APEA Predictor Exam Test Bank 2026 – 200+
FNP/AGPCNP Practice Questions with
Verified Answers for NP Certification Prep &
Board Exam Success
• This test bank features 200+ rigorous FNP/AGPCNP-style practice questions
modeled after the APEA Predictor Exam, covering the full breadth of topics tested
on NP certification and board exams with verified correct answers and detailed
EXPERT RATIONALE.
• To maximize your score, work through each question independently before
checking the answer, use the EXPERT RATIONALE to reinforce clinical reasoning,
and revisit any topic area where you miss two or more questions in a row.
1. A 58-year-old male presents with a fasting blood glucose of 128 mg/dL on
two separate occasions. He has a BMI of 31 and a family history of type 2
diabetes. Which of the following is the most appropriate initial management?
A. Begin insulin glargine immediately
B. Order a C-peptide level before initiating therapy
C. Initiate metformin and recommend lifestyle modification
D. Refer to endocrinology before starting any treatment
E. Prescribe a sulfonylurea as first-line pharmacotherapy
Correct Answer: C. Initiate metformin and recommend lifestyle
modification
Metformin is the first-line pharmacologic agent for type 2 diabetes per ADA
guidelines, combined with lifestyle changes including diet and exercise. It is safe,
effective, inexpensive, and has a favorable cardiovascular profile.
,2. A 34-year-old woman at 10 weeks gestation presents with a urine culture
growing >100,000 CFU/mL of E. coli. She is asymptomatic. What is the most
appropriate treatment?
A. No treatment is needed since she is asymptomatic
B. Recommend increased fluid intake and repeat culture in 2 weeks
C. Treat with ciprofloxacin for 7 days
D. Treat with nitrofurantoin for 5–7 days
E. Refer to OB for hospitalization and IV antibiotics
Correct Answer: D. Treat with nitrofurantoin for 5–7 days
Asymptomatic bacteriuria in pregnancy requires treatment to prevent progression
to pyelonephritis and preterm labor. Nitrofurantoin is safe in the first and second
trimesters and is a first-line agent. Ciprofloxacin is contraindicated in pregnancy.
3. A 45-year-old male with hypertension and type 2 diabetes presents for
routine follow-up. His blood pressure today is 148/92 mmHg. He is currently
on lisinopril 10 mg daily. Which of the following is the best next step?
A. Add a beta-blocker
B. Switch to amlodipine monotherapy
C. Increase lisinopril dose or add a thiazide diuretic
D. Add spironolactone
E. Refer to nephrology
Correct Answer: C. Increase lisinopril dose or add a thiazide diuretic
In a diabetic patient with hypertension, ACE inhibitors are first-line due to
renoprotective effects. If the BP target is not achieved, the next step is to uptitrate
the current agent or add a complementary agent such as a thiazide diuretic per JNC
guidelines.
,4. Which of the following findings is most consistent with hypothyroidism?
A. Exophthalmos and lid lag
B. Heat intolerance and diaphoresis
C. Weight loss and fine tremor
D. Bradycardia, constipation, and dry skin
E. Atrial fibrillation and palpitations
Correct Answer: D. Bradycardia, constipation, and dry skin
Hypothyroidism results from insufficient thyroid hormone production, leading to
slowing of metabolic processes. Classic features include bradycardia, constipation,
dry skin, cold intolerance, fatigue, and weight gain.
5. A 67-year-old woman presents with progressive shortness of breath on
exertion, orthopnea, and bilateral ankle edema. On exam, you note an S3
gallop. Which diagnosis is most likely?
A. Pulmonary embolism
B. Cardiac tamponade
C. Congestive heart failure
D. Chronic obstructive pulmonary disease
E. Nephrotic syndrome
Correct Answer: C. Congestive heart failure
An S3 gallop, orthopnea, exertional dyspnea, and bilateral edema are hallmark
features of heart failure with reduced ejection fraction (HFrEF). The S3 sound is
caused by rapid ventricular filling in a volume-overloaded heart.
, 6. A 29-year-old woman presents with a 3-day history of dysuria, urinary
frequency, and suprapubic discomfort. Urinalysis shows positive leukocyte
esterase and nitrites. What is the most appropriate treatment?
A. Amoxicillin-clavulanate for 10 days
B. Trimethoprim-sulfamethoxazole (TMP-SMX) for 3 days
C. Azithromycin single dose
D. Levofloxacin for 14 days
E. Doxycycline for 7 days
Correct Answer: B. Trimethoprim-sulfamethoxazole (TMP-SMX) for 3 days
Uncomplicated UTI in a non-pregnant woman is treated with a 3-day course of
TMP-SMX as first-line therapy. It is effective, inexpensive, and well-tolerated when
local resistance rates are below 20%.
7. A 72-year-old male with a history of atrial fibrillation is on warfarin. His INR
today is 5.8 and he has no signs of active bleeding. What is the most
appropriate management?
A. Continue warfarin and recheck INR in 1 week
B. Hold warfarin, administer vitamin K 10 mg IV
C. Administer fresh frozen plasma immediately
D. Hold warfarin for 1–2 doses and recheck INR in 24–48 hours
E. Switch to heparin infusion
Correct Answer: D. Hold warfarin for 1–2 doses and recheck INR in 24–48
hours
For an elevated INR between 5.0 and 9.0 without active bleeding, guidelines
recommend holding warfarin for one or two doses and rechecking the INR. Vitamin
K is reserved for INR >9 or patients with bleeding risk factors.
