APEA 3P ( Pathophysiology,
Pharmacology, and Physicacal
Assessment ) ACTUAL EXAM
QUESTIONS AND CORRECT
ANSWERS 2026-2027 .
,1. Sarcomere stretch beyond 2.2 microns is the physiologic mechanism behind which condition? ✓✓ CORRECT
ANSWER CHF
2. A female patient is taking amlodipine 10 mg daily, which controlled her blood pressure, but she could not
tolerate the side effects. She was switched to losartan 100 mg daily, but her blood pressure never achieved goal.
Which statement best characterizes the clinical comparison of these two medica- tions? ✓✓ CORRECT ANSWER
Amlodipine is more eflcacious than losartan
3. During a routine health assessment, the NP appreciates a decrease in pe- ripheral vision bilaterally while
performing visual field assessment by con- frontation. Consequently, the NP anticipates which of the
following findings during fundoscopic assessment? ✓✓ CORRECT ANSWER A cup-to-disk ratio of 70%.
4. A 66-year-old woman presents with a complaint of a 4-day history of a unilateral headache that will not go
away despite taking ibuprofen and aceta- minophen. She has a history of hypertension that is usually well
controlled with an ACE inhibitor, but today her blood pressure is 162/92 mm Hg. During the HPI she admits that
she has had some transient visual loss over the few days, but it has been very short lived and resolves completely.
The next step in the evaluation of this patient should include ✓✓ CORRECT ANSWER ✓✓ CORRECT ANSWER An
erythrocyte sedimentation rate
5. Which information best describes the pathophysiology of most mental health disorders? ✓✓ CORRECT
ANSWER Dysregulation of neurotransmitters in relevant pathways
6. The commonality among all seizure etiologies is ✓✓ CORRECT ANSWER ✓✓ CORRECT ANSWER Increased
neuron excitability
7. The NP is managing a patient newly diagnosed with essential tremor dis- order and prescribed propranolol.
The patient did an internet search for the medication and wants to know how a "heart medication" can make
her stop having hand tremors. What is the best explanation for this patient? ✓✓ CORRECT ANSWER Propranolol
blocks the action of the sympathetic nervous system in all body systems and so it will calm many things, including the tremors
8. A 48-year-old man presents with a complaint of a 3-week history of inter- mittent shooting pain that runs down
the buttocks and left leg. Suspecting sciatica, the NP would expect which of the following during physical
examina- tion? ✓✓ CORRECT ANSWER Pain with straight leg raise
, 9. During the routine wellness examination of a 12-year-old male patient, the NP appreciates a grade II/VI
systolic murmur at the apex while the patient is lying on the exam table. The murmur is louder when the patient
moves to the sitting position, appreciated at grade IV/VI. The cardiac history and review of symptoms is negative.
The appropriate approach to this patient is to ✓✓ CORRECT ANSWER ✓✓ CORRECT ANSWER Order an
echocardiogram
10. A 57-year-old woman presents with a 3-day history of fever, dyspnea, and a purulent cough. Auscultation of
the lungs identifies an area of egophony in the lower left lobe. Palpation reveals increased tactile fremitus. The
NP expects which of the following percussion findings? ✓✓ CORRECT ANSWER Dullness
11. The NP is learning about anginal chest pain unresponsive to nitroglycerin, when does necrotic injury occur? ✓✓
CORRECT ANSWER The mitochondrial membrane ruptures
12. A 35-year-old female is skiing fast down a steep trail. She falls forward and lands on an abducted and
extended arm. She immediately feels a pop, has exquisite pain over her right upper shoulder, and has no sensation
in her right hand. Her diagnosis is most likely ✓✓ CORRECT ANSWER ✓✓ CORRECT ANSWER Anterior dislocation of the
glenohumeral joint.
13. The NP is evaluating a patient with markedly elevated blood pressure that is unresponsive to traditional
medications. There is some mild pedal edema, but other than the elevated BP, the physical exam is essentially
normal. A metabolic panel reveals the following ✓✓ CORRECT ANSWER
Na+ 151 mEq/LK+ 3.0 mEq/LCl- 114 mEq/LCO2 28 mEq/LBUN 10 mg/dLCrea-
tinine 0.9 mg/dL
The NP considers which of the following as a secondary cause of hypertension in this patient? ✓✓ CORRECT ANSWER
Hyperaldosteronism
14. Which of the following statins is preferred for a 67-year-old man with hyper- cholesterolemia who drinks a glass of
grapefruit juice every morning? ✓✓ CORRECT ANSWER Pravastatin
15. A 41-year-old female is being managed by her mental health provider with lithium. She presents for a primary
care wellness exam and has no complaints, but routine laboratory assessment reveals a TSH of 4.5 iU/L. What is the
most appropriate approach for this patient? ✓✓ CORRECT ANSWER Begin thyroid replacement therapy
Pharmacology, and Physicacal
Assessment ) ACTUAL EXAM
QUESTIONS AND CORRECT
ANSWERS 2026-2027 .
