lOMoARcPSD| 19878240
APEA PREDICTOR EXAM QUESTIONS AND ANSWERS
WITH RATIONALE PRE-PREDICTOR LATEST VERSION
2025/2026
1) A 15 years old high school student with a mild sore throat and low-grade fever
that has persisted for about 3 weeks. She reports general malaise, fatigue, and loss
of appetite. The NP suspects mononucleosis. Which of the following is the
LEAST appropriate intervention?
a. Palpate the lymph nodes and spleen
b. Examine the posterior oropharynx for petechiae
c. Obtain a CBC, throat culture, and heterophil antibody test. d. Obtain an
urinalyses and serum for
, lOMoAR cPSD| 19878240
LFTs and amylase
Explanation: mononucleosis is a symptomatic infection caused by the Epstein-
Bar virus. Common is people 15-24 years of age. Common signs and symptoms
following incubation period (1-2 months) include fatigue, chills, malaise, anorexia,
white tonsillar exudates and lymphadenopathy or posterior cervical region.
Splenomegaly can be present. A maculopapular or occasionally a petechial rash
occurs in less than 15% of patients. A diagnosis is usually made using the
Monospot. In addition, neutropenia and lymphocytosis are usually detected in the
CBC.
2) A 32 years old male patient complaint of urinary frequency and burning on
urination for 3 days. Urinalyses reveals bacteriuria and positive nitrites. He denies
any past hx. Of urinary tract infections. The initial treatment should be:
a. trimethoprim-sulfamethoxazole (Bactrim, Sulfatrim) for 7-10 day
b. ciprofloxacin (Cipro) for 3-5 days
c. Trimethoprim-Sulfamethoxazole for 3 days
d. 750 mg ciprofloxacin as a one-time dose
Explanation: trimethoprim-sulfamethoxazole (TMPS) is usually n appropriate
medication to treat urinary tract infections in most patients. In the case of
community resistance to TMPS
>20%^, another medication should be substituted. In men, the appropriate length
of time is 7-10 days. Women may be treated for 3 days for uncomplicated UTI
3) Which agent is most effective for the treatment of nodulocystic acne?
a. Benzoyl peroxide (Benzac)
, lOMoAR cPSD| 19878240
b. Retinoic acid (Retin A)
c. Topical
tetracycline d.
Isotretinoin)
Explanation: Isotretinoin (Accutane) is a systemic agent indicated for treatment
with severe inflammatory acne. Guidelines for its use must be clearly understood
by the patient. A woman of childbearing age must use an effective method of
contraception because isotretinoin is teratogenic. There are many restrictions in
prescribing this medication because of the teratogenic effects is given during
pregnancy. Therefore, it is a pregnancy category X.
4) An 18 y/o woman is taking a combined hormonal oral contraceptive. She
should be instructed to use a backup method for the prevention of pregnancy
a. Throughout the week of placebo pills
b. If prescribed topiramate (Topamax) for the treatment of migraines.
c. If prescribed amoxicillin/clavulanate (Augmentin) for a sinus infection
d. if she forgets to take a single dose of the contraceptive
Explanation: Anticonvulsant including phenytoin (Dilantin), carbamazepine
(Tegretol), primidone (Mysoline), topiramate (Topamax) and oxcarbazepine
(Trileptal) reduce the effectiveness of contraceptives. Depo-medroxyprogesterone
acetate injections or levonorgestrel- releasing intrauterine devices would be a
better method of contraceptive for patients taking anticonvulsants. Most
commonly used antibiotics have not been proven to reduce the effectiveness of
contraceptives. Rifampin is an exception, and additional …. Be used by women
taking this drug and using oral contraceptives, transdermal, or vaginal ring
preparations. Additional backup contraception should be used if taking antifungal
agents. No additional protection is needed thought the week of placebo pills.
, lOMoAR cPSD| 19878240
Missing one single dose of contraceptive does not require additional protection,
missing more than one doses does.
5) A 44 years old female patient has diabetes. Her total cholesterol (TC) is 250
mg/dl (6.5 mmol/L), LDL= 190 mg/dL (4.94 mmol/L), HDL= 25 mg/dL (65
mmol/L), and triglycerides= 344 mg/dL (8.94 mmol/L). What agent have the
greatest effect on improving her lipid profile and reducing morbidity and mortality
associates with dyslipidemia?
a. Niacin
(Niaspan) b.
Atorvastatin
c. Omega 3 fatty acids
d. Fenofibrates
Explanation: First and foremost, it is essential to educate individuals on a
hearthealthy lifestyle. LDL-C is one of the major culprits in the development of
atherosclerotic heart disease. The target level of LDL-C is between 50 to 70mg/dl
to prevent plaque formation in the blood vessels. Guidelines strongly recommend
statin therapy because they primarily lower LDL-C levels, but they also have the
secondary effects of lowering triglyceride and increasing HDL-C levels.
6) A 30 years old female comes into a clinic with classic signs and symptoms of
appendicitis. The NP fails to refer the patient to a surgeon. The appendix ruptures
and the woman die. This is an example of
a. Failure of diligence
b. Professional liability
c. Negligen
ce d.
