NEW GENERATION APEA 3P EXAMS | REAL QUESTIONS AND
ANSWERS
APEA 3P Exam all questions answered 100% correct
1. Which headache sign does not warrant an immediate investigation
Answer: Relieved with use of common analgesics
2. During a migraine what happens to the cerebral arteries?
Answer: they dilate
3. You are evaluating a 15 year old patient for bipolar disorder. His parents tell you that he has
severe mood swings, is easily distracted, and constantly corrects his teachers. You would have a
high suspicion for bipolar if which symptom was present?
Answer: he sleeps less than 4 hours nightly
4. Which risk factor is not associated with breast cancer?
Answer: low socioeconomic status
5. A 26 year old woman with bulimia is likely to be:
Answer: of average weight
6. What medication is used to relieve acute wheezing in a patient with asthma?
Answer: short acting beta agonist
7. You are evaluating an 80 year old patient for recent episodes of incontinence and confusion.
His family states that this is unusual for him and he has become increasingly forgetful over the
past two weeks. Which medication might be responsible for this?
Answer: Tagamet (cimetidine)
8. What suggests hyperandrogenism in an adolescent female?
Answer: hirsutism
9. Which is a synovial joint?
Answer: shoulder
10. 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 to 2 ng/dL for the past 9 months. Today, the level is 0.4
ng/dL. What could account for this change?
Answer: regular use of an antacid
11. Which medication is contraindicated in a child with acute sinusitis?
Answer: nasal steroids
12. Which best describes the lower extremity calf pain associated with peripheral artery disease?
Answer: dull aching or cramping
13. Jugular venous distention accompanied by chest pain is associated with:
Answer: heart failure
14. Which immunization protects against a virus that is transmitted through blood and body
fluids and can lead to chronic liver disease?
Answer: Hepatitis C
15. A pediatric patient has areas of scaling on the scalp with round patches of hair loss. What is
the likely diagnosis?
Answer: tinea capitis
16. Your 70 year old patient complains of a sore mouth that prevents her from eating. On exam
you note a beefy red, glossy smooth tongue. What do you suspect?
Answer: pernicious anemia due to insufficient intrinsic factor
17. 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?
Answer: spinal stenosis
18. Which is not a typical symptom of late stage HIV?
Answer: persistent vomiting
19. A pregnant patient presents for her 16 week prenatal visit. Her blood pressure had reduced
from 118/79 to 109/68. What hemodynamic change is responsible for this?
Answer: decrease in systemic vascular resistance
20. Your 62 year old patient has been taking Griseofulvin 500 mg po BID for 3 weeks to treat
tinea capitis and has only had marginal improvement. What is your next step?
Answer: continue the current therapy for 6-8 weeks
21. Rapid HIV testing would be most appropriate for a patient with complaints of:
Answer: painful urination, dyspareunia, and penile or vaginal discharge
22. What is a frequent side effect of SSRIs?
Answer: sexual dysfunction
23. You might suspect small bowel obstruction in a patient who complains of:
Answer: vomiting and pain
24. What finding would be suggestive of osteosarcoma in a pediatric patient?
Answer: pain in the affected bone
25. What clinical manifestation suggests primary syphilis?
Answer: Chancre
26. What medication is used first line for a patient with benign positional vertigo?
Answer: meclizine
27. Which symptom is most associated with testicular torsion?
Answer: testicular pain
28. A clinical breast exam should include palpation at the tail of Spence. Where is this located?
Answer: laterally across the anterior axillary fold
29. Which area does not drain to the right lymph duct?
Answer: the right leg
30. Which presentation is most suspicious for penile cancer?
Answer: a nontender, indurated penile nodule
31. What is important to consider before prescribing metronidazole for giardiasis?
Answer: whether the patient drinks alcohol
32. In which condition would the use of triptans for migraine headaches be contraindicated?
Answer: hypertension
33. Which is a true statement about varicose veins?
Answer: They are more symptomatic during ovulation.
34. When measuring the fundal height of a pregnant woman at 32 weeks, which measurement
would prompt the nurse practitioner to suspect fetal growth restriction?
Answer: 29 cm
35. What is the term for excess fluid that accumulates in the pleural cavity between the visceral
and parietal spaces?
