APEA 3P EXAM/ ACTUAL EXAM
QUESTIONS AND 100% VERIFIED
ANSWERS WITH RATIONALES
GRADED A+ LATEST
Question 1
A 52-year-old woman presents with fatigue, cold intolerance, weight gain, and
constipation. Laboratory results reveal TSH 9.8 mIU/L and free T4 below normal.
What is the most appropriate initial management?
A. Start levothyroxine therapy
B. Repeat thyroid studies in 6 weeks
C. Start liothyronine
D. Order thyroid ultrasound
Correct Answer: A
Rationale:
Elevated TSH with low free T4 confirms overt hypothyroidism. First-line
treatment is levothyroxine. Delaying therapy is inappropriate once diagnosis is
confirmed.
Question 2
A 67-year-old man with long-standing hypertension presents with new onset atrial
fibrillation. His CHA₂DS₂-VASc score is 3. What is the best management to reduce
stroke risk?
A. Aspirin therapy
B. Dual antiplatelet therapy
C. Oral anticoagulation
D. No therapy required
,Correct Answer: C
Rationale:
A CHA₂DS₂-VASc score ≥2 in men warrants anticoagulation to reduce stroke risk.
Aspirin alone is insufficient.
Question 3
A patient with type 2 diabetes presents with burning pain and numbness in both
feet, worse at night. Which medication is most appropriate for initial management?
A. Acetaminophen
B. Amitriptyline
C. Gabapentin
D. Ibuprofen
Correct Answer: C
Rationale:
Gabapentin is a first-line agent for diabetic peripheral neuropathy due to its
efficacy and tolerability.
Question 4
A 28-year-old woman presents with pelvic pain and fever 2 days after insertion of
an intrauterine device. Which organism is most commonly associated?
A. Escherichia coli
B. Neisseria gonorrhoeae
C. Chlamydia trachomatis
D. Staphylococcus aureus
Correct Answer: B
Rationale:
Pelvic inflammatory disease shortly after IUD insertion is most commonly
associated with sexually transmitted pathogens, particularly Neisseria gonorrhoeae.
,Question 5
A 60-year-old man reports progressive exertional dyspnea. Physical exam reveals a
harsh systolic murmur at the right upper sternal border radiating to the carotids.
What is the most likely diagnosis?
A. Mitral regurgitation
B. Aortic stenosis
C. Pulmonic stenosis
D. Tricuspid regurgitation
Correct Answer: B
Rationale:
Aortic stenosis classically presents with exertional dyspnea and a systolic murmur
radiating to the carotids.
Question 6
A 34-year-old woman presents with unilateral facial drooping involving the
forehead. What is the most appropriate initial treatment?
A. Acyclovir alone
B. Prednisone
C. Antibiotics
D. Observation only
Correct Answer: B
Rationale:
Bell’s palsy involves the entire face and is treated with corticosteroids to reduce
nerve inflammation.
, Question 7
A 72-year-old patient presents with confusion, agitation, and fluctuating levels of
consciousness. Which condition is most likely?
A. Dementia
B. Delirium
C. Depression
D. Psychosis
Correct Answer: B
Rationale:
Delirium is characterized by acute onset, fluctuating course, and altered level of
consciousness.
Question 8
A patient with chronic kidney disease has a potassium level of 6.2 mEq/L with
ECG changes. What is the priority intervention?
A. Oral sodium polystyrene
B. IV calcium gluconate
C. Loop diuretics
D. Insulin infusion only
Correct Answer: B
Rationale:
IV calcium gluconate stabilizes cardiac membranes and is the first priority when
ECG changes are present.
Question 9
A 45-year-old woman presents with morning stiffness lasting over one hour and
symmetric joint pain in the hands. Which lab finding supports the diagnosis?
A. Elevated uric acid
B. Positive rheumatoid factor
QUESTIONS AND 100% VERIFIED
ANSWERS WITH RATIONALES
GRADED A+ LATEST
Question 1
A 52-year-old woman presents with fatigue, cold intolerance, weight gain, and
constipation. Laboratory results reveal TSH 9.8 mIU/L and free T4 below normal.
What is the most appropriate initial management?
A. Start levothyroxine therapy
B. Repeat thyroid studies in 6 weeks
C. Start liothyronine
D. Order thyroid ultrasound
Correct Answer: A
Rationale:
Elevated TSH with low free T4 confirms overt hypothyroidism. First-line
treatment is levothyroxine. Delaying therapy is inappropriate once diagnosis is
confirmed.
Question 2
A 67-year-old man with long-standing hypertension presents with new onset atrial
fibrillation. His CHA₂DS₂-VASc score is 3. What is the best management to reduce
stroke risk?
A. Aspirin therapy
B. Dual antiplatelet therapy
C. Oral anticoagulation
D. No therapy required
,Correct Answer: C
Rationale:
A CHA₂DS₂-VASc score ≥2 in men warrants anticoagulation to reduce stroke risk.
Aspirin alone is insufficient.
Question 3
A patient with type 2 diabetes presents with burning pain and numbness in both
feet, worse at night. Which medication is most appropriate for initial management?
A. Acetaminophen
B. Amitriptyline
C. Gabapentin
D. Ibuprofen
Correct Answer: C
Rationale:
Gabapentin is a first-line agent for diabetic peripheral neuropathy due to its
efficacy and tolerability.
Question 4
A 28-year-old woman presents with pelvic pain and fever 2 days after insertion of
an intrauterine device. Which organism is most commonly associated?
A. Escherichia coli
B. Neisseria gonorrhoeae
C. Chlamydia trachomatis
D. Staphylococcus aureus
Correct Answer: B
Rationale:
Pelvic inflammatory disease shortly after IUD insertion is most commonly
associated with sexually transmitted pathogens, particularly Neisseria gonorrhoeae.
,Question 5
A 60-year-old man reports progressive exertional dyspnea. Physical exam reveals a
harsh systolic murmur at the right upper sternal border radiating to the carotids.
What is the most likely diagnosis?
A. Mitral regurgitation
B. Aortic stenosis
C. Pulmonic stenosis
D. Tricuspid regurgitation
Correct Answer: B
Rationale:
Aortic stenosis classically presents with exertional dyspnea and a systolic murmur
radiating to the carotids.
Question 6
A 34-year-old woman presents with unilateral facial drooping involving the
forehead. What is the most appropriate initial treatment?
A. Acyclovir alone
B. Prednisone
C. Antibiotics
D. Observation only
Correct Answer: B
Rationale:
Bell’s palsy involves the entire face and is treated with corticosteroids to reduce
nerve inflammation.
, Question 7
A 72-year-old patient presents with confusion, agitation, and fluctuating levels of
consciousness. Which condition is most likely?
A. Dementia
B. Delirium
C. Depression
D. Psychosis
Correct Answer: B
Rationale:
Delirium is characterized by acute onset, fluctuating course, and altered level of
consciousness.
Question 8
A patient with chronic kidney disease has a potassium level of 6.2 mEq/L with
ECG changes. What is the priority intervention?
A. Oral sodium polystyrene
B. IV calcium gluconate
C. Loop diuretics
D. Insulin infusion only
Correct Answer: B
Rationale:
IV calcium gluconate stabilizes cardiac membranes and is the first priority when
ECG changes are present.
Question 9
A 45-year-old woman presents with morning stiffness lasting over one hour and
symmetric joint pain in the hands. Which lab finding supports the diagnosis?
A. Elevated uric acid
B. Positive rheumatoid factor
