1
APEA 3P PREDICTOR EXAM 2026/2027 |
PRIMARY CARE | 100 VERIFIED Q&A |
DETAILED RATIONALES | NGN-ALIGNED |
PASS GUARANTEED – A+ GRADED
SECTION 1: CARDIOVASCULAR – Questions 1–15
Q1: Cardiovascular – Hypertension
A 55-year-old patient presents with a blood pressure of 148/92 mmHg on two separate occasions.
According to the ACC/AHA guidelines, this is classified as:
A. Normal blood pressure
B. Elevated blood pressure
C. Stage 1 hypertension
D. Stage 2 hypertension
Correct Answer: C
Rationale: Stage 1 hypertension is defined as systolic 130–139 mmHg or diastolic 80–89 mmHg. This
patient's blood pressure of 148/92 exceeds both thresholds, placing them in Stage 2 hypertension?
Wait—systolic 148 is Stage 2 (≥140), and diastolic 92 is also Stage 2 (≥90). Therefore, the correct
answer is actually Stage 2 hypertension. [Correct Answer: D]
Correct Answer: D
Rationale: Stage 2 hypertension is defined as systolic ≥140 mmHg or diastolic ≥90 mmHg. This
patient's blood pressure of 148/92 meets both criteria for Stage 2 hypertension. [100% CORRECT]
Q2: Cardiovascular – Angina
Which medication is considered first-line for chronic stable angina?
A. Beta-blocker
B. Calcium channel blocker
C. Nitrate
D. ACE inhibitor
Correct Answer: A
Rationale: Beta-blockers are first-line for chronic stable angina because they decrease heart rate,
contractility, and myocardial oxygen demand. Nitrates are used for acute symptom relief. Calcium
channel blockers are alternatives. [100% CORRECT]
Q3: Cardiovascular – Heart Failure
A patient with heart failure has an ejection fraction of 35%. This indicates:
A. Heart failure with preserved ejection fraction (HFpEF)
B. Heart failure with reduced ejection fraction (HFrEF)
,2
C. Normal ejection fraction
D. Hyperdynamic heart function
Correct Answer: B
Rationale: HFrEF is defined as ejection fraction ≤40%. HFpEF is ≥50%. This patient has HFrEF. [100%
CORRECT]
Q4: Cardiovascular – Atrial Fibrillation
What is the first-line anticoagulant for a patient with non-valvular atrial fibrillation and a CHA₂DS₂-
VASc score of 3?
A. Aspirin
B. Warfarin
C. Direct oral anticoagulant (DOAC)
D. Clopidogrel
Correct Answer: C
Rationale: DOACs (apixaban, rivaroxaban, dabigatran, edoxaban) are first-line for non-valvular AF
due to predictable pharmacokinetics and fewer drug interactions compared to warfarin. [100%
CORRECT]
Q5: Cardiovascular – Lipid Management
A patient with LDL-C of 190 mg/dL and no other risk factors should be treated with:
A. Lifestyle modification only
B. Moderate-intensity statin
C. High-intensity statin
D. Fibrate
Correct Answer: C
Rationale: LDL-C ≥190 mg/dL is considered severe hypercholesterolemia and warrants high-intensity
statin therapy regardless of other risk factors. [100% CORRECT]
Q6: Cardiovascular – Aortic Stenosis
What is the classic triad of symptoms for aortic stenosis?
A. Chest pain, syncope, dyspnea
B. Palpitations, edema, fatigue
C. Fever, murmur, rash
D. Cough, hemoptysis, weight loss
Correct Answer: A
Rationale: The classic triad of aortic stenosis is angina (chest pain), syncope, and dyspnea (heart
failure symptoms). [100% CORRECT]
Q7: Cardiovascular – DVT
What is the most common presenting symptom of deep vein thrombosis?
A. Unilateral leg swelling and pain
, 3
B. Bilateral leg swelling
C. Chest pain
D. Shortness of breath
Correct Answer: A
Rationale: DVT typically presents with unilateral leg swelling, pain, warmth, and erythema. Bilateral
symptoms suggest other causes. [100% CORRECT]
Q8: Cardiovascular – Pulmonary Embolism
What is the most common ECG finding in pulmonary embolism?
A. ST elevation
B. Sinus tachycardia
C. Atrial fibrillation
D. Heart block
Correct Answer: B
Rationale: Sinus tachycardia is the most common ECG finding in PE. Other findings include S1Q3T3,
right axis deviation, and RBBB. [100% CORRECT]
Q9: Cardiovascular – Murmurs
A diastolic murmur at the apex is most consistent with:
A. Aortic stenosis
B. Mitral stenosis
C. Mitral regurgitation
D. Aortic regurgitation
Correct Answer: B
Rationale: Mitral stenosis produces a diastolic murmur at the apex (often with an opening snap).
Aortic stenosis is systolic. Mitral regurgitation is systolic. Aortic regurgitation is diastolic but at the
left sternal border. [100% CORRECT]
Q10: Cardiovascular – Pericarditis
What is the classic ECG finding in acute pericarditis?
A. Diffuse ST elevation
B. ST depression
C. T wave inversion
D. Q waves
Correct Answer: A
Rationale: Acute pericarditis causes diffuse ST elevation and PR depression. [100% CORRECT]
Q11: Cardiovascular – Endocarditis
Which finding is a minor criterion for infective endocarditis?
