APEA 3P Exam 2025 – Advanced Practice Comprehensive Study
Guide with Verified Questions & Detailed Rationales | Full AANP &
ANCC Aligned Review | Clinical Decision-Making, Pharmacology,
Pathophysiology & Physical Assessment Mastery
What is another name for fifth disease?
parvovirus/slapped cheek disease/erythema infectiosum
Which type of prevention are vaccinations?
Primary
When should patients begin antiretroviral therapy for HIV infection?
As soon as detected, even if in the acute phase.
What are the first generation antihistamines?
diphenhydramine (benadryl) and chlorpeniramine (actifed)
What are the s/s of the secondary stage of syphilis?
Non-itchy rash on hands and feet, lymphadenopathy, fever, joint pain
Recommended treatment for chronic bacterial prostatitis?
fluoroquinolone (cipro or levo) and bactrim
Recommended treatment for acute prostatitis?
Cipro (if not STI) or ceftriaxone
What are the s/s of an intraductal breast papilloma?
Clear to bloody unilateral nipple discharge (bilateral is usually benign) and also a wart like lump palpated in the
nipple area
If a patient has GABHS but has an allergy to penicillin, what is the second line option?
First generation cephalosporins, unless the allergy is severe, then macrolides like a -mycin
PDE5 inhibitors (sildenafil, tadalafil) are contraindicated in which patient populations?
In those who are on any type of nitrate or triptan because it could result in hypotension
What class of drug is sildenafil (Viagra)?
a PDE5 inhibitor which can cause hypotension so you should do a full cardiac assessment before starting a
patient on this and maybe do an EKG
What are the symptoms of peripheral artery disease?
pain, absent or weak pulses, eschar or shiny legs, intermittent claudication
,What is the first line treatment for PAD?
Walking and physical activity to improve circulation. Second line is aspirin or anti-platelet.
What should we tell our patients with PAD not to do?
Do not elevate the feet, keep them down.
What is the biggest side effect of colchicine?
Diarrhea
How would you describe the appearance of molluscum contagiosum?
Papules that are umbilicated and contain a caseous plug.
How do we treat a broken clavicle in an infant?
No treatment; it should heal on its own.
At what week of pregnancy is the uterus palpable just above the pubic symphysis?
Week 12
At what week of pregnancy is the fundus palpable halfway between the pubic symphysis and umbilicus?
Week 16
At what week of pregnancy is the fundus of the uterus at the umbilicus?
Week 20
At what week of pregnancy is the fundus just below the xiphoid process?
Week 34
At what week of pregnancy is the fundus of the uterus halfway between the xiphoid process and umbilicus?
28
Increased sweat production is a sign of what endocrine disorder?
Hyperthyroidism
What is Paget's disease?
Localized increased bone turnover and blood flow resulting in the breakdown of bone and replacing it with
weakened and highly vascular bone putting the person at risk of fractures.
How do we treat Paget's disease?
Bisphosphonates
How should pregnant women wear their seatbelts?
With the shoulder strap like normal and then the groin strap below the belly and across the hips.
How do we diagnose PAD?
,ABI<7, doppler can also be used to diagnose but that is the second choice.
What are the s/s of peripheral vascular disease?
Think V meaning volume overload aka edema, may ache or be uncomfortable but is not painful, bounding
pulses, ruddy discoloration
If a patient is on Coumadin but then may need an antibiotic for an infection and Bactrim is the drug of choice,
what should you do?
Bactrim increases INR so we would want to decrease Coumadin while patient is taking Bactrim.
If a patient is on Coumadin but then needs to be on Rifampin, what should you do?
Rifampin decreases INR, would need to increase Coumadin.
If a patient is on Coumadin and their INR is 3.1-4, what should you do?
Decrease the weekly dose by 5-10%
If a patient is on Coumadin and their INR is 4.1-5.0, what should you do?
Hold one dose then decrease the weekly dose by 10%.
If a patient's INR is greater than 5, what should you do?
Consult cardiology, likely would hold two doses then decrease the weekly dose.
An anorexic patient will have a BMI of what?