Answer: pleural effusion
36. Which pathogen is associated with common UTIs?
Answer: E coli
37. Which medication inhibits blood coagulation by selectively blocking the active site of factor
X
Answer: Eliquis (apixaban)
38. Which is a contraindication for menopausal estrogen replacement therapy in a 55 year old
woman?
Answer: prior breast or uterine carcinoma
39. During abdominal exam, which sound over the bulging area of the abdomen would indicate
ascitic fluid?
Answer: dullness
40. What is a typical finding in a patient with a meniscal tear?
Answer: positive McMurray's test
41. What is the most common presenting symptom of a woman with trichomoniasis?
Answer: vaginal discharge
42. What is the single dose treatment for chlamydia?
Answer: Zithromax (azithromycin) 1 g po
43. What is the mechanism of action of prostaglandin E1 in a patient with transposition of the
great arteries?
Answer: to produce vasodilation and adequate oxygen saturation
44. How do 5-alpha reductase inhibitors work to reduce the symptoms of BPH?
Answer: decrease the size of the prostate
45. Which condition is best treated by using alpha adrenergic antagonists?
Answer: overflow incontinence
46. What should not be prescribed for migraine prophylaxis in a 42 year old woman?
Answer: amitriptyline (Elavil)
47. How would a 60 year old man typically describe prostate pain?
Answer: Located in the perineum
48. What is the most common characteristic among patients with migraine headache?
Answer: family history
49. Which patient would be at highest risk for contracting TB?
Answer: A low income immigrant
50. Which is not a location of pain associated with kidney and ureter disorders?
Answer: suprapubic
51. Which medication is appropriate for a woman with bladder sphincter dysfunction and stress
incontinence?
Answer: Urispas (flavoxate)
52. Which condition is associated with chronic, bloody diarrhea?
Answer: Crohn's disease
53. Which medication is indicated for patients with Generalized Anxiety Disorder (GAD)?
Answer: Buspirone (Buspar)
54. At what point in pregnancy should Rh negative women receive Rhogam (Rho D immune
globulin)?
Answer: 28 weeks
55. Which is common among patients with psoriasis?
Answer: pitted nails and plaques
56. What historical finding may predispose a patient to testicular cancer?
Answer: cryptorchidism
57. What would you advise for a patient taking an oral glucocorticoid?
Answer: take it with food
58. A child with enuresis should be treated with nasal desmopressin (DDAVP) for which
symptom?
Answer: nocturnal enuresis
59. Which medication is contraindicated in a patient with sulfa allergy?
Answer: silver sulfadiazine (Silvadene)
60. What is likely to be elevated in a woman with polycystic ovarian syndrome?
Answer: insulin
61. Which medication should not be prescribed during an acute gout flare?
Answer: Allopurinol
62. A Hispanic woman at 26 weeks of pregnancy tells you that she has been eating ice. What
should the NP do?
Answer: check the patient for anemia
63. A 40 year old female patient has breasts with a soft texture, but uneven contour bilaterally.
What is the most likely diagnosis?
Answer: cystic breasts
64. What test of renal function is the best measure of renal insufficiency?
Answer: 24 hour creatinine clearance
65. You are seeing a 63 year old male who has decreased chest expansion, symmetric thorax with
moderate kyphosis, and bilateral diaphragm distention of 2 cm. What is the most likely
diagnosis?
Answer: COPD
66. Which cranial nerves are assessed when assessing bilateral eye movement?
Answer: III, IV, and VI
67. What pathological finding is noted in asthma?
Answer: hypertrophy of smooth muscle
68. Which type of incontinence is most likely in a patient with Alzheimer's disease who cannot
reach the toilet in time?
Answer: Functional
69. Using GTPAL nomenclature, how would you document a patient currently pregnant with a
history of an uncomplicated term vaginal delivery, preterm delivery of liveborn twins, and an 8
week elective abortion?
Answer: G4 T1 P1 A1 L3
70. The right lymphatic ducts drain into what part of the circulatory system?
Answer: venous
71. What is the most likely presenting symptom in a pediatric patient with croup?
Answer: A barking cough
72. Which medication targets postprandial glucose by blocking its transport across the intestine
into the bloodstream?
Answer: acarbose (Precose)
73. Which type of insulin will help to reduce nocturnal hypoglycemia?
Answer: long-acting
74. What symptoms in a college student living in a dorm would be suspicious for atypical
community acquired pneumonia?
