2026/2027
APEA 3P Actual Exam 2026/2027
Full-Length Exam Preparation
Study Guide Featuring Practice
Tests, Quiz Reviews, and Exam
Success Strategies
Question 1
A nurse is assessing a patient with a suspicious skin lesion. Which statement correctly
identifies the most common type of skin cancer in the United States?
A. Squamous cell carcinoma
B. Basal cell carcinoma
C. Melanoma
D. Kaposi sarcoma
Correct Answer: B. Basal cell carcinoma
Rationale: Basal cell carcinoma is the most common type of skin cancer in the United
States and typically arises from chronic sun exposure. It is slow growing and rarely
metastasizes. Squamous cell carcinoma is also common but less frequent than basal
cell carcinoma. Melanoma is more aggressive but less common overall. Kaposi
sarcoma is associated with immunosuppression, particularly HIV infection.
Question 2
Which description best characterizes basal cell carcinoma?
A. Irregular dark mole with rapid growth
B. Scaly red plaque with ulceration
C. Pearly, shiny papule with rolled borders
D. Painful blistering lesion with necrosis
Correct Answer: C. Pearly, shiny papule with rolled borders
Rationale: Basal cell carcinoma typically presents as a pearly or shiny papule with
rolled borders and may ulcerate. It is slow growing and commonly appears on sun-
exposed areas. Melanoma presents as irregular pigmented lesions. Squamous cell
carcinoma appears as scaly, rough plaques, and blistering necrotic lesions are more
consistent with severe infections or burns.
,2026/2027
Question 3
Which is the gold standard for diagnosing basal cell carcinoma?
A. Dermoscopy
B. Skin biopsy
C. CT scan
D. Visual inspection only
Correct Answer: B. Skin biopsy
Rationale: Skin biopsy is the definitive diagnostic test for basal cell carcinoma. While
dermoscopy and clinical examination may raise suspicion, only histological
evaluation confirms the diagnosis. Imaging studies are not used for primary diagnosis.
Question 4
Actinic keratosis is clinically significant because it:
A. Is benign and requires no treatment
B. Is a precursor to squamous cell carcinoma
C. Is a form of melanoma
D. Always metastasizes
Correct Answer: B. Is a precursor to squamous cell carcinoma
Rationale: Actinic keratosis is a premalignant lesion that can progress to squamous
cell carcinoma if untreated. It appears as rough, scaly, pink or red lesions in sun-
exposed areas. It is not benign in a completely harmless sense and requires monitoring
or treatment.
Question 5
Which treatment is most appropriate for extensive actinic keratosis?
A. Oral antibiotics
B. 5-fluorouracil (Efudex)
C. Antifungal cream
D. Systemic steroids
Correct Answer: B. 5-fluorouracil (Efudex)
Rationale: 5-fluorouracil is used for widespread actinic keratosis and causes local skin
irritation, redness, and crusting as it destroys abnormal cells. Cryotherapy is used for
small lesions. Antibiotics, antifungals, and steroids are not indicated.
,2026/2027
Question 6
Which skin cancer is characterized by a chronic scaly lesion with irregular borders
and possible bleeding?
A. Basal cell carcinoma
B. Squamous cell carcinoma
C. Melanoma
D. Dermatofibroma
Correct Answer: B. Squamous cell carcinoma
Rationale: Squamous cell carcinoma presents as a scaly, rough lesion with irregular
borders that may crust or bleed. It often occurs in sun-exposed areas. Basal cell
carcinoma is pearly and shiny, while melanoma is pigmented and irregular.
Question 7
Which lesion is most concerning for melanoma?
A. Symmetrical brown mole with uniform color
B. Small flesh-colored papule
C. Asymmetrical lesion with color variation
D. Flat, scaly patch that resolves spontaneously
Correct Answer: C. Asymmetrical lesion with color variation
Rationale: Melanoma is assessed using the ABCDE criteria. Asymmetry, irregular
borders, color variation, diameter >6mm, and evolving changes are concerning.