FNP/AGPCNP Practice Questions with
Verified Answers for NP Certification Prep &
Board Exam Success
• This test bank features 200+ rigorous FNP/AGPCNP-style practice questions
modeled after the APEA Predictor Exam, covering the full breadth of topics tested
on NP certification and board exams with verified correct answers and detailed
EXPERT RATIONALE.
• To maximize your score, work through each question independently before
checking the answer, use the EXPERT RATIONALE to reinforce clinical reasoning,
and revisit any topic area where you miss two or more questions in a row.
1. A 58-year-old male presents with a fasting blood glucose of 128 mg/dL on
two separate occasions. He has a BMI of 31 and a family history of type 2
diabetes. Which of the following is the most appropriate initial management?
A. Begin insulin glargine immediately
B. Order a C-peptide level before initiating therapy
C. Initiate metformin and recommend lifestyle modification
D. Refer to endocrinology before starting any treatment
E. Prescribe a sulfonylurea as first-line pharmacotherapy
Correct Answer: C. Initiate metformin and recommend lifestyle
modification
Metformin is the first-line pharmacologic agent for type 2 diabetes per ADA
guidelines, combined with lifestyle changes including diet and exercise. It is safe,
effective, inexpensive, and has a favorable cardiovascular profile.
,2. A 34-year-old woman at 10 weeks gestation presents with a urine culture
growing >100,000 CFU/mL of E. coli. She is asymptomatic. What is the most
appropriate treatment?
A. No treatment is needed since she is asymptomatic
B. Recommend increased fluid intake and repeat culture in 2 weeks
C. Treat with ciprofloxacin for 7 days
D. Treat with nitrofurantoin for 5–7 days
E. Refer to OB for hospitalization and IV antibiotics
Correct Answer: D. Treat with nitrofurantoin for 5–7 days
Asymptomatic bacteriuria in pregnancy requires treatment to prevent progression
to pyelonephritis and preterm labor. Nitrofurantoin is safe in the first and second
trimesters and is a first-line agent. Ciprofloxacin is contraindicated in pregnancy.
3. A 45-year-old male with hypertension and type 2 diabetes presents for
routine follow-up. His blood pressure today is 148/92 mmHg. He is currently
on lisinopril 10 mg daily. Which of the following is the best next step?
A. Add a beta-blocker
B. Switch to amlodipine monotherapy
C. Increase lisinopril dose or add a thiazide diuretic
D. Add spironolactone
E. Refer to nephrology
Correct Answer: C. Increase lisinopril dose or add a thiazide diuretic
In a diabetic patient with hypertension, ACE inhibitors are first-line due to
renoprotective effects. If the BP target is not achieved, the next step is to uptitrate
the current agent or add a complementary agent such as a thiazide diuretic per JNC
guidelines.
,4. Which of the following findings is most consistent with hypothyroidism?
A. Exophthalmos and lid lag
B. Heat intolerance and diaphoresis
C. Weight loss and fine tremor
D. Bradycardia, constipation, and dry skin
E. Atrial fibrillation and palpitations
Correct Answer: D. Bradycardia, constipation, and dry skin
Hypothyroidism results from insufficient thyroid hormone production, leading to
slowing of metabolic processes. Classic features include bradycardia, constipation,
dry skin, cold intolerance, fatigue, and weight gain.
5. A 67-year-old woman presents with progressive shortness of breath on
exertion, orthopnea, and bilateral ankle edema. On exam, you note an S3
gallop. Which diagnosis is most likely?
A. Pulmonary embolism
B. Cardiac tamponade
C. Congestive heart failure
D. Chronic obstructive pulmonary disease
E. Nephrotic syndrome
Correct Answer: C. Congestive heart failure
An S3 gallop, orthopnea, exertional dyspnea, and bilateral edema are hallmark
features of heart failure with reduced ejection fraction (HFrEF). The S3 sound is
caused by rapid ventricular filling in a volume-overloaded heart.
, 6. A 29-year-old woman presents with a 3-day history of dysuria, urinary
frequency, and suprapubic discomfort. Urinalysis shows positive leukocyte
esterase and nitrites. What is the most appropriate treatment?
A. Amoxicillin-clavulanate for 10 days
B. Trimethoprim-sulfamethoxazole (TMP-SMX) for 3 days
C. Azithromycin single dose
D. Levofloxacin for 14 days
E. Doxycycline for 7 days
Correct Answer: B. Trimethoprim-sulfamethoxazole (TMP-SMX) for 3 days
Uncomplicated UTI in a non-pregnant woman is treated with a 3-day course of
TMP-SMX as first-line therapy. It is effective, inexpensive, and well-tolerated when
local resistance rates are below 20%.
7. A 72-year-old male with a history of atrial fibrillation is on warfarin. His INR
today is 5.8 and he has no signs of active bleeding. What is the most
appropriate management?
A. Continue warfarin and recheck INR in 1 week
B. Hold warfarin, administer vitamin K 10 mg IV
C. Administer fresh frozen plasma immediately
D. Hold warfarin for 1–2 doses and recheck INR in 24–48 hours
E. Switch to heparin infusion
Correct Answer: D. Hold warfarin for 1–2 doses and recheck INR in 24–48
hours
For an elevated INR between 5.0 and 9.0 without active bleeding, guidelines
recommend holding warfarin for one or two doses and rechecking the INR. Vitamin
K is reserved for INR >9 or patients with bleeding risk factors.
