APEA 3P EXAM 2025–2026: COMPREHENSIVE
EXAMINATION STUDY GUIDE
SECTION 1: ADVANCED PATHOPHYSIOLOGY
1. A 43-year-old Hispanic male presents with an audible diastolic murmur best heard at the
mitral listening point. There is no audible click. His status has been monitored for the past
two years. This murmur is most likely indicative of:
A. Mitral valve prolapse
B. Aortic stenosis
C. Mitral stenosis
D. Tricuspid regurgitation
Answer: C
2. A patient with hypertension describes a previous allergic reaction to a sulfa antibiotic as
"sloughing of skin" and hospitalization. Which medication is contraindicated in this
patient?
A. Lisinopril
B. Amlodipine
,C. Hydrochlorothiazide
D. Metoprolol
Answer: C
3. A 75-year-old patient with aortic stenosis asks the NP what symptoms indicate
worsening of his condition. The NP correctly responds:
A. Chest pain and palpitations
B. Shortness of breath and syncope
C. Headache and dizziness
D. Fatigue and weight gain
Answer: B
4. Aortic regurgitation is characterized by:
A. Short asymptomatic period followed by rapid decompensation
B. Long asymptomatic period followed by exercise intolerance, then dyspnea at rest
C. Immediate symptoms of heart failure from onset
D. Spontaneous resolution in most cases
Answer: B
5. Which valve is most commonly involved in chronic rheumatic heart disease?
,A. Aortic valve
B. Mitral valve
C. Tricuspid valve
D. Pulmonic valve
Answer: B
6. A patient with diabetes presents with pain in his lower legs when he walks, with pain
resolution upon rest. When asked about the pain, he will most likely report pain in the:
A. Thigh muscles
B. Calf muscles
C. Feet and toes
D. Knees and ankles
Answer: B
7. Which factor contributes most significantly to the development of abdominal aortic
aneurysm?
A. Hypertension
B. Diabetes mellitus
C. Cigarette smoking
D. Hyperlipidemia
Answer: C
, 8. A patient presents with swelling, pain, and discoloration of the lower extremity. These
findings are classic symptoms of:
A. Peripheral artery disease
B. Deep vein thrombosis
C. Cellulitis
D. Venous insufficiency
Answer: B
9. The first sign of diabetic nephropathy is:
A. Proteinuria >3.5 g/day
B. Microalbuminuria
C. Elevated serum creatinine
D. Decreased GFR
Answer: B
10. Papilledema is an unusual finding in which condition?
A. Diabetic retinopathy
B. Increased intracranial pressure
C. Hypertensive emergency
D. Optic neuritis
EXAMINATION STUDY GUIDE
SECTION 1: ADVANCED PATHOPHYSIOLOGY
1. A 43-year-old Hispanic male presents with an audible diastolic murmur best heard at the
mitral listening point. There is no audible click. His status has been monitored for the past
two years. This murmur is most likely indicative of:
A. Mitral valve prolapse
B. Aortic stenosis
C. Mitral stenosis
D. Tricuspid regurgitation
Answer: C
2. A patient with hypertension describes a previous allergic reaction to a sulfa antibiotic as
"sloughing of skin" and hospitalization. Which medication is contraindicated in this
patient?
A. Lisinopril
B. Amlodipine
,C. Hydrochlorothiazide
D. Metoprolol
Answer: C
3. A 75-year-old patient with aortic stenosis asks the NP what symptoms indicate
worsening of his condition. The NP correctly responds:
A. Chest pain and palpitations
B. Shortness of breath and syncope
C. Headache and dizziness
D. Fatigue and weight gain
Answer: B
4. Aortic regurgitation is characterized by:
A. Short asymptomatic period followed by rapid decompensation
B. Long asymptomatic period followed by exercise intolerance, then dyspnea at rest
C. Immediate symptoms of heart failure from onset
D. Spontaneous resolution in most cases
Answer: B
5. Which valve is most commonly involved in chronic rheumatic heart disease?
,A. Aortic valve
B. Mitral valve
C. Tricuspid valve
D. Pulmonic valve
Answer: B
6. A patient with diabetes presents with pain in his lower legs when he walks, with pain
resolution upon rest. When asked about the pain, he will most likely report pain in the:
A. Thigh muscles
B. Calf muscles
C. Feet and toes
D. Knees and ankles
Answer: B
7. Which factor contributes most significantly to the development of abdominal aortic
aneurysm?
A. Hypertension
B. Diabetes mellitus
C. Cigarette smoking
D. Hyperlipidemia
Answer: C
, 8. A patient presents with swelling, pain, and discoloration of the lower extremity. These
findings are classic symptoms of:
A. Peripheral artery disease
B. Deep vein thrombosis
C. Cellulitis
D. Venous insufficiency
Answer: B
9. The first sign of diabetic nephropathy is:
A. Proteinuria >3.5 g/day
B. Microalbuminuria
C. Elevated serum creatinine
D. Decreased GFR
Answer: B
10. Papilledema is an unusual finding in which condition?
A. Diabetic retinopathy
B. Increased intracranial pressure
C. Hypertensive emergency
D. Optic neuritis
