APEA 3P Predictor-Style Practice Exam Questions And Correct
Answers (Verified Answers) Plus Rationales 2025/2026 Q&A |
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Question 1
A 62-year-old man presents with crushing substernal chest pain radiating to his left arm for 30
minutes. ECG demonstrates ST-segment elevation in leads II, III, and aVF. Which coronary
artery is most likely occluded?
A. Left anterior descending artery
B. Right coronary artery
C. Circumflex artery
D. Left main coronary artery
Answer: B. Right coronary artery
Rationale:
Inferior myocardial infarctions typically involve leads II, III, and aVF and are most commonly
caused by occlusion of the right coronary artery.
Clinical Pearl: Inferior MI = RCA until proven otherwise.
Question 2
A patient with type 2 diabetes has an HbA1c of 9.5% despite taking maximum-dose metformin.
Which medication has proven cardiovascular benefit?
A. Glipizide
B. Pioglitazone
C. Empagliflozin
D. Acarbose
Answer: C. Empagliflozin
Rationale:
SGLT2 inhibitors such as empagliflozin reduce cardiovascular mortality and slow progression of
chronic kidney disease.
Clinical Pearl: SGLT2 inhibitors benefit the heart and kidneys.
Question 3
,Which electrolyte abnormality most commonly produces peaked T waves on ECG?
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hyponatremia
Answer: B. Hyperkalemia
Rationale:
Hyperkalemia causes tall peaked T waves and, if severe, widened QRS complexes and ventricular
arrhythmias.
Question 4
A patient presents with exophthalmos, weight loss, heat intolerance, and tachycardia. Which
diagnosis is most likely?
A. Hashimoto thyroiditis
B. Graves disease
C. Subacute thyroiditis
D. Toxic adenoma
Answer: B. Graves disease
Rationale:
Graves disease is characterized by hyperthyroidism with ophthalmopathy and diffuse goiter.
Question 5
Which antihypertensive medication is contraindicated during pregnancy?
A. Labetalol
B. Nifedipine
C. Methyldopa
D. Lisinopril
Answer: D. Lisinopril
Rationale:
ACE inhibitors are teratogenic and should not be used during pregnancy.
,Question 6
A patient has unilateral calf swelling and tenderness after a long flight. Which diagnostic test
should be obtained first?
A. MRI
B. Venous duplex ultrasound
C. CT angiography
D. X-ray
Answer: B. Venous duplex ultrasound
Rationale:
Compression venous ultrasonography is the preferred initial test for suspected deep vein
thrombosis.
Question 7
Which heart murmur becomes louder with the Valsalva maneuver?
A. Aortic stenosis
B. Mitral regurgitation
C. Hypertrophic cardiomyopathy
D. Pulmonic stenosis
Answer: C. Hypertrophic cardiomyopathy
Rationale:
Valsalva decreases preload, increasing left ventricular outflow obstruction in hypertrophic
cardiomyopathy.
Question 8
Which organism is the most common cause of community-acquired pneumonia?
A. Pseudomonas aeruginosa
B. Mycoplasma pneumoniae
C. Streptococcus pneumoniae
D. Klebsiella pneumoniae
Answer: C. Streptococcus pneumoniae
Rationale:
S. pneumoniae remains the leading cause of community-acquired bacterial pneumonia.
, Question 9
A patient with COPD suddenly develops pleuritic chest pain and dyspnea. Which diagnosis
should be suspected?
A. Asthma
B. Pneumothorax
C. Bronchitis
D. Heart failure
Answer: B. Pneumothorax
Rationale:
COPD patients are at increased risk for spontaneous pneumothorax due to rupture of
emphysematous blebs.
Question 10
Which laboratory finding confirms diabetic ketoacidosis?
A. Hyperglycemia only
B. Elevated ketones with metabolic acidosis
C. Elevated HbA1c
D. Glucosuria only
Answer: B. Elevated ketones with metabolic acidosis
Rationale:
DKA is defined by hyperglycemia, ketosis, and high anion gap metabolic acidosis.
