APEA 3P Exam (Advanced Practice Education Associates)
2025 Comprehensive Question Bank with Answers and
Rationales | Updated Clinical, Diagnostic &
Pharmacology
1. A 5-year-old child is diagnosed with pinworms and lives with only the mother. What is
the next best step regarding the mother?
A. Reassure the mother that treatment is unnecessary unless symptoms develop
B. Collect a stool sample for ova and parasites
C. Perform a tape test on the mother and examine it under a microscope
D. Visually inspect the perianal area for adult worms
The tape test is the standard method for diagnosing pinworms. It collects eggs laid at
night and is more reliable than stool samples.
2. Which of the following is the most appropriate initial diagnostic test for a child suspected
of having asthma?
A. Chest x-ray
B. Bronchoscopy
C. Spirometry
D. Methacholine challenge
Spirometry measures lung function and is the primary tool used to confirm asthma
diagnosis.
3. A 72-year-old male reports progressive urinary hesitancy and weak stream. Which
condition is most likely?
A. Benign prostatic hyperplasia
B. Urinary tract infection
C. Bladder cancer
D. Prostatitis
BPH is common in older men and causes lower urinary tract symptoms such as weak
stream and hesitancy.
,4. A 14-year-old female presents with a butterfly-shaped rash over the cheeks and nose.
Which lab test should be ordered first?
A. ESR
B. ANA (antinuclear antibody)
C. Anti-dsDNA
D. Rheumatoid factor
ANA is a sensitive test for autoimmune diseases like lupus and is typically ordered first
when lupus is suspected.
5. A patient with a diagnosis of hypothyroidism presents with weight gain and fatigue.
Which lab result is expected?
A. TSH elevated, free T4 low
B. TSH low, free T4 high
C. TSH normal, free T4 low
D. TSH and T4 both elevated
Primary hypothyroidism causes increased TSH due to pituitary stimulation and decreased
free T4.
6. A woman with a positive Anti-HBs and negative HBsAg and Anti-HBc serology is being
screened for hepatitis. What does this pattern suggest?
A. Active hepatitis B infection
B. Past exposure to hepatitis B
C. Immunity due to hepatitis B vaccination
D. Chronic carrier state
Positive Anti-HBs and negative Anti-HBc indicate immunity through vaccination, not
natural infection.
7. A 28-year-old woman presents with dysuria, frequency, and urgency. Urinalysis shows
WBCs but no nitrates. What is the best next step?
A. Order a pelvic ultrasound
B. Treat empirically for uncomplicated UTI
C. Refer to urology
D. Repeat urinalysis in 48 hours
, Empiric treatment is appropriate in young women with classic UTI symptoms, even if
nitrites are absent.
8. A client taking phenytoin reports nausea, ataxia, and nystagmus. What is the likely
cause?
A. Hyponatremia
B. Acute alcohol intoxication
C. Phenytoin toxicity
D. Seizure recurrence
These symptoms are classic signs of phenytoin toxicity and require evaluation of serum
levels.
9. A patient with diabetes has microalbuminuria on urine testing. Which medication class is
most appropriate?
A. Beta blockers
B. ACE inhibitors
C. Thiazide diuretics
D. Calcium channel blockers
ACE inhibitors reduce glomerular pressure and are renoprotective in diabetic
nephropathy.
10. A 16-year-old athlete complains of shin pain after increasing running intensity. The area
is tender but has no swelling or bruising. What is the most likely diagnosis?
A. Medial tibial stress syndrome (shin splints)
B. Compartment syndrome
C. Tibial fracture
D. Achilles tendonitis
Shin splints are a common overuse injury in runners characterized by pain along the
inner tibia.
11. A client taking isoniazid (INH) for latent TB reports tingling in the hands and feet. What
supplement should be added?
A. Vitamin B6 (pyridoxine)
B. Vitamin D
C. Iron
2025 Comprehensive Question Bank with Answers and
Rationales | Updated Clinical, Diagnostic &
Pharmacology
1. A 5-year-old child is diagnosed with pinworms and lives with only the mother. What is
the next best step regarding the mother?
A. Reassure the mother that treatment is unnecessary unless symptoms develop
B. Collect a stool sample for ova and parasites
C. Perform a tape test on the mother and examine it under a microscope
D. Visually inspect the perianal area for adult worms
The tape test is the standard method for diagnosing pinworms. It collects eggs laid at
night and is more reliable than stool samples.
2. Which of the following is the most appropriate initial diagnostic test for a child suspected
of having asthma?
A. Chest x-ray
B. Bronchoscopy
C. Spirometry
D. Methacholine challenge
Spirometry measures lung function and is the primary tool used to confirm asthma
diagnosis.
3. A 72-year-old male reports progressive urinary hesitancy and weak stream. Which
condition is most likely?
A. Benign prostatic hyperplasia
B. Urinary tract infection
C. Bladder cancer
D. Prostatitis
BPH is common in older men and causes lower urinary tract symptoms such as weak
stream and hesitancy.
,4. A 14-year-old female presents with a butterfly-shaped rash over the cheeks and nose.
Which lab test should be ordered first?
A. ESR
B. ANA (antinuclear antibody)
C. Anti-dsDNA
D. Rheumatoid factor
ANA is a sensitive test for autoimmune diseases like lupus and is typically ordered first
when lupus is suspected.
5. A patient with a diagnosis of hypothyroidism presents with weight gain and fatigue.
Which lab result is expected?
A. TSH elevated, free T4 low
B. TSH low, free T4 high
C. TSH normal, free T4 low
D. TSH and T4 both elevated
Primary hypothyroidism causes increased TSH due to pituitary stimulation and decreased
free T4.
6. A woman with a positive Anti-HBs and negative HBsAg and Anti-HBc serology is being
screened for hepatitis. What does this pattern suggest?
A. Active hepatitis B infection
B. Past exposure to hepatitis B
C. Immunity due to hepatitis B vaccination
D. Chronic carrier state
Positive Anti-HBs and negative Anti-HBc indicate immunity through vaccination, not
natural infection.
7. A 28-year-old woman presents with dysuria, frequency, and urgency. Urinalysis shows
WBCs but no nitrates. What is the best next step?
A. Order a pelvic ultrasound
B. Treat empirically for uncomplicated UTI
C. Refer to urology
D. Repeat urinalysis in 48 hours
, Empiric treatment is appropriate in young women with classic UTI symptoms, even if
nitrites are absent.
8. A client taking phenytoin reports nausea, ataxia, and nystagmus. What is the likely
cause?
A. Hyponatremia
B. Acute alcohol intoxication
C. Phenytoin toxicity
D. Seizure recurrence
These symptoms are classic signs of phenytoin toxicity and require evaluation of serum
levels.
9. A patient with diabetes has microalbuminuria on urine testing. Which medication class is
most appropriate?
A. Beta blockers
B. ACE inhibitors
C. Thiazide diuretics
D. Calcium channel blockers
ACE inhibitors reduce glomerular pressure and are renoprotective in diabetic
nephropathy.
10. A 16-year-old athlete complains of shin pain after increasing running intensity. The area
is tender but has no swelling or bruising. What is the most likely diagnosis?
A. Medial tibial stress syndrome (shin splints)
B. Compartment syndrome
C. Tibial fracture
D. Achilles tendonitis
Shin splints are a common overuse injury in runners characterized by pain along the
inner tibia.
11. A client taking isoniazid (INH) for latent TB reports tingling in the hands and feet. What
supplement should be added?
A. Vitamin B6 (pyridoxine)
B. Vitamin D
C. Iron
