APEA 3P Exam 2025
#1 risk factor for COPD - ANS smoking
+what is the significance of AV nicking? - ANS this is indicative of longstanding
hypertension
1. Symptoms of heartburn and regurgitation are associated with: - ANS
Gastroesophageal reflux (Gastroesophageal reflux disease (GERD) is commonly
associated with heartburn and regurgitation.)
5-alpha reductase inhibitors work to improve symptoms of benign prostatic
hyperplasia by: - ANS Decreasing the size of the prostate
A 15-year-old male has worked this summer as a lifeguard at a local swimming pool.
He complains of itching in the groin area. He is dx with tinea cruris. The NP is likely
to identify - ANS well marginated half moon shape macules on the inner thigh
A 17-year-old is diagnosed with mild bronchospasm. Which of the following would
provide relief? - ANS Inhaled levalbuterol (Xopenex)
A 26 year old woman with bulimia is likely to be: - ANS average weight
A 26 year old woman with bulimia is likely to be: - ANS of average weight
A 26-year-old man with a past medical history of sickle cell disease arrives at the
office with complaints of a penile erection that has lasted 4 hours. He is experiencing
symptoms of: - ANS Low flow priapism
A 26-year-old man with a past medication history of sickle cell disease arrives at the
office with complaints of a penile erection that has lasted 4 hours. He is experiencing
symptoms of... - ANS low-flow Priapism
A 27-year-old male patient presents with a painless chancre on the shaft of his penis
and regional lymphadenopathy. He is diagnosed with primary syphilis. The best initial
treatment is: - ANS Benzathine penicillin G (Bicillin L.A.)
A 30-year-old female pt. with complaints of fatigue undergoes a screening TSH. Her
TSH is 8 what should be done next? - ANS repeat the TSH and add T4
,A 32-year-old female is diagnosed with hypertension for the first time. She has a BMI
of 32 and a family history of hypertension. The initial treatment for her condition is: -
ANS Lifestyle modifications (Lifestyle changes are recommended as initial
treatment for hypertension.)
A 32-year-old woman presents with dull puffiness of the eyes pronounced not pitting
periorbital edema. This finding is suggestive of this condition: - ANS
Myxedema (Myxedema, often associated with hypothyroidism, presents with
non-pitting periorbital edema.
a 38-year-old male pt. presents for his annual exam. He reports nervousness and
weight loss, but denies any change in his dietary intake or exercise level. Based on
this findings and the following lab values: TSH 0.01, free T4 6, free T3 205. what is
the most likely dx? - ANS Hyperthyroidism
A 38-year-old patient with a history of abdominal pain presents to the nurse
practitioner. Findings reveal superficial edema and bruising in the subcutaneous fatty
tissue around the umbilicus. Hemorrhagic pancreatic is suspected because of which
finding? - ANS A positive Cullen's sign (Cullen's sign, bruising around the
umbilicus, can be indicative of hemorrhagic pancreatitis.)
A 40 year old female patient has breasts with soft texture, but uneven contour
bilaterally. What is the most likely diagnosis? - ANS cystic breasts
A 40 year old female patient with breasts of soft texture and uneven contour
bilaterally is likely to have: - ANS Normal finding.
A 40-year-old African-American pt. has a b/p of 175/100 and 170/102. What is a
reasonable plan of care for this pt today? - ANS initiate amlodipine 5mg daily
A 40-year-old female, the overall texture of the breast is soft, with an uneven contour
bilaterally. The NP informs the patient that: - ANS Is considered normal
a 40-year-old pt. with newly dx of T2DM asks what his target b/p should be. the most
correct answer is: - ANS less than 140/90
A 42-year-old woman with a past medical history of migraine headaches is
requesting prophylactic medication treatment. Which medication should the Nurse
Practitioner prescribe? - ANS Amitriptyline (Elavil) (Amitriptyline is used
off-label for migraine prophylaxis.)