Answer: temp of 101.2, sore throat, and diminished lung sounds on auscultation
75. How would you describe the lesions of condyloma accuminata in a male patient?
Answer: multiple papular lesions with a verrucous appearance
76. When performing a visual acuity test, the nurse practitioner notes 20/30 in the left eye and
20/60 in the right eye. The next step is to
Answer: Refer the patient to an ophthalmologist
77. The American Psychiatric Association's Diagnostic and Statistical Manual Disorder fifth
edition (DMS 5) describes Munchausen Syndrome by proxy as
Answer: A caregiver making up or causing an illness or injury in a person under his or her care
78. Symptoms of depression are a side effect of which neurotransmitter medication?
Answer: Dopamine
79. The right lymphatic ducts drain into what part of the circulatory system? (There are two
lymph ducts, the right lymphatic duct and the thoracic duct. The right drains lymph from the
right upper limb, the right side of thorax, and the right halves of head and neck. The thoracic duct
drains lymph into the circulatory system between the left subclavian and the left internal jugular
veins)
Answer: Venous
80. Which lesion is dark, raised and asymmetric with irregular borders?
Answer: Melanoma
81. A pediatric patient has areas of scaling on the scalp, with round patches of alopecia. This
clinical finding is consistent with
Answer: Tinea capitis
82. A patient with an acute presentation of acute aortic regurgitation (AR) typically presents with
sudden severe shortness of breath, lower extremity edema, a rapid heartbeat, and
Answer: Chest pain
83. Which of the following conditions is associated with chronic bloody diarrhea?
Answer: Crohn's disease
84. Which condition is caused by an insufficient production of intrinsic factor by the gastric
mucosa and vitamin B insufficiency?
Answer: Pernicious anemia
85. A 32 year old woman presents with dull puffiness of the eyes with pronounced non pitting
periorbital edema. This finding is suggestive of what condition?
Answer: Myxedema
86. A 52 year old woman is inquiring about estrogen replacement therapy for symptoms of
menopause. Which of the following is a contraindication
Answer: Prior breast or uterine carcinoma
87. Patient with asthma have a pathological finding of:
Answer: Hypertrophy of smooth muscle
88. A 65 year old patient with a history of a deep vein thrombosis (DVT) is being treated for a
dental abscess. Which antibiotics is safe to use with warfarin (Coumadin).
Answer: Amoxicillin (Amoxil)----[Penicillin abx]
89. What is the area of fundal height palpation on a woman who is 12 weeks pregnant?
Answer: At the level of the symphysis pubis (12 weeks)
90. Which of the following is NOT associated with assessment finding in a patient diabetic
retinopathy?
Answer: Papilledema (swelling of the optic nerve optic disk)
91. A 3 year old child has enterobiasis (PINWORM). When should the dose of mebendazole
(Vermox) be repeated?
Answer: In 2 weeks
92. Which area does not allow lymphatic fluid to be drained from the right lymph duct?
Answer: The right leg
93. Snellen chart evaluation indicates that a patient's vision is 20/30. What is the proper
description of this result?
Answer: At 20 feet, this patient can see what a person with normal vision can see at 30 feet
94. Based on the mechanism of hearing, sensorineural loss in an adult involves the?
Cochlea and the cochlea nerve
95. Which of the appropriate medication choice for a 31 year old pregnant patient diagnosed with
a urinary tract infection?
Answer: Nitrofurantoin (Macrobid) or Ciprofloxacin (Cipro)
96. Pregnant women are evaluated for syphilis with serology testing because?
Answer: Syphilis during pregnancy predisposes the fetus to spontaneously abort or the newborn
to have congenital syphilis.
97. Which of the following is a typical finding in a patient with a meniscal tear?
Answer: A positive McMurray's test
98. Hyperkalemia is associated with:
Answer: Diminished renal function
99. Short bands of tough, flexible, ropelike, collagen fibrils that connect two bones is called:
Answer: Ligaments
100. The finding of a dome-shaped lesion in the dermis that forms a benign closed, firm sac
attached to the epidermis is?
Answer: a cutaneous cyst
101. Vitamins prescribed for pregnant women should contain what two components?
Answer: Folic acid and Iron
102. A prostate gland that is found to be tender, swollen, boggy, and warm on a digital rectal
exam is consistent with:
Answer: Acute bacterial prostatitis
103. Which medication can cause a false positive result for amphetamines in a urine drug screen?
Answer: Bupropion
104. Fine, silky appearance of the hair is a common finding in:
Answer: Hyperthyroidism
105. Which of the following is commonly associated with increased risk for prostatic
hypertrophy?