Less than 18
What is primary amenorrhea?
Patient has never gotten period but have all of their secondary sex characteristics.
Secondary amenorrhea is a lack of menses after ________ of not having a period, but you have had one before.
3 months.
What do we need to do first when a patient comes in with secondary amenorrhea?
Rule out pregnancy.
Anorexia can put you at risk for what?
Osteoporosis, amenorrhea, cardiac damage
Amenorrhea is considered a risk factor for what?
Osteoporosis
What is the best indication of a patient with anorexia doing better?
Got their period again.
If a pregnant woman has syphilis, what should we do?
Treat with PCN because there is risk for spontaneous abortion.
, What is the causative organism for mastitis?
Staph
What is the first line treatment for mastitis?
Keflex (a cephalosporin). If that doesn't work, then try another antibiotic. If that STILL doesn't work, then refer
for an ultrasound.
What is one of the biggest risk factors for cervical cancer?
Numerous sexual partners.
Preeclampsia most commonly shows up at what time in pregnancy?
Around week 20
How do we treat UTis in a pregnant woman?
PCN, cephalosporin, or macrolide (can NOT do doxy or fluoroquinolone).
When do fibrocystic breasts tend to flare up and cause tenderness and lumps?
About 10 days before menses.
What can be a sequelae of an ectopic pregnancy?
Pelvic inflammatory disease and infertility due to scarring of the fallopian tube (salpingitis)
What is the Coomb's test and when is this completed?
Given at 8 weeks in pregnancy to determine RH compatibility.
If a patient's Coomb's test is positive, what do we do?
Nothing, she is RH positive so we do not need to treat.
If a patient's Coomb's test is negative, what do we do?
Give Rhogam at 28 weeks and 72 hours after birth.
What is the only form of non-hormonal contraception other than barrier methods such as condoms?
IUD
The vaginal ring for contraception must be taken out how often?
Every 3 weeks.
If a patient is on birth control and currently having breakthrough bleeding, what do we do?
Increase progesterone.
How do we treat temporal arteritis?
Steroids
If a patient is on birth control and they miss one pill, what should they do?
Guide with Verified Questions & Detailed Rationales | Full AANP &
ANCC Aligned Review | Clinical Decision-Making, Pharmacology,
Pathophysiology & Physical Assessment Mastery
What is another name for fifth disease?
parvovirus/slapped cheek disease/erythema infectiosum
Which type of prevention are vaccinations?
Primary
When should patients begin antiretroviral therapy for HIV infection?
As soon as detected, even if in the acute phase.
What are the first generation antihistamines?
diphenhydramine (benadryl) and chlorpeniramine (actifed)
What are the s/s of the secondary stage of syphilis?
Non-itchy rash on hands and feet, lymphadenopathy, fever, joint pain
Recommended treatment for chronic bacterial prostatitis?
fluoroquinolone (cipro or levo) and bactrim
Recommended treatment for acute prostatitis?
Cipro (if not STI) or ceftriaxone
What are the s/s of an intraductal breast papilloma?
Clear to bloody unilateral nipple discharge (bilateral is usually benign) and also a wart like lump palpated in the
nipple area
If a patient has GABHS but has an allergy to penicillin, what is the second line option?
First generation cephalosporins, unless the allergy is severe, then macrolides like a -mycin
PDE5 inhibitors (sildenafil, tadalafil) are contraindicated in which patient populations?
In those who are on any type of nitrate or triptan because it could result in hypotension
What class of drug is sildenafil (Viagra)?
a PDE5 inhibitor which can cause hypotension so you should do a full cardiac assessment before starting a
patient on this and maybe do an EKG
What are the symptoms of peripheral artery disease?
pain, absent or weak pulses, eschar or shiny legs, intermittent claudication
,What is the first line treatment for PAD?
Walking and physical activity to improve circulation. Second line is aspirin or anti-platelet.
What should we tell our patients with PAD not to do?
Do not elevate the feet, keep them down.
What is the biggest side effect of colchicine?
Diarrhea
How would you describe the appearance of molluscum contagiosum?
Papules that are umbilicated and contain a caseous plug.
