APEA PRE-PREDICTOR EXAM 2026 –
COMPREHENSIVE QUESTIONS WITH
VERIFIED CORRECT ANSWERS FOR
ADVANCED PRACTICE NURSING REVIEW
1. First-Pass Effect
1. What cytochrome metabolizes a medication drug during the FIRST-PASS
Effect?
2. CYP450 enzyme is the most .
3. It can either be induced or inhibited (T/F): 1. CYP450 metabolizes the drug in the liver to release
the drug to the body where it can be used.
2. Active
3. True
2. Pharmacokinetics
1. What are age-related changes?
(Distribution, Metabolism, Excretion)?: 1. Increase in fat-to-water ratio, decrease in liver function,
decrease in GFR
3. Pharmacology: Cardiac Glycosides
1. What order of line of treatment is Digoxin?
2. Signs of Digoxin Overdose
3. Laboratory tests
4. Treatment: 1. Second and Third
2. N/V, Hyperkalemia, Confusion, visual color changes
3. Digoxin level, CMP, EKG
4. Digoxin-specific antibodies
4. Pharmacology: Warfarin (Coumadin)
1. Category for pregnancy.
,2. Target INR for patients without mitral prosthetic valves? With prosthetic
valves?
3. Referral to for initiation and stabilization of warfarin dose.
4. How often do you check for consistently stable INR?
5. How often do you check for single out-of-range INR?
6. What do you educate the patient to do if the INR less than 5 with no
,significant bleeding risk?
7. If one dose is missed, what do you do?
8. What kind of foods to avoid messing up the INR?: 1. X
2. 2.0-3.0, 2.5-3.5
3. Cardiologist or anticoagulation clinic
4. Check every 2-4 weeks up to 12 weeks.
5. Continue warfarin dose, retest INR in 1-2 weeks.
6. Omit one dose, recheck INR.
7. Take the dose as soon as possible. Do not double dose.
8. Vitamin K foods
5. Pharmacology: Direct Oran Anticoagulants (DOAC)
1. Why are DOACs better than Warfarin?
2. Example of DOACs?
3. How long does it take for platelet function to return to normal after a patient
stops taking Plavix?: 1. Less monitoring and less side ettects
2. Apixaban (Eliquis)
3. 10 days
6. Pharmacology: Thiazide Diuretics
1. Examples
2. Contraindication
3. Adverse effects
4. Patients with osteoporosis receive an extra benefit from thiazide diuretics by
reducing excretion (T/F): 1. HCTZ, Chlorthalidone
2. Sulfa allergy
3. Hykpokalemia, increases uric acid and increases LDL
4. Calcium, True
7. Pharmacology: Potassium-Sparing Diuretics
1. Examples
2. Contraindication
, 3. Adverse effects
4. Do not combine with which cardiac drugs to prevent hyperkalemia?: 1. Tri-
amterene, Amiloride
2. Hyperkalemia
3. Elevates K+ levels
4. ACEIs and ARBs
8. Pharmacology: Loop Diuretics
1. Examples
2. Contraindication/Allergy
3. Adverse effects
4. Which toxicity with loop diuretics can occur?: 1. Furosemide
2. Sulfa Allergy
3. Hypokalemia, Hyponatremia, hypomagnesemia
4. Ototoxicity
9. Pharmacology: ACEIs and ARBs
1. Examples
2. Black Box Warning/Contraindications
3. Adverse Effects
4. ACEIs are first-line therapy for
5. ACEIs and ARBs protect the kidneys. But if severe CKD, should you continue
ACEIs and ARBs? Why?: 1. Lisinopril, Losartan
2. Pregnancy
3. Dry cough, Hyperkalemia, Angioedema
4. Heart Failure w/ left ventricular dysfinction (HFrEF)
5. No, because severe CKD and ACEIs and ARBs will lead to increased risk of hyperkalemia.
10. Pharmacology: CCBs
1. Two types and Examples of both types
2. Cardiac contraindications for Nondihydropyridines
3. Why does pedal edema occur with dihydropyridines?: 1. Dihydropyridines: Amlodipine,
COMPREHENSIVE QUESTIONS WITH
VERIFIED CORRECT ANSWERS FOR
ADVANCED PRACTICE NURSING REVIEW
1. First-Pass Effect
1. What cytochrome metabolizes a medication drug during the FIRST-PASS
Effect?
