NURSING MSN 572 APEA 3P QUESTION
BANK WITH ANSWERS (VERIFIED
ANSWERS GRADED A+) LATEST UPDATE
2026
1. A 45-year-old male presents with fatigue, weight gain, and cold intolerance.
Laboratory results show TSH 12 mIU/L, free T4 0.6 ng/dL. Which of the
following is the most likely diagnosis?
• A. Hyperthyroidism
• B. Hypothyroidism
• C. Thyroid storm
• D. Subacute thyroiditis
Correct ,,,,answer,,,,: B
Rationale: Elevated TSH with low free T4 indicates primary hypothyroidism.
Symptoms include fatigue, weight gain, cold intolerance, and constipation.
2. A patient with type 1 diabetes presents with nausea, vomiting, abdominal
pain, and Kussmaul respirations. Laboratory findings show blood glucose 450
mg/dL, pH 7.25, HCO3 14 mEq/L, and positive urine ketones. Which of the
following is the most appropriate initial fluid?
• A. 0.45% sodium chloride
• B. 0.9% sodium chloride
• C. 5% dextrose in water
• D. Lactated Ringer's solution
Correct ,,,,answer,,,,: B
,Rationale: Diabetic ketoacidosis (DKA) requires initial volume resuscitation with
isotonic saline (0.9% NaCl) to restore circulating volume.
3. A 65-year-old female with a history of hypertension presents with sudden
onset of severe, tearing chest pain radiating to the back. Blood pressure is
180/100 in the right arm and 100/60 in the left arm. Which of the following is
the most likely diagnosis?
• A. Acute myocardial infarction
• B. Pulmonary embolism
• C. Aortic dissection
• D. Pericarditis
Correct ,,,,answer,,,,: C
Rationale: Aortic dissection presents with sudden, severe tearing chest pain and
may cause unequal blood pressures between arms.
4. A 30-year-old female presents with episodic headaches, palpitations, and
severe hypertension. During an episode, blood pressure is 210/110 mm Hg.
Which of the following is the most likely diagnosis?
• A. Essential hypertension
• B. Pheochromocytoma
• C. Renal artery stenosis
• D. Hyperaldosteronism
Correct ,,,,answer,,,,: B
Rationale: Pheochromocytoma is a catecholamine-secreting tumor that causes
paroxysmal hypertension, headache, and palpitations.
5. A patient with systemic lupus erythematosus (SLE) develops proteinuria
and hematuria. Which of the following is the most likely complication?
, • A. Lupus nephritis
• B. Urinary tract infection
• C. Nephrolithiasis
Correct ,,,,answer,,,,: A
Rationale: Lupus nephritis is a common and serious complication of SLE,
characterized by proteinuria, hematuria, and renal dysfunction.
6. A 68-year-old male presents with a several-month history of progressively
worsening bilateral hand numbness, clumsiness, and a sensation of "walking
on sponges." On examination, you note hyperreflexia in the lower extremities,
bilateral Babinski signs, and atrophy of the thenar eminences. What is the
most likely diagnosis?
• A. Peripheral neuropathy
• B. Cervical spondylitic myelopathy
• C. Carpal tunnel syndrome
• D. Multiple sclerosis
Correct ,,,,answer,,,,: B
Rationale: The combination of upper motor neuron signs (hyperreflexia, Babinski)
in the legs with lower motor neuron signs (atrophy, weakness) in the upper
extremities is classic for cervical myelopathy. This results from spinal cord
compression in the cervical spine.
7. A patient with a history of heart failure with reduced ejection fraction
(HFrEF) is on a maximally tolerated dose of lisinopril, carvedilol, and
furosemide. The patient's ejection fraction is 35% and they remain
symptomatic with NYHA class III symptoms. Which medication is most
appropriate to add next?
• A. Spironolactone
, • B. Digoxin
• C. Hydralazine and isosorbide dinitrate
• D. Ivabradine
Correct ,,,,answer,,,,: A
Rationale: Spironolactone (an aldosterone antagonist) is indicated for patients
with NYHA class III-IV HFrEF who remain symptomatic on optimal medical
therapy.
8. What is the hallmark symptom of Peripheral Arterial Disease (PAD)?
• A. Edema
• B. Bruising
• C. Rash
• D. Intermittent claudication
Correct ,,,,answer,,,,: D
Rationale: Intermittent claudication is the classic symptom of PAD, characterized
by muscle pain, cramping, or fatigue in the legs that occurs with exercise and is
relieved by rest. This occurs due to narrowed arteries reducing blood flow to the
limbs.
9. Which test is best to confirm Peripheral Arterial Disease?
• A. ECG
• B. Ankle-Brachial Index (ABI)
• C. Echocardiogram
Correct ,,,,answer,,,,: B
Rationale: The Ankle-Brachial Index (ABI) is the diagnostic test of choice for
PAD. An ABI of less than 0.90 is diagnostic of PAD.
