100% APEA 3P ACTUAL NURSING EXAM
2026/2027 | Top Grade | Free
Comprehensive Review | Questions &
Verified Answers | NP Certification Prep |
Pass Guaranteed - A+ Graded
Instructions: Select the best ,,,,answer,,,,. Rationales are
provided to mimic APEA's "most correct" reasoning.
DOMAIN: CARDIOLOGY & HEMODYNAMICS
1. A 68-year-old male with a history of HTN presents with
acute onset of tearing chest pain radiating to the back. BP is
180/110 in the right arm and 100/70 in the left arm. What is
the priority intervention?
• A) Administer sublingual NTG
• B) STAT CT angiography
• C) Start IV heparin
• D) Order a CXR
,,,,answer,,,,: B. Rationale: This is an aortic dissection until
proven otherwise (tearing pain + pulse/blood pressure
differential). CTA is the gold standard. NTG is contraindicated
before ruling out right ventricular infarction; heparin won't fix
a dissection.
,2. Which EKG finding is most specific for pericarditis?
• A) ST-segment depression in V1-V3
• B) Diffuse PR depression and widespread concave-up ST
elevation
• C) Pathological Q waves in II, III, aVF
• D) Tall peaked T waves
,,,,answer,,,,: B. Rationale: Pericarditis causes diffuse,
concave-up (saddle-shaped) ST elevation with reciprocal PR
depression. Q waves indicate infarction.
3. A 55-year-old female with CHF (EF 35%) is on Lisinopril,
Carvedilol, and Furosemide. She presents with a non-
productive cough and angioedema. Which medication should
be held and replaced?
• A) Carvedilol
• B) Furosemide
• C) Lisinopril
• D) Aspirin
,,,,answer,,,,: C. Rationale: ACE inhibitors (Lisinopril) cause
bradykinin-mediated angioedema and cough. Switch to an
ARB (e.g., Losartan).
4. What is the first-line pharmacologic therapy for stable
angina in a patient with known CAD?
• A) Amlodipine
• B) Isosorbide dinitrate
• C) Metoprolol succinate
• D) Ranolazine
,,,,answer,,,,: C. Rationale: Beta-blockers (Metoprolol) are
, first-line for stable angina because they reduce myocardial
oxygen demand by decreasing heart rate and contractility.
5. A patient has a JVP of 12 cm H2O, hepatomegaly, and
peripheral edema. Which medication is MOST appropriate to
reduce preload?
• A) Dobutamine
• B) Furosemide
• C) Digoxin
• D) Spironolactone
,,,,answer,,,,: B. Rationale: Loop diuretics (Furosemide) are the
mainstay for acute volume overload (preload reduction).
6. A-fib with RVR at 140 bpm. Patient is hemodynamically
stable. What is the immediate treatment?
• A) Amiodarone IV push
• B) Synchronized cardioversion
• C) Metoprolol IV
• D) Digoxin loading
,,,,answer,,,,: C. Rationale: Rate control with IV beta-blocker
(Metoprolol) or Diltiazem is first-line for stable A-fib.
Cardioversion is for unstable.
7. Which murmur increases with squatting?
• A) Aortic stenosis
• B) Mitral valve prolapse
• C) Hypertrophic cardiomyopathy
• D) Aortic regurgitation
,,,,answer,,,,: C. Rationale: Squatting increases venous return
(preload), which reduces the LVOT obstruction in HCM,
, causing the murmur to decrease, wait—correction: Squatting
increases afterload, which increases the murmur of HCM?
Actually, HCM murmur decreases with squatting (increased
preload). The murmur that increases with squatting is Aortic
Regurgitation (increased diastolic pressure) and Mitral
Stenosis? Let's be precise: Murmur that increases with
squatting: HCM decreases; Aortic Stenosis increases? No. The
APEA correct ,,,,answer,,,, is usually Hypertrophic
Cardiomyopathy decreases; Mitral Valve Prolapse
increases... Please recall: Squatting increases afterload and
preload. It increases murmurs of Aortic Stenosis and Aortic
Regurgitation, but decreases HCM and MVP. The APEA
trick: Valsalva increases HCM/MVP. Squatting increases
AS/AR. (Correction: The question asks "increases"—the classic
,,,,answer,,,, is Aortic Stenosis). Let's select A in this context.
DOMAIN: PULMONOLOGY
8. A 72-year-old with COPD (FEV1 35%) presents with
worsening dyspnea and purulent sputum. ABG: pH 7.31,
PaCO2 58, PaO2 62, HCO3 30. What is the interpretation?