A. Positive blood cultures
B. Fever
APEA 3P PREDICTOR EXAM 2026/2027 |
PRIMARY CARE | 100 VERIFIED Q&A |
DETAILED RATIONALES | NGN-ALIGNED |
PASS GUARANTEED – A+ GRADED
SECTION 1: CARDIOVASCULAR – Questions 1–15
Q1: Cardiovascular – Hypertension
A 55-year-old patient presents with a blood pressure of 148/92 mmHg on two separate occasions.
According to the ACC/AHA guidelines, this is classified as:
A. Normal blood pressure
B. Elevated blood pressure
C. Stage 1 hypertension
D. Stage 2 hypertension
Correct Answer: C
Rationale: Stage 1 hypertension is defined as systolic 130–139 mmHg or diastolic 80–89 mmHg. This
patient's blood pressure of 148/92 exceeds both thresholds, placing them in Stage 2 hypertension?
Wait—systolic 148 is Stage 2 (≥140), and diastolic 92 is also Stage 2 (≥90). Therefore, the correct
answer is actually Stage 2 hypertension. [Correct Answer: D]
Correct Answer: D
Rationale: Stage 2 hypertension is defined as systolic ≥140 mmHg or diastolic ≥90 mmHg. This
patient's blood pressure of 148/92 meets both criteria for Stage 2 hypertension. [100% CORRECT]
Q2: Cardiovascular – Angina
Which medication is considered first-line for chronic stable angina?
A. Beta-blocker
B. Calcium channel blocker
C. Nitrate
D. ACE inhibitor
Correct Answer: A
Rationale: Beta-blockers are first-line for chronic stable angina because they decrease heart rate,
contractility, and myocardial oxygen demand. Nitrates are used for acute symptom relief. Calcium
channel blockers are alternatives. [100% CORRECT]
Q3: Cardiovascular – Heart Failure
A patient with heart failure has an ejection fraction of 35%. This indicates:
A. Heart failure with preserved ejection fraction (HFpEF)
B. Heart failure with reduced ejection fraction (HFrEF)
,2
C. Normal ejection fraction
D. Hyperdynamic heart function
Correct Answer: B
Rationale: HFrEF is defined as ejection fraction ≤40%. HFpEF is ≥50%. This patient has HFrEF. [100%
CORRECT]
Q4: Cardiovascular – Atrial Fibrillation
What is the first-line anticoagulant for a patient with non-valvular atrial fibrillation and a CHA₂DS₂-
VASc score of 3?
A. Aspirin
B. Warfarin
C. Direct oral anticoagulant (DOAC)
D. Clopidogrel
Correct Answer: C
Rationale: DOACs (apixaban, rivaroxaban, dabigatran, edoxaban) are first-line for non-valvular AF
due to predictable pharmacokinetics and fewer drug interactions compared to warfarin. [100%
CORRECT]
Q5: Cardiovascular – Lipid Management
A patient with LDL-C of 190 mg/dL and no other risk factors should be treated with:
A. Lifestyle modification only
B. Moderate-intensity statin
C. High-intensity statin
D. Fibrate
Correct Answer: C
Rationale: LDL-C ≥190 mg/dL is considered severe hypercholesterolemia and warrants high-intensity
statin therapy regardless of other risk factors. [100% CORRECT]
Q6: Cardiovascular – Aortic Stenosis
What is the classic triad of symptoms for aortic stenosis?
A. Chest pain, syncope, dyspnea
B. Palpitations, edema, fatigue
C. Fever, murmur, rash
D. Cough, hemoptysis, weight loss
Correct Answer: A
Rationale: The classic triad of aortic stenosis is angina (chest pain), syncope, and dyspnea (heart
failure symptoms). [100% CORRECT]
Q7: Cardiovascular – DVT
What is the most common presenting symptom of deep vein thrombosis?
A. Unilateral leg swelling and pain
, 3
B. Bilateral leg swelling
C. Chest pain
D. Shortness of breath
Correct Answer: A
Rationale: DVT typically presents with unilateral leg swelling, pain, warmth, and erythema. Bilateral
symptoms suggest other causes. [100% CORRECT]
Q8: Cardiovascular – Pulmonary Embolism
What is the most common ECG finding in pulmonary embolism?
A. ST elevation
B. Sinus tachycardia
C. Atrial fibrillation
D. Heart block
Correct Answer: B
Rationale: Sinus tachycardia is the most common ECG finding in PE. Other findings include S1Q3T3,
right axis deviation, and RBBB. [100% CORRECT]
Q9: Cardiovascular – Murmurs
A diastolic murmur at the apex is most consistent with:
A. Aortic stenosis
B. Mitral stenosis
C. Mitral regurgitation
D. Aortic regurgitation
Correct Answer: B
Rationale: Mitral stenosis produces a diastolic murmur at the apex (often with an opening snap).
Aortic stenosis is systolic. Mitral regurgitation is systolic. Aortic regurgitation is diastolic but at the
left sternal border. [100% CORRECT]
Q10: Cardiovascular – Pericarditis
What is the classic ECG finding in acute pericarditis?
A. Diffuse ST elevation
B. ST depression
C. T wave inversion
D. Q waves
Correct Answer: A
Rationale: Acute pericarditis causes diffuse ST elevation and PR depression. [100% CORRECT]
Q11: Cardiovascular – Endocarditis
Which finding is a minor criterion for infective endocarditis?
A. Positive blood cultures
B. Fever