2. CYP450 enzyme is the most .
3. It can either be induced or inhibited (T/F): 1. CYP450 metabolizes the drug in the liver to release
the drug to the body where it can be used.
2. Active
3. True
2. Pharmacokinetics
1. What are age-related changes?
(Distribution, Metabolism, Excretion)?: 1. Increase in fat-to-water ratio, decrease in liver function,
decrease in GFR
3. Pharmacology: Cardiac Glycosides
1. What order of line of treatment is Digoxin?
2. Signs of Digoxin Overdose
3. Laboratory tests
4. Treatment: 1. Second and Third
2. N/V, Hyperkalemia, Confusion, visual color changes
3. Digoxin level, CMP, EKG
4. Digoxin-specific antibodies
4. Pharmacology: Warfarin (Coumadin)
1. Category for pregnancy.
,2. Target INR for patients without mitral prosthetic valves? With prosthetic
valves?
3. Referral to for initiation and stabilization of warfarin dose.
4. How often do you check for consistently stable INR?
5. How often do you check for single out-of-range INR?
6. What do you educate the patient to do if the INR less than 5 with no
,significant bleeding risk?
7. If one dose is missed, what do you do?
8. What kind of foods to avoid messing up the INR?: 1. X
2. 2.0-3.0, 2.5-3.5
3. Cardiologist or anticoagulation clinic
4. Check every 2-4 weeks up to 12 weeks.
5. Continue warfarin dose, retest INR in 1-2 weeks.
6. Omit one dose, recheck INR.
7. Take the dose as soon as possible. Do not double dose.
8. Vitamin K foods
5. Pharmacology: Direct Oran Anticoagulants (DOAC)
1. Why are DOACs better than Warfarin?
2. Example of DOACs?
3. How long does it take for platelet function to return to normal after a patient
stops taking Plavix?: 1. Less monitoring and less side ettects
2. Apixaban (Eliquis)
3. 10 days
6. Pharmacology: Thiazide Diuretics
1. Examples
2. Contraindication
3. Adverse effects
4. Patients with osteoporosis receive an extra benefit from thiazide diuretics by
reducing excretion (T/F): 1. HCTZ, Chlorthalidone
2. Sulfa allergy
3. Hykpokalemia, increases uric acid and increases LDL
4. Calcium, True
7. Pharmacology: Potassium-Sparing Diuretics
1. Examples
2. Contraindication
, 3. Adverse effects
4. Do not combine with which cardiac drugs to prevent hyperkalemia?: 1. Tri-
amterene, Amiloride
2. Hyperkalemia
3. Elevates K+ levels
4. ACEIs and ARBs
8. Pharmacology: Loop Diuretics
1. Examples
2. Contraindication/Allergy
3. Adverse effects
4. Which toxicity with loop diuretics can occur?: 1. Furosemide
2. Sulfa Allergy
3. Hypokalemia, Hyponatremia, hypomagnesemia
4. Ototoxicity
9. Pharmacology: ACEIs and ARBs
1. Examples
2. Black Box Warning/Contraindications
3. Adverse Effects
4. ACEIs are first-line therapy for
5. ACEIs and ARBs protect the kidneys. But if severe CKD, should you continue
ACEIs and ARBs? Why?: 1. Lisinopril, Losartan
2. Pregnancy
3. Dry cough, Hyperkalemia, Angioedema
4. Heart Failure w/ left ventricular dysfinction (HFrEF)
5. No, because severe CKD and ACEIs and ARBs will lead to increased risk of hyperkalemia.
10. Pharmacology: CCBs
1. Two types and Examples of both types
2. Cardiac contraindications for Nondihydropyridines
3. Why does pedal edema occur with dihydropyridines?: 1. Dihydropyridines: Amlodipine,