Malpracti
APEA PREDICTOR EXAM QUESTIONS AND ANSWERS
WITH RATIONALE PRE-PREDICTOR LATEST VERSION
2025/2026
1) A 15 years old high school student with a mild sore throat and low-grade fever
that has persisted for about 3 weeks. She reports general malaise, fatigue, and loss
of appetite. The NP suspects mononucleosis. Which of the following is the
LEAST appropriate intervention?
a. Palpate the lymph nodes and spleen
b. Examine the posterior oropharynx for petechiae
c. Obtain a CBC, throat culture, and heterophil antibody test. d. Obtain an
urinalyses and serum for
, lOMoAR cPSD| 19878240
LFTs and amylase
Explanation: mononucleosis is a symptomatic infection caused by the Epstein-
Bar virus. Common is people 15-24 years of age. Common signs and symptoms
following incubation period (1-2 months) include fatigue, chills, malaise, anorexia,
white tonsillar exudates and lymphadenopathy or posterior cervical region.
Splenomegaly can be present. A maculopapular or occasionally a petechial rash
occurs in less than 15% of patients. A diagnosis is usually made using the
Monospot. In addition, neutropenia and lymphocytosis are usually detected in the
CBC.
2) A 32 years old male patient complaint of urinary frequency and burning on
urination for 3 days. Urinalyses reveals bacteriuria and positive nitrites. He denies
any past hx. Of urinary tract infections. The initial treatment should be:
a. trimethoprim-sulfamethoxazole (Bactrim, Sulfatrim) for 7-10 day
b. ciprofloxacin (Cipro) for 3-5 days
c. Trimethoprim-Sulfamethoxazole for 3 days
d. 750 mg ciprofloxacin as a one-time dose
Explanation: trimethoprim-sulfamethoxazole (TMPS) is usually n appropriate
medication to treat urinary tract infections in most patients. In the case of
community resistance to TMPS
>20%^, another medication should be substituted. In men, the appropriate length
of time is 7-10 days. Women may be treated for 3 days for uncomplicated UTI
3) Which agent is most effective for the treatment of nodulocystic acne?
a. Benzoyl peroxide (Benzac)
, lOMoAR cPSD| 19878240
b. Retinoic acid (Retin A)
c. Topical
tetracycline d.
Isotretinoin)
Explanation: Isotretinoin (Accutane) is a systemic agent indicated for treatment
with severe inflammatory acne. Guidelines for its use must be clearly understood
by the patient. A woman of childbearing age must use an effective method of
contraception because isotretinoin is teratogenic. There are many restrictions in
prescribing this medication because of the teratogenic effects is given during
pregnancy. Therefore, it is a pregnancy category X.
4) An 18 y/o woman is taking a combined hormonal oral contraceptive. She
should be instructed to use a backup method for the prevention of pregnancy
a. Throughout the week of placebo pills
b. If prescribed topiramate (Topamax) for the treatment of migraines.
c. If prescribed amoxicillin/clavulanate (Augmentin) for a sinus infection
d. if she forgets to take a single dose of the contraceptive
Explanation: Anticonvulsant including phenytoin (Dilantin), carbamazepine
(Tegretol), primidone (Mysoline), topiramate (Topamax) and oxcarbazepine
(Trileptal) reduce the effectiveness of contraceptives. Depo-medroxyprogesterone
acetate injections or levonorgestrel- releasing intrauterine devices would be a
better method of contraceptive for patients taking anticonvulsants. Most
commonly used antibiotics have not been proven to reduce the effectiveness of
contraceptives. Rifampin is an exception, and additional …. Be used by women
taking this drug and using oral contraceptives, transdermal, or vaginal ring
preparations. Additional backup contraception should be used if taking antifungal
agents. No additional protection is needed thought the week of placebo pills.
, lOMoAR cPSD| 19878240
Missing one single dose of contraceptive does not require additional protection,
missing more than one doses does.
5) A 44 years old female patient has diabetes. Her total cholesterol (TC) is 250
mg/dl (6.5 mmol/L), LDL= 190 mg/dL (4.94 mmol/L), HDL= 25 mg/dL (65
mmol/L), and triglycerides= 344 mg/dL (8.94 mmol/L). What agent have the
greatest effect on improving her lipid profile and reducing morbidity and mortality
associates with dyslipidemia?
a. Niacin
(Niaspan) b.
Atorvastatin
c. Omega 3 fatty acids
d. Fenofibrates
Explanation: First and foremost, it is essential to educate individuals on a
hearthealthy lifestyle. LDL-C is one of the major culprits in the development of
atherosclerotic heart disease. The target level of LDL-C is between 50 to 70mg/dl
to prevent plaque formation in the blood vessels. Guidelines strongly recommend
statin therapy because they primarily lower LDL-C levels, but they also have the
secondary effects of lowering triglyceride and increasing HDL-C levels.
6) A 30 years old female comes into a clinic with classic signs and symptoms of
appendicitis. The NP fails to refer the patient to a surgeon. The appendix ruptures
and the woman die. This is an example of
a. Failure of diligence
b. Professional liability
c. Negligen
ce d.
Malpracti