• A) Acute respiratory acidosis
• B) Chronic respiratory acidosis with acute exacerbation
• C) Metabolic acidosis with respiratory compensation
• D) Compensated metabolic alkalosis
,,,,answer,,,,: B. Rationale: Baseline HCO3 is elevated (30)
suggesting chronic compensation (renal retention). pH is low
2026/2027 | Top Grade | Free
Comprehensive Review | Questions &
Verified Answers | NP Certification Prep |
Pass Guaranteed - A+ Graded
Instructions: Select the best ,,,,answer,,,,. Rationales are
provided to mimic APEA's "most correct" reasoning.
DOMAIN: CARDIOLOGY & HEMODYNAMICS
1. A 68-year-old male with a history of HTN presents with
acute onset of tearing chest pain radiating to the back. BP is
180/110 in the right arm and 100/70 in the left arm. What is
the priority intervention?
• A) Administer sublingual NTG
• B) STAT CT angiography
• C) Start IV heparin
• D) Order a CXR
,,,,answer,,,,: B. Rationale: This is an aortic dissection until
proven otherwise (tearing pain + pulse/blood pressure
differential). CTA is the gold standard. NTG is contraindicated
before ruling out right ventricular infarction; heparin won't fix
a dissection.
,2. Which EKG finding is most specific for pericarditis?
• A) ST-segment depression in V1-V3
• B) Diffuse PR depression and widespread concave-up ST
elevation
• C) Pathological Q waves in II, III, aVF
• D) Tall peaked T waves
,,,,answer,,,,: B. Rationale: Pericarditis causes diffuse,
concave-up (saddle-shaped) ST elevation with reciprocal PR
depression. Q waves indicate infarction.
3. A 55-year-old female with CHF (EF 35%) is on Lisinopril,
Carvedilol, and Furosemide. She presents with a non-
productive cough and angioedema. Which medication should
be held and replaced?
• A) Carvedilol
• B) Furosemide
• C) Lisinopril
• D) Aspirin
,,,,answer,,,,: C. Rationale: ACE inhibitors (Lisinopril) cause
bradykinin-mediated angioedema and cough. Switch to an
ARB (e.g., Losartan).
4. What is the first-line pharmacologic therapy for stable
angina in a patient with known CAD?
• A) Amlodipine
• B) Isosorbide dinitrate
• C) Metoprolol succinate
• D) Ranolazine
,,,,answer,,,,: C. Rationale: Beta-blockers (Metoprolol) are
, first-line for stable angina because they reduce myocardial
oxygen demand by decreasing heart rate and contractility.
5. A patient has a JVP of 12 cm H2O, hepatomegaly, and
peripheral edema. Which medication is MOST appropriate to
reduce preload?
• A) Dobutamine
• B) Furosemide
• C) Digoxin
• D) Spironolactone
,,,,answer,,,,: B. Rationale: Loop diuretics (Furosemide) are the
mainstay for acute volume overload (preload reduction).
6. A-fib with RVR at 140 bpm. Patient is hemodynamically
stable. What is the immediate treatment?
• A) Amiodarone IV push
• B) Synchronized cardioversion
• C) Metoprolol IV
• D) Digoxin loading
,,,,answer,,,,: C. Rationale: Rate control with IV beta-blocker
(Metoprolol) or Diltiazem is first-line for stable A-fib.
Cardioversion is for unstable.
7. Which murmur increases with squatting?
• A) Aortic stenosis
• B) Mitral valve prolapse
• C) Hypertrophic cardiomyopathy
• D) Aortic regurgitation
,,,,answer,,,,: C. Rationale: Squatting increases venous return
(preload), which reduces the LVOT obstruction in HCM,
, causing the murmur to decrease, wait—correction: Squatting
increases afterload, which increases the murmur of HCM?
Actually, HCM murmur decreases with squatting (increased
preload). The murmur that increases with squatting is Aortic
Regurgitation (increased diastolic pressure) and Mitral
Stenosis? Let's be precise: Murmur that increases with
squatting: HCM decreases; Aortic Stenosis increases? No. The
APEA correct ,,,,answer,,,, is usually Hypertrophic
Cardiomyopathy decreases; Mitral Valve Prolapse
increases... Please recall: Squatting increases afterload and
preload. It increases murmurs of Aortic Stenosis and Aortic
Regurgitation, but decreases HCM and MVP. The APEA
trick: Valsalva increases HCM/MVP. Squatting increases
AS/AR. (Correction: The question asks "increases"—the classic
,,,,answer,,,, is Aortic Stenosis). Let's select A in this context.
DOMAIN: PULMONOLOGY
8. A 72-year-old with COPD (FEV1 35%) presents with
worsening dyspnea and purulent sputum. ABG: pH 7.31,
PaCO2 58, PaO2 62, HCO3 30. What is the interpretation?
• A) Acute respiratory acidosis
• B) Chronic respiratory acidosis with acute exacerbation
• C) Metabolic acidosis with respiratory compensation
• D) Compensated metabolic alkalosis
,,,,answer,,,,: B. Rationale: Baseline HCO3 is elevated (30)
suggesting chronic compensation (renal retention). pH is low