How do we treat a broken clavicle in an infant?
No treatment; it should heal on its own.
At what week of pregnancy is the uterus palpable just above the pubic symphysis?
Week 12
At what week of pregnancy is the fundus palpable halfway between the pubic symphysis and umbilicus?
Week 16
At what week of pregnancy is the fundus of the uterus at the umbilicus?
Week 20
At what week of pregnancy is the fundus just below the xiphoid process?
Week 34
At what week of pregnancy is the fundus of the uterus halfway between the xiphoid process and umbilicus?
28
Increased sweat production is a sign of what endocrine disorder?
Hyperthyroidism
What is Paget's disease?
Localized increased bone turnover and blood flow resulting in the breakdown of bone and replacing it with
weakened and highly vascular bone putting the person at risk of fractures.
How do we treat Paget's disease?
Bisphosphonates
How should pregnant women wear their seatbelts?
With the shoulder strap like normal and then the groin strap below the belly and across the hips.
How do we diagnose PAD?
,ABI<7, doppler can also be used to diagnose but that is the second choice.
What are the s/s of peripheral vascular disease?
Think V meaning volume overload aka edema, may ache or be uncomfortable but is not painful, bounding
pulses, ruddy discoloration
If a patient is on Coumadin but then may need an antibiotic for an infection and Bactrim is the drug of choice,
what should you do?
Bactrim increases INR so we would want to decrease Coumadin while patient is taking Bactrim.
If a patient is on Coumadin but then needs to be on Rifampin, what should you do?
Rifampin decreases INR, would need to increase Coumadin.
If a patient is on Coumadin and their INR is 3.1-4, what should you do?
Decrease the weekly dose by 5-10%
If a patient is on Coumadin and their INR is 4.1-5.0, what should you do?
Hold one dose then decrease the weekly dose by 10%.
If a patient's INR is greater than 5, what should you do?
Consult cardiology, likely would hold two doses then decrease the weekly dose.
An anorexic patient will have a BMI of what?
Less than 18
What is primary amenorrhea?
Patient has never gotten period but have all of their secondary sex characteristics.
Secondary amenorrhea is a lack of menses after ________ of not having a period, but you have had one before.
3 months.
What do we need to do first when a patient comes in with secondary amenorrhea?
Rule out pregnancy.
Anorexia can put you at risk for what?
Osteoporosis, amenorrhea, cardiac damage
Amenorrhea is considered a risk factor for what?
Osteoporosis
What is the best indication of a patient with anorexia doing better?
Got their period again.
If a pregnant woman has syphilis, what should we do?
Treat with PCN because there is risk for spontaneous abortion.
, What is the causative organism for mastitis?
Staph
What is the first line treatment for mastitis?
Keflex (a cephalosporin). If that doesn't work, then try another antibiotic. If that STILL doesn't work, then refer
for an ultrasound.
What is one of the biggest risk factors for cervical cancer?
Numerous sexual partners.
Preeclampsia most commonly shows up at what time in pregnancy?
Around week 20
How do we treat UTis in a pregnant woman?
PCN, cephalosporin, or macrolide (can NOT do doxy or fluoroquinolone).
When do fibrocystic breasts tend to flare up and cause tenderness and lumps?
About 10 days before menses.
What can be a sequelae of an ectopic pregnancy?
Pelvic inflammatory disease and infertility due to scarring of the fallopian tube (salpingitis)
What is the Coomb's test and when is this completed?
Given at 8 weeks in pregnancy to determine RH compatibility.
If a patient's Coomb's test is positive, what do we do?
Nothing, she is RH positive so we do not need to treat.
If a patient's Coomb's test is negative, what do we do?
Give Rhogam at 28 weeks and 72 hours after birth.
What is the only form of non-hormonal contraception other than barrier methods such as condoms?
IUD
The vaginal ring for contraception must be taken out how often?
Every 3 weeks.
If a patient is on birth control and currently having breakthrough bleeding, what do we do?
Increase progesterone.
How do we treat temporal arteritis?
Steroids
If a patient is on birth control and they miss one pill, what should they do?