A 43 year old Hispanic male has an audible diastolic murmur best heard in the mitral
listening point. There is no audible click. His status has been monitored for the past
two years. This murmur is probably - ANS mitral stenosis
,A 44-year-old male presents to the nurse practitioner for an employment physical
and is concerned about testing positive for amphetamines on a drug screen, even
though he is not taking amphetamines. His current medication list includes
metformin, lisinopril, glyburide, and bupropion. The most likely medication cause for
a false positive result for amphetamines would be: - ANS Bupropion
A 45-year-old female pt has fatigue for the past 3 months and a 10-lbs weight gain.
She previously had regular menses occurring about every 30 days, but in the last 3
months her menses have varied between 30-45 days . Her TSH value is 13. It was
repeated 1week later and found to be 15. What explains this finding? - ANS
hypothyroidism
A 48-year-old female patient presents with diffuse skin rash, arthralgia, and a recent
history of prolonged exposure to the sun. The nurse practitioner should be most
concerned about: - ANS Systemic lupus erythematosus (SLE) (These
symptoms are characteristic of SLE, an autoimmune condition.)
A 50-year-old male describes difficulty emptying his bladder. On exam, a
distended bladder is noted following urination. This finding may be associated
with - ANS Overflow incontinence
A 50-year-old male describes difficulty emptying his bladder. On exam, a
distended bladder is noted following urination. This finding may be associated
with - ANS Overflow incontinence
A 50-year-old male describes difficulty emptying his bladder. On exam, a distended
bladder is noted following urination. This finding may be associated with: - ANS
Overflow incontinence
A 50-year-old male describes difficulty emptying his bladder. On exam, a distended
bladder is noted following urination. This finding may be associated with... - ANS
Overflow incontinence
A 50-year-old male has a non-tender, enlarged scrotum. The nurse practitioner
suspects which of the following conditions: - ANS Hydrocele
A 50-year-old patient with a history of chronic hypertension presents with a severe
headache, blurred vision, and nausea. The nurse practitioner should be concerned
about: - ANS Hypertensive crisis (These symptoms can indicate a
hypertensive crisis.)
, A 50-year-old patient with hypertension has taken HCTZ 25mg daily for the past 4
weeks. Her b/p has decreased from 155/95 to 145/90. How should the NP proceed?
- ANS add another drug from another class to the daily 25mg HCTZ
A 52-year-old presents w/thirst and frequent urination today. His glucose is 352. How
should this be managed today? - ANS start insulin
A 57-year-old post-menopausal female presents with a complaint of vaginal burning,
pruritus, and painful intercourse. On examination, the nurse practitioner would be
most concerned with the findings: - ANS A friable cervix (A friable cervix can
be a sign of cervical pathology or malignancy.)
A 60-year-old patient with severe, deep left eye pain. Findings reveal dilated and
fixed left pupil and the cornea is cloudy. There is no ocular discharge noted. These
findings are most likely consistent with... - ANS Acute angle closure glaucoma
A 62 year old male presents with leg pain and occasional numbness that is worse
with ambulation and improved with lumbar flexion. What is the likely diagnosis? -
ANS spinal stenosis
A 63 year old male with decreased chest expansion and symmetric thorax with
moderate kyphosis is likely to have: - ANS COPD
A 64-year-old man complains of leg pain and occasional numbness that worsens
with ambulation and improves with lumbar flexion. The symptoms are consistent
with: - ANS Spinal stenosis
A 65-year-old diabetic has been on oral antihyperglycemic agents and is still having
poor glycemic control. His AM fasting glucose range from 140-160. You decide to
add insulin. He weighs 127 kg. What should the NP order as an initial starting dose?
- ANS 10u of long-acting insulin at bedtime
A 65-year-old man has a history of one kidney with early renal insufficiency. He is
diagnosed with pneumonia and will require: - ANS Lower dose of antibiotics
A 65-year-old with a history of one kidney and early renal insufficiency is diagnosed
with pneumonia and will require: - ANS Lower dose of antibiotics
A 67 year old woman with atrial fibrillation and an ejection fraction of 48% is on
digoxin and has had normal digoxin levels of 0.8-2 ng/dL for the past 9 months.