,1. Sarcomere stretch beyond 2.2 microns is the physiologic mechanism behind which condition? ✓✓ CORRECT
ANSWER CHF
2. A female patient is taking amlodipine 10 mg daily, which controlled her blood pressure, but she could not
tolerate the side effects. She was switched to losartan 100 mg daily, but her blood pressure never achieved goal.
Which statement best characterizes the clinical comparison of these two medica- tions? ✓✓ CORRECT ANSWER
Amlodipine is more eflcacious than losartan
3. During a routine health assessment, the NP appreciates a decrease in pe- ripheral vision bilaterally while
performing visual field assessment by con- frontation. Consequently, the NP anticipates which of the
following findings during fundoscopic assessment? ✓✓ CORRECT ANSWER A cup-to-disk ratio of 70%.
4. A 66-year-old woman presents with a complaint of a 4-day history of a unilateral headache that will not go
away despite taking ibuprofen and aceta- minophen. She has a history of hypertension that is usually well
controlled with an ACE inhibitor, but today her blood pressure is 162/92 mm Hg. During the HPI she admits that
she has had some transient visual loss over the few days, but it has been very short lived and resolves completely.
The next step in the evaluation of this patient should include ✓✓ CORRECT ANSWER ✓✓ CORRECT ANSWER An
erythrocyte sedimentation rate
5. Which information best describes the pathophysiology of most mental health disorders? ✓✓ CORRECT
ANSWER Dysregulation of neurotransmitters in relevant pathways
6. The commonality among all seizure etiologies is ✓✓ CORRECT ANSWER ✓✓ CORRECT ANSWER Increased
neuron excitability
7. The NP is managing a patient newly diagnosed with essential tremor dis- order and prescribed propranolol.
The patient did an internet search for the medication and wants to know how a "heart medication" can make
her stop having hand tremors. What is the best explanation for this patient? ✓✓ CORRECT ANSWER Propranolol
blocks the action of the sympathetic nervous system in all body systems and so it will calm many things, including the tremors
8. A 48-year-old man presents with a complaint of a 3-week history of inter- mittent shooting pain that runs down
the buttocks and left leg. Suspecting sciatica, the NP would expect which of the following during physical
examina- tion? ✓✓ CORRECT ANSWER Pain with straight leg raise
, 9. During the routine wellness examination of a 12-year-old male patient, the NP appreciates a grade II/VI
systolic murmur at the apex while the patient is lying on the exam table. The murmur is louder when the patient
moves to the sitting position, appreciated at grade IV/VI. The cardiac history and review of symptoms is negative.
The appropriate approach to this patient is to ✓✓ CORRECT ANSWER ✓✓ CORRECT ANSWER Order an
echocardiogram
10. A 57-year-old woman presents with a 3-day history of fever, dyspnea, and a purulent cough. Auscultation of
the lungs identifies an area of egophony in the lower left lobe. Palpation reveals increased tactile fremitus. The
NP expects which of the following percussion findings? ✓✓ CORRECT ANSWER Dullness
11. The NP is learning about anginal chest pain unresponsive to nitroglycerin, when does necrotic injury occur? ✓✓
CORRECT ANSWER The mitochondrial membrane ruptures
12. A 35-year-old female is skiing fast down a steep trail. She falls forward and lands on an abducted and
extended arm. She immediately feels a pop, has exquisite pain over her right upper shoulder, and has no sensation
in her right hand. Her diagnosis is most likely ✓✓ CORRECT ANSWER ✓✓ CORRECT ANSWER Anterior dislocation of the
glenohumeral joint.
13. The NP is evaluating a patient with markedly elevated blood pressure that is unresponsive to traditional
medications. There is some mild pedal edema, but other than the elevated BP, the physical exam is essentially
normal. A metabolic panel reveals the following ✓✓ CORRECT ANSWER
Na+ 151 mEq/LK+ 3.0 mEq/LCl- 114 mEq/LCO2 28 mEq/LBUN 10 mg/dLCrea-
tinine 0.9 mg/dL
The NP considers which of the following as a secondary cause of hypertension in this patient? ✓✓ CORRECT ANSWER
Hyperaldosteronism
14. Which of the following statins is preferred for a 67-year-old man with hyper- cholesterolemia who drinks a glass of
grapefruit juice every morning? ✓✓ CORRECT ANSWER Pravastatin
15. A 41-year-old female is being managed by her mental health provider with lithium. She presents for a primary
care wellness exam and has no complaints, but routine laboratory assessment reveals a TSH of 4.5 iU/L. What is the
most appropriate approach for this patient? ✓✓ CORRECT ANSWER Begin thyroid replacement therapy
