3P APEA EXAM questions with verified answers
graded A+ already passed
1. Difference between varicose vein and arteriosclerosis Is the
attected vessel
Arteriosclerosis attects
ar- teries whereas
varicose veins attects
veins
2. A patient has poorly controlled hypertension for more 5th ICS, left
of MCL
than 10 years. Indicate the most likely position
of his point of maximal impulse (PMI)
3. 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
4. A patient who has diabetes presents with
pain in his lower legs when he walks and pain
resolution with rest. When specifically asked
about his pain in his lower leg, he likely will
report pain
mitral stenosis
in the calf muscle
5. A patient with hypertension describes a previous
hydrochlorothiazide
gic reaction to a sulfa antibiotic as "sloughing
of skin" and hospitalization. Which medication is
contraindicat- ed in this patient?
aller-
6. A 75 year old patient who has aortic stenosis wants to shortness of
breath and
know what symptoms indicate worsening of his steno- syncope
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3P APEA EXAM questions with verified answers
graded A+ already passed
sis. the NP replies:
7. A 74 year old patient has PAD. Which item listed below diabetes
is an important nonmodifiable risk factor for PAD?
8. Benazepril should be d/c immediately if
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pregnancy occurs
3P APEA EXAM questions with verified answers
graded A+ already passed
9. aortic regurgitation characteristics
long
asymptomatic
period
follow
by
exercise intoler- ance,
then dyspnea at rest
10. DVT classic symptoms
swelling, pain, and
discol- oration of lower
extremity
11. Characteristic of ACE-induced cough is that?
weeks
usually begins two
of starting therapy
12. Valve most commonly involved in chronic
rheumatic heart disease
mitral
13. Medication that can exacerbate HF
naproxen
14. Patient taking ACE inhibitors should avoid?
supplements
potassium
15. Grade 3 murmur indication for a referral
a fixed split
16. Group of meds used to treat HF
verapamil
fosinopril, HCTZ,
17. Mr. Smith is a 72-year-old patient who takes
warfarin for chronic A-fib. INR today is 4.0.
the NP should:
stop the warfarin
today and repeat INR
tomorrow
18. According to the NHLBI, which characteristic is a coro- diabetes
mellitus
nary heart disease risk equivalent, that is,
which risk factor places the pt. as a CHD risk
similar to a hx of CHD
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3P APEA EXAM questions with verified answers
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19. good drug to reduce morbidity and
mortality in mild HF
metoprolol
20. A pt. taking atorvastatin newly diagnosed with dyslipi- Stop the
atorvastatin imdemia complaints of fatigue, weakness, and muscle
mediately
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3P APEA EXAM questions with verified answers
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aches in his lower back, arms, legs for the past 3
days. it is not improved with rest How should
this be evalu- ated?
21. symptom not indicative of HF
headache
22. What class of meds is preferred to
normalized lipid levels and reduce risk of
cardiac events
HMG CoA reductase inhibitors
23. Highest sensitivity in diagnosing HF
BNP
24. The NP is caring for a 74-year-old who had an ACE, ASA, beta blockers,
acute coronary syndrome 6 weeks ago. What and statin
medications should be part of his regimen
unless contraindicated
25. patient with the highest systolic B/P
75-year-old male
26. test that is most cost effective to screen for abdominal abdominal
ultrasound
aortic aneurysm
27. a 74-year-old patient has had an increase in
Calcium channel blocker
b/p since the last exam. his b/p has increased
from 144/90 to reading in the upper
160's/upper 80's. If medication is to be started
on this patient, what would be a good first
choice?
28. Factor contributing to the development of AAA cigarette smoking
29. 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?
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initiate amlodipine 5mg
daily
3P APEA EXAM questions with verified answers
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30. Usual course of treatment for mitral valve prolapse is benign
6 / 19
3P APEA EXAM questions with verified answers
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31. A 50-year-old patient with hypertension has add another drug from
taken HCTZ 25mg daily for the past 4 weeks. another class to the daily
Her b/p has decreased from 155/95 to 145/90.
25mg HCTZ
How should the NP proceed?