Answer: Urinary tract infections
106. Patients with bacterial meningitis experience headache symptoms due to:
Answer: Increased intracranial pressure
107. What diagnostic test is performed to diagnose acute lymphocytic leukemia (ALL)?
Answer: A bone marrow examination
108. Which of the following medications should NOT be prescribed during an acute gout flare?
Answer: Allopurinol (Zyloprim)
109. What is the appropriate prophylactic medication for an 18 year old woman with a past
medical history of migraine headache?
Answer: Propranolol
110. Which of the following is the single dose treatment for a patient with diagnose chlamydia?
Answer: Azithromycin (Zithromax) 1 gram orally
111. The nurse practitioner prescribes deferoxamine (Desferal) for a pediatric patient with beta
thalassemia and hemosiderosis because the medication:
Answer: Eliminates excessive iron and prevent organ damage.
112. The combination of benzoyl peroxide and erythromycin is prescribed for acne because
benzoyl peroxide:
Answer: Decreases the risk of resistance to erythromycin
113. Which of the following conditions is NOT associated with the symptom of hemoptysis?
Answer: Viral pneumonia
114. Why would a combined hormonal contraceptive be contraindicated in a 36 year old patient
with a past medical history of Type 2 diabetes, obesity, current smoking and sedentary lifestyle?
Answer: Her age and tobacco use
115. During the breast examination of a perimenopausal woman. The NP detects a bloody
spontaneous discharge from the right nipple. This indicates further evaluation for:
Answer: An intraductal papilloma (a small, benign tumor that forms in a milk duct in the breast)
116. A 26 year old woman complains of acute right lower abdominal pain. Which of the
following conditions is NOT associated with this symptom?
Answer: Irritable bowel syndrome
117. During an abdominal examination, the nurse practitioner percusses the bulging area of the
abdomen. Which sound suggest the presence of ascitic fluid?
Answer: Dullness
118. What is the drug of choice for the pediatric patient diagnosed with scabies?
Answer: Permethrin (Nix) cream
119. When interpreting a complete blood count (CBC) lab report which of the following results
describes the size of the RBC's?
Answer: Mean corpuscular volume (MCV) [An MCV blood test measures the average size of
your red blood cells, also known as erythrocytes]
120. What medication should be avoided when prescribing prophylactic therapy for headache in
a patient with a past history of asthma and chronic migraines?
Answer: Propranolol
121. A nonpregnant woman diagnosed with trichomoniasis should be treated with
Answer: Metronidazole (Flagyl)
122. A 17 year old is diagnosed with mild bronchospasm. Which of the following would provide
relief?
Answer: Inhaled levalbuterol (Xopenex)
123. Which patient causes the greatest concern for complication related to scoliosis?
Answer: 17-year-old girl with a 10 degree curve
124. Which of the following complaints best describes lower extremity calf pain associated with
peripheral artery disease?
Answer: A dull pain or cramp
125. The immunization that protect against the contagious disease that cause fever, headache,
stiff neck, photophobia, and altered mental status is?
Answer: Meningococcal vaccine
126. A 75 year old man who recently lost his spouse of 50 year in an auto accident tells the nurse
practitioner that he "has no purpose in this life". The next most appropriate question for the nurse
practitioner to ask is:
Answer: "Have you thought about hurting yourself?"
127. Which of the following conditions is NOT a typical finding of hyperprolactinemia in a 47
year old premenopausal woman?
Answer: Gynecomastia
128. Which structure in the eye is affected by cataract disease?
Answer: The lens
129. Which medication is used as an anticoagulant reversal agent for dabigatran etexilate
(Pradaxa)?
Answer: Idarucizumab (Praxbind)
130. Which immunization reduces a patient's risk for infection with the virus that causes painful,
localized, blistering rash?
Answer: Shingles (herpes zoster)
131. A 34 year old man presents with complaints of abdominal pain. The nurse practitioner
suspects hemorrhagic pancreatitis due to finding of superficial edema, bruising around the
umbilicus, and what other assessment finding?
Answer: A positive Cullen's sign (Cullen's sign is superficial edema and bruising