BANK WITH ANSWERS (VERIFIED
ANSWERS GRADED A+) LATEST UPDATE
2026
1. A 45-year-old male presents with fatigue, weight gain, and cold intolerance.
Laboratory results show TSH 12 mIU/L, free T4 0.6 ng/dL. Which of the
following is the most likely diagnosis?
• A. Hyperthyroidism
• B. Hypothyroidism
• C. Thyroid storm
• D. Subacute thyroiditis
Correct ,,,,answer,,,,: B
Rationale: Elevated TSH with low free T4 indicates primary hypothyroidism.
Symptoms include fatigue, weight gain, cold intolerance, and constipation.
2. A patient with type 1 diabetes presents with nausea, vomiting, abdominal
pain, and Kussmaul respirations. Laboratory findings show blood glucose 450
mg/dL, pH 7.25, HCO3 14 mEq/L, and positive urine ketones. Which of the
following is the most appropriate initial fluid?
• A. 0.45% sodium chloride
• B. 0.9% sodium chloride
• C. 5% dextrose in water
• D. Lactated Ringer's solution
Correct ,,,,answer,,,,: B
,Rationale: Diabetic ketoacidosis (DKA) requires initial volume resuscitation with
isotonic saline (0.9% NaCl) to restore circulating volume.
3. A 65-year-old female with a history of hypertension presents with sudden
onset of severe, tearing chest pain radiating to the back. Blood pressure is
180/100 in the right arm and 100/60 in the left arm. Which of the following is
the most likely diagnosis?
• A. Acute myocardial infarction
• B. Pulmonary embolism
• C. Aortic dissection
• D. Pericarditis
Correct ,,,,answer,,,,: C
Rationale: Aortic dissection presents with sudden, severe tearing chest pain and
may cause unequal blood pressures between arms.
4. A 30-year-old female presents with episodic headaches, palpitations, and
severe hypertension. During an episode, blood pressure is 210/110 mm Hg.
Which of the following is the most likely diagnosis?
• A. Essential hypertension
• B. Pheochromocytoma
• C. Renal artery stenosis
• D. Hyperaldosteronism
Correct ,,,,answer,,,,: B
Rationale: Pheochromocytoma is a catecholamine-secreting tumor that causes
paroxysmal hypertension, headache, and palpitations.
5. A patient with systemic lupus erythematosus (SLE) develops proteinuria
and hematuria. Which of the following is the most likely complication?
, • A. Lupus nephritis
• B. Urinary tract infection
• C. Nephrolithiasis
Correct ,,,,answer,,,,: A
Rationale: Lupus nephritis is a common and serious complication of SLE,
characterized by proteinuria, hematuria, and renal dysfunction.
6. A 68-year-old male presents with a several-month history of progressively
worsening bilateral hand numbness, clumsiness, and a sensation of "walking
on sponges." On examination, you note hyperreflexia in the lower extremities,
bilateral Babinski signs, and atrophy of the thenar eminences. What is the
most likely diagnosis?
• A. Peripheral neuropathy
• B. Cervical spondylitic myelopathy
• C. Carpal tunnel syndrome
• D. Multiple sclerosis
Correct ,,,,answer,,,,: B
Rationale: The combination of upper motor neuron signs (hyperreflexia, Babinski)
in the legs with lower motor neuron signs (atrophy, weakness) in the upper
extremities is classic for cervical myelopathy. This results from spinal cord
compression in the cervical spine.
7. A patient with a history of heart failure with reduced ejection fraction
(HFrEF) is on a maximally tolerated dose of lisinopril, carvedilol, and
furosemide. The patient's ejection fraction is 35% and they remain
symptomatic with NYHA class III symptoms. Which medication is most
appropriate to add next?
• A. Spironolactone
, • B. Digoxin
• C. Hydralazine and isosorbide dinitrate
• D. Ivabradine
Correct ,,,,answer,,,,: A
Rationale: Spironolactone (an aldosterone antagonist) is indicated for patients
with NYHA class III-IV HFrEF who remain symptomatic on optimal medical
therapy.
8. What is the hallmark symptom of Peripheral Arterial Disease (PAD)?
• A. Edema
• B. Bruising
• C. Rash
• D. Intermittent claudication
Correct ,,,,answer,,,,: D
Rationale: Intermittent claudication is the classic symptom of PAD, characterized
by muscle pain, cramping, or fatigue in the legs that occurs with exercise and is
relieved by rest. This occurs due to narrowed arteries reducing blood flow to the
limbs.
9. Which test is best to confirm Peripheral Arterial Disease?
• A. ECG
• B. Ankle-Brachial Index (ABI)
• C. Echocardiogram
Correct ,,,,answer,,,,: B
Rationale: The Ankle-Brachial Index (ABI) is the diagnostic test of choice for
PAD. An ABI of less than 0.90 is diagnostic of PAD.