32. A patient with mitral valve prolapse reports chest pain metoprolol
and frequent arrhythmias. In the absence of
other car- diac anomalies, the drug of choice to
treat her symp- toms is:
33. which hypertensive pt. is most likely to have
adverse b/p effects from excessive sodium
consumption?
a 70-year-old African
American
34. where would the murmur associated w/mitral regurgi- mitral
listening point
tation best be auscultated?
35. A pt. with a positive hx of a tick bite 2 weeks 39. A 15-yearold male
ago and erythema migrans has a positive
has worked
ELISA for borrelia burgdorferi. The Western
this summer
blot is positive. How should he be managed?
as a life36. a pt. has/seborrheic dermatitis. Which
guard at a
vehicle would be most appropriate to use in
local
the hairline area to treat this?
swimming
pool. He
37. A microscopic exam of the sample taken
complains of
from a skin lesion indicates hyphae. What type
itchof infection might this indicate?
38. A pt. has been dx w/MRSA. she is allergic to
sulfa. Which medication could be used to
treat her?
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3P APEA EXAM questions with verified answers
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he should receive Doxycy- cline for Lyme disease
foam
fungal
doxycycline
8 / 19
3P APEA EXAM questions with verified answers
graded A+ already passed
ing in the groin area. He is dx with tinea cruris. The NP well
marginated half moon
is likely to identify
shape macules on the
in- ner thigh
40. A pt. exhibits petechiae on both lower legs w/o order a CBC
other complaints. How should the NP
proceed?
41. A pt. has been dx w/scabies. What is the medication of permethrin
and good
choice to treat this?
hand
42. A pt. has been in the sun for the past few
hygiene
weeks and has developed darkened skin and
numerous 3-6 mm light-colored, flat lesions on tinea
his trunk. What is the likely etiology?
vesicolor
43. Which vehicle is least appropriate in a pt.
w/atopic dermatitis?
44. a pt. presents w/small vesicles on the lateral edges
of his fingers and intense itching. there are small lotions
vesicles on the palmar surface of the hand. What
is this called?
dyshidrotic dermatitis
45. a low-potency topical hydrocortisone cream would
be most appropriate in a pt. who has been dx
with?
atopic dermatitis
46. most common form of skin cancer
basal cell carcinoma
47. greatest percutaneous absorption areas in the body
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genitalia
3P APEA EXAM questions with verified answers
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48. most common place for basal cell carcinoma
face
49. A 74-year-old is dx w/shingles. The NP is deciding how an oral
antiviral agent
to best manage her care. What should be prescribed?
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19
3P APEA EXAM questions with verified answers
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50. the American Cancer Society uses an ABCDE
Mneu- monic to help pt.'s develop awareness of
suspicious skin lesions what do they
represent?
A= asymetry
B=border
C=color
D=diameter
E=enlarging or
elevated
51. characteristic of shingles
single dermatome
attect- ed
52. an example of a premalignant lesion that develops on actinic
keratosis
sun-damaged skin is:
53. A patient w/Diabetes has right anterior shin
edema, erythema, warmth, and tenderness to
touch. This de- veloped over the past 3 past.
There is no visible pus. What is the most likely
diagnosis to consider?
54. A pt. was burned w/hot water. He has several
2-3 cm fluid-filled lesions. What are theses
termed?
cellulitis
bullae
stage II
55. A wound has the following
characteristics; par- tial thickness loss of
dermis, a shallow open ulcer
w/red/pink bed, and no evidence of sloughing.
What stage of pressure ulcer does this
describe?
56. A pt. present w/plaques on the extensor surface of the Plaque
psoriasis
elbows, knees, and back. The plaques are
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19
3P APEA EXAM questions with verified answers
graded A+ already passed
erythema- tous and thick, silvery scale are
present. This is likely:
57. An adolescent has acne. The NP prescribed a
benzoyl peroxide product for him. What
important teaching point should be given to
this adolescent regarding the benzoyl
peroxide.
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19
photosensitivity of the
skin can occur
3P APEA EXAM questions with verified answers
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58. A 76-year-old obese pt. has fatigue, thirst,
and fre- quent urination. She was asked to
measure AM fast- ing glucose values for 1
week. The values range from 142-175 this pt:
can be dx w/DMT2
59. The most appropriate time to begin screening for renal at diagnosis
nephropathy in a pt w/ T2DM
60. In order to determine how much T4 replacement a pt. the pt.'s
body weight
needs to reestablish a euthyroid state, the NP
consid- ers:
61. A pt. has been dx w/T2DM. A criterion for dx is:
a fasting glucose > or
equal to 126 and confirmed on a previous
day.