Today, the level is 0.4 ng/dL. What could account for this change? - ANS
Regular use of an antacid
#1 risk factor for COPD - ANS smoking
+what is the significance of AV nicking? - ANS this is indicative of longstanding
hypertension
1. Symptoms of heartburn and regurgitation are associated with: - ANS
Gastroesophageal reflux (Gastroesophageal reflux disease (GERD) is commonly
associated with heartburn and regurgitation.)
5-alpha reductase inhibitors work to improve symptoms of benign prostatic
hyperplasia by: - ANS Decreasing the size of the prostate
A 15-year-old male has worked this summer as a lifeguard at a local swimming pool.
He complains of itching in the groin area. He is dx with tinea cruris. The NP is likely
to identify - ANS well marginated half moon shape macules on the inner thigh
A 17-year-old is diagnosed with mild bronchospasm. Which of the following would
provide relief? - ANS Inhaled levalbuterol (Xopenex)
A 26 year old woman with bulimia is likely to be: - ANS average weight
A 26 year old woman with bulimia is likely to be: - ANS of average weight
A 26-year-old man with a past medical history of sickle cell disease arrives at the
office with complaints of a penile erection that has lasted 4 hours. He is experiencing
symptoms of: - ANS Low flow priapism
A 26-year-old man with a past medication history of sickle cell disease arrives at the
office with complaints of a penile erection that has lasted 4 hours. He is experiencing
symptoms of... - ANS low-flow Priapism
A 27-year-old male patient presents with a painless chancre on the shaft of his penis
and regional lymphadenopathy. He is diagnosed with primary syphilis. The best initial
treatment is: - ANS Benzathine penicillin G (Bicillin L.A.)
A 30-year-old female pt. with complaints of fatigue undergoes a screening TSH. Her
TSH is 8 what should be done next? - ANS repeat the TSH and add T4
,A 32-year-old female is diagnosed with hypertension for the first time. She has a BMI
of 32 and a family history of hypertension. The initial treatment for her condition is: -
ANS Lifestyle modifications (Lifestyle changes are recommended as initial
treatment for hypertension.)
A 32-year-old woman presents with dull puffiness of the eyes pronounced not pitting
periorbital edema. This finding is suggestive of this condition: - ANS
Myxedema (Myxedema, often associated with hypothyroidism, presents with
non-pitting periorbital edema.
a 38-year-old male pt. presents for his annual exam. He reports nervousness and
weight loss, but denies any change in his dietary intake or exercise level. Based on
this findings and the following lab values: TSH 0.01, free T4 6, free T3 205. what is
the most likely dx? - ANS Hyperthyroidism
A 38-year-old patient with a history of abdominal pain presents to the nurse
practitioner. Findings reveal superficial edema and bruising in the subcutaneous fatty
tissue around the umbilicus. Hemorrhagic pancreatic is suspected because of which
finding? - ANS A positive Cullen's sign (Cullen's sign, bruising around the
umbilicus, can be indicative of hemorrhagic pancreatitis.)
A 40 year old female patient has breasts with soft texture, but uneven contour
bilaterally. What is the most likely diagnosis? - ANS cystic breasts
A 40 year old female patient with breasts of soft texture and uneven contour
bilaterally is likely to have: - ANS Normal finding.
A 40-year-old African-American pt. has a b/p of 175/100 and 170/102. What is a
reasonable plan of care for this pt today? - ANS initiate amlodipine 5mg daily
A 40-year-old female, the overall texture of the breast is soft, with an uneven contour
bilaterally. The NP informs the patient that: - ANS Is considered normal
a 40-year-old pt. with newly dx of T2DM asks what his target b/p should be. the most
correct answer is: - ANS less than 140/90
A 42-year-old woman with a past medical history of migraine headaches is
requesting prophylactic medication treatment. Which medication should the Nurse
Practitioner prescribe? - ANS Amitriptyline (Elavil) (Amitriptyline is used
off-label for migraine prophylaxis.)
