APEA FNP Practice Exam 200 Questions
With Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A |
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1. A 58-year-old male with a 30-pack-year smoking history presents with
progressive dyspnea and chronic productive cough for 3 years. Physical
exam reveals barrel chest and diminished breath sounds. What is the most
likely diagnosis?
Correct Answer: Chronic Obstructive Pulmonary Disease
Rationale: Key findings of chronic cough, long smoking history, dyspnea, and
barrel chest strongly indicate COPD, particularly emphysema-predominant
disease.
2. A 45-year-old female reports fatigue, weight gain, cold intolerance, and
constipation. TSH is elevated and free T4 is low. What is the diagnosis?
Correct Answer: Primary hypothyroidism
Rationale: Elevated TSH with low free T4 indicates thyroid gland failure,
consistent with primary hypothyroidism.
3. A 30-year-old presents with acute right lower quadrant pain, rebound
tenderness, and fever. What is the most likely diagnosis?
Correct Answer: Acute appendicitis
Rationale: Classic presentation includes RLQ pain, fever, and peritoneal
signs, indicating appendiceal inflammation.
4. A patient with diabetes has fasting glucose consistently above 130 mg/dL
despite metformin therapy. What is the next best medication class to add?
, Correct Answer: GLP-1 receptor agonist
Rationale: GLP-1 agonists improve glycemic control and promote weight
loss when metformin alone is insufficient.
5. A 65-year-old presents with sudden unilateral weakness and slurred speech
starting 1 hour ago. What is the priority intervention?
Correct Answer: Immediate CT scan of the head
Rationale: A non-contrast CT is essential to differentiate ischemic from
hemorrhagic stroke before thrombolysis.
6. A child presents with a barking cough, inspiratory stridor, and low-grade
fever. What is the diagnosis?
Correct Answer: Croup
Rationale: Parainfluenza virus commonly causes croup with stridor and
barking cough.
7. A patient presents with chest pain relieved by nitroglycerin and ST
depression on ECG. What is the likely diagnosis?
Correct Answer: Unstable angina
Rationale: Ischemia without infarction presents with ST depression and
episodic chest pain.
8. A 22-year-old female has dysuria and urinary frequency. Urinalysis shows
nitrites and leukocyte esterase. What is the diagnosis?
Correct Answer: Acute uncomplicated urinary tract infection
Rationale: Nitrites and leukocyte esterase indicate bacterial UTI, commonly
E. coli.
9. A patient presents with butterfly rash, joint pain, and positive anti-dsDNA
antibodies. What is the diagnosis?
Correct Answer: Systemic lupus erythematosus
Rationale: Anti-dsDNA positivity and malar rash are diagnostic of SLE.
10.A newborn has cyanosis that improves with crying and a harsh systolic
murmur. What condition is suspected?
, Correct Answer: Tetralogy of Fallot
Rationale: Tet spells and cyanosis relieved by crying indicate TOF.
11.A hypertensive patient on ACE inhibitor develops dry cough. What is the
mechanism?
Correct Answer: Bradykinin accumulation
Rationale: ACE inhibitors increase bradykinin, causing cough.
12.A patient presents with tremor, weight loss, and exophthalmos. What lab
finding is expected?
Correct Answer: Decreased TSH and increased T4
Rationale: Hyperthyroidism (Graves disease) suppresses TSH and elevates
T4.
13.A 70-year-old presents with fever, confusion, and neck stiffness. What is the
priority diagnosis?
Correct Answer: Bacterial meningitis
Rationale: Triad of fever, neck stiffness, altered mental status suggests
meningitis.
14.A patient has epigastric pain relieved by eating. What is the likely diagnosis?
Correct Answer: Duodenal ulcer
Rationale: Pain relief with food is characteristic of duodenal ulcers.
15.A 50-year-old diabetic patient has microalbuminuria. What medication is
indicated for renal protection?
Correct Answer: ACE inhibitor
*Rationale: ACE inhibitors reduce intraglomerular pressure and proteinuria.
16.A patient presents with sudden severe tearing chest pain radiating to the
back. What is the diagnosis?
Correct Answer: Aortic dissection
Rationale: Tearing pain radiating posteriorly is classic for dissection.
With Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A |
Instant Download Pdf A+ Grade
Guarantee Verified By Professionals
1. A 58-year-old male with a 30-pack-year smoking history presents with
progressive dyspnea and chronic productive cough for 3 years. Physical
exam reveals barrel chest and diminished breath sounds. What is the most
likely diagnosis?
Correct Answer: Chronic Obstructive Pulmonary Disease
Rationale: Key findings of chronic cough, long smoking history, dyspnea, and
barrel chest strongly indicate COPD, particularly emphysema-predominant
disease.
2. A 45-year-old female reports fatigue, weight gain, cold intolerance, and
constipation. TSH is elevated and free T4 is low. What is the diagnosis?
Correct Answer: Primary hypothyroidism
Rationale: Elevated TSH with low free T4 indicates thyroid gland failure,
consistent with primary hypothyroidism.
3. A 30-year-old presents with acute right lower quadrant pain, rebound
tenderness, and fever. What is the most likely diagnosis?
Correct Answer: Acute appendicitis
Rationale: Classic presentation includes RLQ pain, fever, and peritoneal
signs, indicating appendiceal inflammation.
4. A patient with diabetes has fasting glucose consistently above 130 mg/dL
despite metformin therapy. What is the next best medication class to add?
, Correct Answer: GLP-1 receptor agonist
Rationale: GLP-1 agonists improve glycemic control and promote weight
loss when metformin alone is insufficient.
5. A 65-year-old presents with sudden unilateral weakness and slurred speech
starting 1 hour ago. What is the priority intervention?
Correct Answer: Immediate CT scan of the head
Rationale: A non-contrast CT is essential to differentiate ischemic from
hemorrhagic stroke before thrombolysis.
6. A child presents with a barking cough, inspiratory stridor, and low-grade
fever. What is the diagnosis?
Correct Answer: Croup
Rationale: Parainfluenza virus commonly causes croup with stridor and
barking cough.
7. A patient presents with chest pain relieved by nitroglycerin and ST
depression on ECG. What is the likely diagnosis?
Correct Answer: Unstable angina
Rationale: Ischemia without infarction presents with ST depression and
episodic chest pain.
8. A 22-year-old female has dysuria and urinary frequency. Urinalysis shows
nitrites and leukocyte esterase. What is the diagnosis?
Correct Answer: Acute uncomplicated urinary tract infection
Rationale: Nitrites and leukocyte esterase indicate bacterial UTI, commonly
E. coli.
9. A patient presents with butterfly rash, joint pain, and positive anti-dsDNA
antibodies. What is the diagnosis?
Correct Answer: Systemic lupus erythematosus
Rationale: Anti-dsDNA positivity and malar rash are diagnostic of SLE.
10.A newborn has cyanosis that improves with crying and a harsh systolic
murmur. What condition is suspected?
, Correct Answer: Tetralogy of Fallot
Rationale: Tet spells and cyanosis relieved by crying indicate TOF.
11.A hypertensive patient on ACE inhibitor develops dry cough. What is the
mechanism?
Correct Answer: Bradykinin accumulation
Rationale: ACE inhibitors increase bradykinin, causing cough.
12.A patient presents with tremor, weight loss, and exophthalmos. What lab
finding is expected?
Correct Answer: Decreased TSH and increased T4
Rationale: Hyperthyroidism (Graves disease) suppresses TSH and elevates
T4.
13.A 70-year-old presents with fever, confusion, and neck stiffness. What is the
priority diagnosis?
Correct Answer: Bacterial meningitis
Rationale: Triad of fever, neck stiffness, altered mental status suggests
meningitis.
14.A patient has epigastric pain relieved by eating. What is the likely diagnosis?
Correct Answer: Duodenal ulcer
Rationale: Pain relief with food is characteristic of duodenal ulcers.
15.A 50-year-old diabetic patient has microalbuminuria. What medication is
indicated for renal protection?
Correct Answer: ACE inhibitor
*Rationale: ACE inhibitors reduce intraglomerular pressure and proteinuria.
16.A patient presents with sudden severe tearing chest pain radiating to the
back. What is the diagnosis?
Correct Answer: Aortic dissection
Rationale: Tearing pain radiating posteriorly is classic for dissection.