Symmetrical lesions are usually benign.
Question 8
Acral lentiginous melanoma is most commonly found:
A. On the trunk of young adults
B. On the palms, soles, and nail beds
C. On the scalp of elderly patients
D. Only on sun-exposed facial areas
Correct Answer: B. On the palms, soles, and nail beds
Rationale: Acral lentiginous melanoma is most common in individuals with darker
skin and appears on palms, soles, or under nails as dark streaks. It is not primarily
sun-exposure related.
, 2026/2027
Question 9
Seborrheic keratosis is best described as:
A. Malignant ulcerating lesion
B. Benign, “stuck-on” wart-like growth
C. Painful blistering infection
D. Precursor to melanoma
Correct Answer: B. Benign, “stuck-on” wart-like growth
Rationale: Seborrheic keratosis is a benign lesion that appears waxy, “stuck-on,” and
varies in color. It is not malignant or premalignant.
Question 10
Which organism is the most common cause of bacterial meningitis in adults?
A. Escherichia coli
B. Neisseria meningitidis
C. Streptococcus pneumoniae
D. Listeria monocytogenes
Correct Answer: C. Streptococcus pneumoniae
Rationale: Streptococcus pneumoniae is the most common cause of bacterial
meningitis in adults. Neisseria meningitidis is also common, especially in younger
populations. E. coli is more common in neonates.
Question 11
Which triad is classic for bacterial meningitis?
A. Fever, cough, chest pain
B. Fever, nuchal rigidity, altered mental status
C. Rash, diarrhea, vomiting
D. Headache, sore throat, abdominal pain
Correct Answer: B. Fever, nuchal rigidity, altered mental status
Rationale: The classic triad of bacterial meningitis includes fever, neck stiffness
(nuchal rigidity), and altered mental status. Rash and petechiae may also be present in
meningococcal infection.
Question 12
APEA 3P Actual Exam 2026/2027
Full-Length Exam Preparation
Study Guide Featuring Practice
Tests, Quiz Reviews, and Exam
Success Strategies
Question 1
A nurse is assessing a patient with a suspicious skin lesion. Which statement correctly
identifies the most common type of skin cancer in the United States?
A. Squamous cell carcinoma
B. Basal cell carcinoma
C. Melanoma
D. Kaposi sarcoma
Correct Answer: B. Basal cell carcinoma
Rationale: Basal cell carcinoma is the most common type of skin cancer in the United
States and typically arises from chronic sun exposure. It is slow growing and rarely
metastasizes. Squamous cell carcinoma is also common but less frequent than basal
cell carcinoma. Melanoma is more aggressive but less common overall. Kaposi
sarcoma is associated with immunosuppression, particularly HIV infection.
Question 2
Which description best characterizes basal cell carcinoma?
A. Irregular dark mole with rapid growth
B. Scaly red plaque with ulceration
C. Pearly, shiny papule with rolled borders
D. Painful blistering lesion with necrosis
Correct Answer: C. Pearly, shiny papule with rolled borders
Rationale: Basal cell carcinoma typically presents as a pearly or shiny papule with
rolled borders and may ulcerate. It is slow growing and commonly appears on sun-
exposed areas. Melanoma presents as irregular pigmented lesions. Squamous cell
carcinoma appears as scaly, rough plaques, and blistering necrotic lesions are more
consistent with severe infections or burns.
,2026/2027
Question 3
Which is the gold standard for diagnosing basal cell carcinoma?
A. Dermoscopy
B. Skin biopsy
C. CT scan
D. Visual inspection only
Correct Answer: B. Skin biopsy
Rationale: Skin biopsy is the definitive diagnostic test for basal cell carcinoma. While
dermoscopy and clinical examination may raise suspicion, only histological
evaluation confirms the diagnosis. Imaging studies are not used for primary diagnosis.