62. the most appropriate screen for diabetic nephropathy urinary
albumin to creatinine ration and eGFR
63. a 38-year-old male pt. presents for his
Hyperthyroidism
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?
64. a pt. has two fasting glucose values of 121 and 136 that should
have an Hgb A1C
were measured on 2 separate days in the same 65. a diabetic
pt.
week. This pt:
w/albuminu
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19
3P APEA EXAM questions with verified answers
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ria has been placed on an ACE inhibitor. How
soon can the antiproteinuric effect of the ACEi
be realized for this pt.
66. how does hyperthyroidism affect b/p
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performed
6-8 weeks
3P APEA EXAM questions with verified answers
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by producing an
increase in systolic
and diastolic
readings
67. Symptoms least likely associated with
DMT2 fatigue, constipation, athletes
foot, impetigo
constipation
68. What is the relationship between Hgb A1C
and lipid values?
As Hgb A1C decreases,
triglycerides decrease
69. when the serum free T4 falls:
the TSH rises
70. earliest detectable glycemic abnormality in
a pt. w/t2DM
postprandial glucose
ele- vation
71. acanthosis nigricans in a teen suggest?
insulin resistant
72. risk factor for T2DM?
History of gestational
dia- betes
73. a 40-year-old pt. with newly dx of T2DM asks
what his target b/p should be. the most
correct answer is:
less than 140/90
74. the following values TSH 14, free T4 0.1 is indicative of?
hypothyroidism
75. diabetic medication associated with diarrhea
and flat- ulence
76. 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
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19
every 30
days, but in
the last 3
months her
menses
have varied
3P APEA EXAM questions with verified answers
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between 30-45 days . Her TSH value is 13. It was metformin
repeated 1week later and found to be 15.
What explains this finding?
hypothyroidism
16 /
19
3P APEA EXAM questions with verified answers
graded A+ already passed
77. A pt. who is taking who is taking a longAM fasting
acting insulin basal insulin has elevated
blood sugars. Which blood sugars are
important to review in order to increase the dose
of insulin?
78. A pt. has a TSH value of 13.1 today. The NP has
decided 6 weeks to initiate replacement with
levothyroxine 88mcg daily. When should the NP
recheck pt's TSH levels
79. A pt. presents with consistently elevated
blood glu- cose before his evening meal.
What choice below represents an insulin
change that would improve his evening
glucose?
current AM regimen 22u NPH, 12u short-acting
insulin Current PM regimen 10u NPH, 8u
short-acting insulin
type
1
diab
etes
is
83. what is the
most
sensitive lab
assay for
80. A 30-year-old female pt. with complaints of
screening
fatigue undergoes a screening TSH. Her TSH is 8
and
what should be done next?
identifying
81. A 65-year-old diabetic has been on oral
the vast
antihyper- glycemic agents and is still having
majority of
poor glycemic con- trol. His AM fasting glucose
ambulatory
range from 140-160. You decide to add insulin.
pt.'s w/
He weighs 127 kg. What should the NP order
primary
as an initial starting dose?
hypothyroid
ism
82. the most appropriate time to screen
for renal nephropathy in a pt. with
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3P APEA EXAM questions with verified answers
graded A+ already passed
24u NPH insulin in AM
repeat the TSH and add T4
10u of long-acting insulin at bedtime
5 years after diagnosis
TSH only
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19
3P APEA EXAM questions with verified answers
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84. A 52-year-old presents w/thirst and frequent urination start insulin
today. His glucose is 352. How should this be
managed today?
85. +what is the significance of AV nicking?
this is indicative of
long- standing
hypertension
86. Mr O. has been dx w/hearing loss secondary to aspirin
an exposure to an ototoxic medication. Which
one may be associated with ototoxicity?
87. yellowish, triangular nodule near the iris
is a pinguecula
88. a 93-year-old demented pt. has been recently presence of foreign
treated w/an URI but drainage from the right body
nostril persists. What should the NP suspect?
89. A 70-year-old pt. has begun to have hearing loss.
She relates that her elderly parents had difficulty inability to hear consohearing. Which complaints below is typical of nants
presbycusis?
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