APEA 3P Mock Exam | Full-Length Clinical Readiness
Practice Test with Verified Answers & Detailed Rationales
2026/2027
QUESTION 1
A 45-year-old patient presents with fatigue, weight gain, constipation,
and cold intolerance. Laboratory results reveal an elevated TSH and low
free T4. This clinical presentation is most consistent with:
A. Graves disease
B. Primary hypothyroidism
C. Hashimoto thyroiditis with thyrotoxicosis
D. Secondary hypothyroidism due to pituitary failure
Correct Answer: B Primary hypothyroidism
Rationale: Elevated TSH paired with low free T4 reflects primary failure
of the thyroid gland to produce adequate thyroid hormone, reducing
negative feedback on the pituitary.
QUESTION 2
Which of the following physical examination techniques is best utilized
to assess for peritoneal inflammation or appendicitis by deep palpation
of the left lower quadrant resulting in right lower quadrant pain?
A. Obturator sign
B. Psoas sign
,C. Rovsing sign
D. McBurney sign
Correct Answer: C Rovsing sign
Rationale: Rovsing sign is positive when deep palpation of the left lower
quadrant elicits referred pain in the right lower quadrant, indicating
peritoneal irritation.
QUESTION 3
A patient with a history of chronic obstructive pulmonary disease
presents with acute respiratory distress. Arterial blood gas results show
respiratory acidosis with elevated bicarbonate. This indicates:
A. Acute uncompensated respiratory failure
B. Chronic respiratory acidosis with metabolic compensation
C. Mixed metabolic and respiratory alkalosis
D. Primary metabolic acidosis with hyperventilation
Correct Answer: B Chronic respiratory acidosis with metabolic
compensation
Rationale: Chronic retention of carbon dioxide leads to a chronically
elevated PCO2, prompting renal retention of bicarbonate to
compensate and maintain pH stability.
QUESTION 4
,Which class of antihypertensive medications is considered first-line
treatment for non-black patients with hypertension and chronic kidney
disease with proteinuria?
A. Beta-blockers
B. Loop diuretics
C. Angiotensin-converting enzyme inhibitors
D. Dihydropyridine calcium channel blockers
Correct Answer: C Angiotensin-converting enzyme inhibitors
Rationale: Angiotensin-converting enzyme inhibitors reduce
intraglomerular pressure, slowing the progression of renal disease and
decreasing proteinuria in chronic kidney disease.
QUESTION 5
During a neurological examination, the nurse practitioner tests the
corneal reflex. The afferent sensory limb of this reflex is mediated by
which cranial nerve?
A. Cranial Nerve II
B. Cranial Nerve V
C. Cranial Nerve VII
D. Cranial Nerve IX
Correct Answer: B Cranial Nerve V
, Rationale: The sensory input of the corneal reflex travels via the
ophthalmic branch of the trigeminal nerve (Cranial Nerve V), while the
motor response (blink) is mediated by Cranial Nerve VII.
QUESTION 6
A patient presents with a history of recurrent kidney stones. Analysis
reveals the stones are composed of pure uric acid. Which characteristic
is true regarding uric acid stones?
A. They are clearly radiopaque on standard abdominal X-rays
B. They are radiolucent and require ultrasound or CT for visualization
C. They form exclusively in an alkaline urinary pH environment
D. They are treated primarily with lifelong calcium restriction
Correct Answer: B They are radiolucent and require ultrasound or CT for
visualization
Rationale: Uric acid stones lack calcium content, making them
radiolucent on plain radiographs; they typically precipitate in acidic
urine.
QUESTION 7
The nurse practitioner is evaluating a patient with suspected iron
deficiency anemia. Which of the following lab profiles is most indicative
of this condition?
A. Low ferritin, high total iron-binding capacity, low serum iron
Practice Test with Verified Answers & Detailed Rationales
2026/2027
QUESTION 1
A 45-year-old patient presents with fatigue, weight gain, constipation,
and cold intolerance. Laboratory results reveal an elevated TSH and low
free T4. This clinical presentation is most consistent with:
A. Graves disease
B. Primary hypothyroidism
C. Hashimoto thyroiditis with thyrotoxicosis
D. Secondary hypothyroidism due to pituitary failure
Correct Answer: B Primary hypothyroidism
Rationale: Elevated TSH paired with low free T4 reflects primary failure
of the thyroid gland to produce adequate thyroid hormone, reducing
negative feedback on the pituitary.
QUESTION 2
Which of the following physical examination techniques is best utilized
to assess for peritoneal inflammation or appendicitis by deep palpation
of the left lower quadrant resulting in right lower quadrant pain?
A. Obturator sign
B. Psoas sign
,C. Rovsing sign
D. McBurney sign
Correct Answer: C Rovsing sign
Rationale: Rovsing sign is positive when deep palpation of the left lower
quadrant elicits referred pain in the right lower quadrant, indicating
peritoneal irritation.
QUESTION 3
A patient with a history of chronic obstructive pulmonary disease
presents with acute respiratory distress. Arterial blood gas results show
respiratory acidosis with elevated bicarbonate. This indicates:
A. Acute uncompensated respiratory failure
B. Chronic respiratory acidosis with metabolic compensation
C. Mixed metabolic and respiratory alkalosis
D. Primary metabolic acidosis with hyperventilation
Correct Answer: B Chronic respiratory acidosis with metabolic
compensation
Rationale: Chronic retention of carbon dioxide leads to a chronically
elevated PCO2, prompting renal retention of bicarbonate to
compensate and maintain pH stability.
QUESTION 4
,Which class of antihypertensive medications is considered first-line
treatment for non-black patients with hypertension and chronic kidney
disease with proteinuria?
A. Beta-blockers
B. Loop diuretics
C. Angiotensin-converting enzyme inhibitors
D. Dihydropyridine calcium channel blockers
Correct Answer: C Angiotensin-converting enzyme inhibitors
Rationale: Angiotensin-converting enzyme inhibitors reduce
intraglomerular pressure, slowing the progression of renal disease and
decreasing proteinuria in chronic kidney disease.
QUESTION 5
During a neurological examination, the nurse practitioner tests the
corneal reflex. The afferent sensory limb of this reflex is mediated by
which cranial nerve?
A. Cranial Nerve II
B. Cranial Nerve V
C. Cranial Nerve VII
D. Cranial Nerve IX
Correct Answer: B Cranial Nerve V
, Rationale: The sensory input of the corneal reflex travels via the
ophthalmic branch of the trigeminal nerve (Cranial Nerve V), while the
motor response (blink) is mediated by Cranial Nerve VII.
QUESTION 6
A patient presents with a history of recurrent kidney stones. Analysis
reveals the stones are composed of pure uric acid. Which characteristic
is true regarding uric acid stones?
A. They are clearly radiopaque on standard abdominal X-rays
B. They are radiolucent and require ultrasound or CT for visualization
C. They form exclusively in an alkaline urinary pH environment
D. They are treated primarily with lifelong calcium restriction
Correct Answer: B They are radiolucent and require ultrasound or CT for
visualization
Rationale: Uric acid stones lack calcium content, making them
radiolucent on plain radiographs; they typically precipitate in acidic
urine.
QUESTION 7
The nurse practitioner is evaluating a patient with suspected iron
deficiency anemia. Which of the following lab profiles is most indicative
of this condition?
A. Low ferritin, high total iron-binding capacity, low serum iron