Question 4
Actinic keratosis is clinically significant because it:
A. Is benign and requires no treatment
B. Is a precursor to squamous cell carcinoma
C. Is a form of melanoma
D. Always metastasizes
Correct Answer: B. Is a precursor to squamous cell carcinoma
Rationale: Actinic keratosis is a premalignant lesion that can progress to squamous
cell carcinoma if untreated. It appears as rough, scaly, pink or red lesions in sun-
exposed areas. It is not benign in a completely harmless sense and requires monitoring
or treatment.
Question 5
Which treatment is most appropriate for extensive actinic keratosis?
A. Oral antibiotics
B. 5-fluorouracil (Efudex)
C. Antifungal cream
D. Systemic steroids
Correct Answer: B. 5-fluorouracil (Efudex)
Rationale: 5-fluorouracil is used for widespread actinic keratosis and causes local skin
irritation, redness, and crusting as it destroys abnormal cells. Cryotherapy is used for
small lesions. Antibiotics, antifungals, and steroids are not indicated.
,2026/2027
Question 6
Which skin cancer is characterized by a chronic scaly lesion with irregular borders
and possible bleeding?
A. Basal cell carcinoma
B. Squamous cell carcinoma
C. Melanoma
D. Dermatofibroma
Correct Answer: B. Squamous cell carcinoma
Rationale: Squamous cell carcinoma presents as a scaly, rough lesion with irregular
borders that may crust or bleed. It often occurs in sun-exposed areas. Basal cell
carcinoma is pearly and shiny, while melanoma is pigmented and irregular.
Question 7
Which lesion is most concerning for melanoma?
A. Symmetrical brown mole with uniform color
B. Small flesh-colored papule
C. Asymmetrical lesion with color variation
D. Flat, scaly patch that resolves spontaneously
Correct Answer: C. Asymmetrical lesion with color variation
Rationale: Melanoma is assessed using the ABCDE criteria. Asymmetry, irregular
borders, color variation, diameter >6mm, and evolving changes are concerning.
Symmetrical lesions are usually benign.
Question 8
Acral lentiginous melanoma is most commonly found:
A. On the trunk of young adults
B. On the palms, soles, and nail beds
C. On the scalp of elderly patients
D. Only on sun-exposed facial areas
Correct Answer: B. On the palms, soles, and nail beds
Rationale: Acral lentiginous melanoma is most common in individuals with darker
skin and appears on palms, soles, or under nails as dark streaks. It is not primarily
sun-exposure related.
, 2026/2027
Question 9
Seborrheic keratosis is best described as:
A. Malignant ulcerating lesion
B. Benign, “stuck-on” wart-like growth
C. Painful blistering infection
D. Precursor to melanoma
Correct Answer: B. Benign, “stuck-on” wart-like growth
Rationale: Seborrheic keratosis is a benign lesion that appears waxy, “stuck-on,” and
varies in color. It is not malignant or premalignant.
Question 10
Which organism is the most common cause of bacterial meningitis in adults?
A. Escherichia coli
B. Neisseria meningitidis
C. Streptococcus pneumoniae
D. Listeria monocytogenes
Correct Answer: C. Streptococcus pneumoniae
Rationale: Streptococcus pneumoniae is the most common cause of bacterial
meningitis in adults. Neisseria meningitidis is also common, especially in younger
populations. E. coli is more common in neonates.
Question 11
Which triad is classic for bacterial meningitis?
A. Fever, cough, chest pain
B. Fever, nuchal rigidity, altered mental status
C. Rash, diarrhea, vomiting
D. Headache, sore throat, abdominal pain
Correct Answer: B. Fever, nuchal rigidity, altered mental status
Rationale: The classic triad of bacterial meningitis includes fever, neck stiffness
(nuchal rigidity), and altered mental status. Rash and petechiae may also be present in
meningococcal infection.
Question 12