A 43 year old Hispanic male has an audible diastolic murmur best heard in the mitral
listening point. There is no audible click. His status has been monitored for the past
two years. This murmur is probably - ANS mitral stenosis
,A 44-year-old male presents to the nurse practitioner for an employment physical
and is concerned about testing positive for amphetamines on a drug screen, even
though he is not taking amphetamines. His current medication list includes
metformin, lisinopril, glyburide, and bupropion. The most likely medication cause for
a false positive result for amphetamines would be: - ANS Bupropion
A 45-year-old female pt has fatigue for the past 3 months and a 10-lbs weight gain.
She previously had regular menses occurring about every 30 days, but in the last 3
months her menses have varied between 30-45 days . Her TSH value is 13. It was
repeated 1week later and found to be 15. What explains this finding? - ANS
hypothyroidism
A 48-year-old female patient presents with diffuse skin rash, arthralgia, and a recent
history of prolonged exposure to the sun. The nurse practitioner should be most
concerned about: - ANS Systemic lupus erythematosus (SLE) (These
symptoms are characteristic of SLE, an autoimmune condition.)
A 50-year-old male describes difficulty emptying his bladder. On exam, a
distended bladder is noted following urination. This finding may be associated
with - ANS Overflow incontinence
A 50-year-old male describes difficulty emptying his bladder. On exam, a
distended bladder is noted following urination. This finding may be associated
with - ANS Overflow incontinence
A 50-year-old male describes difficulty emptying his bladder. On exam, a distended
bladder is noted following urination. This finding may be associated with: - ANS
Overflow incontinence
A 50-year-old male describes difficulty emptying his bladder. On exam, a distended
bladder is noted following urination. This finding may be associated with... - ANS
Overflow incontinence
A 50-year-old male has a non-tender, enlarged scrotum. The nurse practitioner
suspects which of the following conditions: - ANS Hydrocele
A 50-year-old patient with a history of chronic hypertension presents with a severe
headache, blurred vision, and nausea. The nurse practitioner should be concerned
about: - ANS Hypertensive crisis (These symptoms can indicate a
hypertensive crisis.)
, A 50-year-old patient with hypertension has taken HCTZ 25mg daily for the past 4
weeks. Her b/p has decreased from 155/95 to 145/90. How should the NP proceed?
- ANS add another drug from another class to the daily 25mg HCTZ
A 52-year-old presents w/thirst and frequent urination today. His glucose is 352. How
should this be managed today? - ANS start insulin
A 57-year-old post-menopausal female presents with a complaint of vaginal burning,
pruritus, and painful intercourse. On examination, the nurse practitioner would be
most concerned with the findings: - ANS A friable cervix (A friable cervix can
be a sign of cervical pathology or malignancy.)
A 60-year-old patient with severe, deep left eye pain. Findings reveal dilated and
fixed left pupil and the cornea is cloudy. There is no ocular discharge noted. These
findings are most likely consistent with... - ANS Acute angle closure glaucoma
A 62 year old male presents with leg pain and occasional numbness that is worse
with ambulation and improved with lumbar flexion. What is the likely diagnosis? -
ANS spinal stenosis
A 63 year old male with decreased chest expansion and symmetric thorax with
moderate kyphosis is likely to have: - ANS COPD
A 64-year-old man complains of leg pain and occasional numbness that worsens
with ambulation and improves with lumbar flexion. The symptoms are consistent
with: - ANS Spinal stenosis
A 65-year-old diabetic has been on oral antihyperglycemic agents and is still having
poor glycemic control. His AM fasting glucose range from 140-160. You decide to
add insulin. He weighs 127 kg. What should the NP order as an initial starting dose?
- ANS 10u of long-acting insulin at bedtime
A 65-year-old man has a history of one kidney with early renal insufficiency. He is
diagnosed with pneumonia and will require: - ANS Lower dose of antibiotics
A 65-year-old with a history of one kidney and early renal insufficiency is diagnosed
with pneumonia and will require: - ANS Lower dose of antibiotics
A 67 year old woman with atrial fibrillation and an ejection fraction of 48% is on
digoxin and has had normal digoxin levels of 0.8-2 ng/dL for the past 9 months.
Today, the level is 0.4 ng/dL. What could account for this change? - ANS
Regular use of an antacid