Question 11
The first-line treatment for anaphylaxis is:
A. Diphenhydramine
B. Prednisone
C. Intramuscular epinephrine
D. Albuterol
Answer: C. Intramuscular epinephrine
Answers (Verified Answers) Plus Rationales 2025/2026 Q&A |
Instant Download Pdf
Question 1
A 62-year-old man presents with crushing substernal chest pain radiating to his left arm for 30
minutes. ECG demonstrates ST-segment elevation in leads II, III, and aVF. Which coronary
artery is most likely occluded?
A. Left anterior descending artery
B. Right coronary artery
C. Circumflex artery
D. Left main coronary artery
Answer: B. Right coronary artery
Rationale:
Inferior myocardial infarctions typically involve leads II, III, and aVF and are most commonly
caused by occlusion of the right coronary artery.
Clinical Pearl: Inferior MI = RCA until proven otherwise.
Question 2
A patient with type 2 diabetes has an HbA1c of 9.5% despite taking maximum-dose metformin.
Which medication has proven cardiovascular benefit?
A. Glipizide
B. Pioglitazone
C. Empagliflozin
D. Acarbose
Answer: C. Empagliflozin
Rationale:
SGLT2 inhibitors such as empagliflozin reduce cardiovascular mortality and slow progression of
chronic kidney disease.
Clinical Pearl: SGLT2 inhibitors benefit the heart and kidneys.
Question 3
,Which electrolyte abnormality most commonly produces peaked T waves on ECG?
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hyponatremia
Answer: B. Hyperkalemia
Rationale:
Hyperkalemia causes tall peaked T waves and, if severe, widened QRS complexes and ventricular
arrhythmias.
Question 4
A patient presents with exophthalmos, weight loss, heat intolerance, and tachycardia. Which
diagnosis is most likely?
A. Hashimoto thyroiditis
B. Graves disease
C. Subacute thyroiditis
D. Toxic adenoma
Answer: B. Graves disease
Rationale:
Graves disease is characterized by hyperthyroidism with ophthalmopathy and diffuse goiter.
Question 5
Which antihypertensive medication is contraindicated during pregnancy?
A. Labetalol
B. Nifedipine
C. Methyldopa
D. Lisinopril
Answer: D. Lisinopril
Rationale:
ACE inhibitors are teratogenic and should not be used during pregnancy.
,Question 6
A patient has unilateral calf swelling and tenderness after a long flight. Which diagnostic test
should be obtained first?
A. MRI
B. Venous duplex ultrasound
C. CT angiography
D. X-ray
Answer: B. Venous duplex ultrasound
Rationale:
Compression venous ultrasonography is the preferred initial test for suspected deep vein
thrombosis.
Question 7
Which heart murmur becomes louder with the Valsalva maneuver?
A. Aortic stenosis
B. Mitral regurgitation
C. Hypertrophic cardiomyopathy
D. Pulmonic stenosis
Answer: C. Hypertrophic cardiomyopathy
Rationale:
Valsalva decreases preload, increasing left ventricular outflow obstruction in hypertrophic
cardiomyopathy.
Question 8
Which organism is the most common cause of community-acquired pneumonia?
A. Pseudomonas aeruginosa
B. Mycoplasma pneumoniae
C. Streptococcus pneumoniae
D. Klebsiella pneumoniae
Answer: C. Streptococcus pneumoniae
Rationale:
S. pneumoniae remains the leading cause of community-acquired bacterial pneumonia.
, Question 9
A patient with COPD suddenly develops pleuritic chest pain and dyspnea. Which diagnosis
should be suspected?
A. Asthma
B. Pneumothorax
C. Bronchitis
D. Heart failure
Answer: B. Pneumothorax
Rationale:
COPD patients are at increased risk for spontaneous pneumothorax due to rupture of
emphysematous blebs.
Question 10
Which laboratory finding confirms diabetic ketoacidosis?
A. Hyperglycemia only
B. Elevated ketones with metabolic acidosis
C. Elevated HbA1c
D. Glucosuria only
Answer: B. Elevated ketones with metabolic acidosis
Rationale:
DKA is defined by hyperglycemia, ketosis, and high anion gap metabolic acidosis.
Question 11
The first-line treatment for anaphylaxis is:
A. Diphenhydramine
B. Prednisone
C. Intramuscular epinephrine
D. Albuterol
Answer: C. Intramuscular epinephrine
