
forward. The pain worsens with inspiration and lying supine.
Fever and malaise suggest an inflammatory or viral prodrome.
1
,An MI typically presents with pressure-like pain that does not
change with position.
2. A 28-year-old woman reports 3 months of heavy menstrual
bleeding, fatigue, and dyspnea on exertion. Labs: Hb 8.5
g/dL, MCV 72 fL, ferritin 6 ng/mL. What is the most
appropriate next step?
A. Oral ferrous sulfate 325 mg daily
B. Blood transfusion
C. Parenteral iron infusion
D. Colonoscopy
Correct Answer: A
Rationale: The patient has iron deficiency anemia from
menorrhagia. Oral iron is first-line for mild to moderate anemia
without hemodynamic instability. Transfusion is for severe
symptoms or Hb <7. Colonoscopy is not indicated without GI
bleeding symptoms.
3. A 72-year-old man with hypertension and diabetes
presents with a 1-hour history of difficulty speaking and right
arm weakness. Symptoms resolved completely after 30
2
,minutes. NIHSS is 0. What is the most appropriate next step?
A. Aspirin 325 mg and discharge home
B. Urgent CTA of head and neck
C. Tissue plasminogen activator (tPA)
D. Carotid endarterectomy
Correct Answer: B
Rationale: This is a transient ischemic attack (TIA). Urgent
neuroimaging (CTA or MRA) is indicated to identify carotid
stenosis or intracranial pathology for secondary prevention. tPA
is for acute ischemic stroke. Aspirin is indicated but after imaging.
4. A 55-year-old woman reports a 3-day history of right knee
pain, swelling, and erythema. She denies trauma or fever.
Aspiration reveals 65,000 WBC/mm³ with 90% neutrophils,
no crystals. What is the most likely diagnosis?
A. Gouty arthritis
B. Osteoarthritis exacerbation
C. Septic arthritis
D. Pseudogout
Correct Answer: C
Rationale: Septic arthritis is suspected with WBC >50,000/mm³
3
, with high neutrophil percentage and absence of crystals. This
requires emergent joint drainage and antibiotics.
Gout/pseudogout crystals would be present.
5. A 34-year-old woman presents with 4 weeks of
progressive fatigue, arthralgias, malar rash, and oral ulcers.
Labs: ANA positive, anti-dsDNA positive, C3 low. What is the
most appropriate treatment for active lupus without major
organ involvement?
A. Hydroxychloroquine
B. Prednisone 60 mg daily
C. Cyclophosphamide
D. Methotrexate
Correct Answer: A
Rationale: Hydroxychloroquine is first-line for mild to moderate
systemic lupus erythematosus (SLE). Prednisone is for moderate-
severe flares. Cyclophosphamide is for lupus nephritis.
Methotrexate is not first-line.
6. A 68-year-old man with a 50-pack-year smoking history
presents with new-onset hoarseness for 6 weeks. Direct
4
