1
APEA Predictor Test Bank 2025/2026: 200
Multiple Choice Questions with Verified
Correct Answers and Detailed Rationales
for FNP Certification Success A+
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1–25)
Question 1
A 68-year-old male with a history of hypertension presents with sudden onset of severe
"tearing" chest pain radiating to his back. Blood pressure is 100/60 in the right arm and 140/80
in the left arm. Which diagnosis is most likely?
A) Acute myocardial infarction
B) Acute pericarditis
C) Aortic dissection
D) Pulmonary embolism
Correct Answer: C
Rationale: Aortic dissection presents with sudden severe tearing chest pain radiating to the
back, often with a blood pressure differential ≥20 mmHg between arms. This is a medical
emergency requiring immediate CT angiography and surgical consultation .
Question 2
A 65-year-old male with a 40-pack-year smoking history presents with progressive shortness of
breath, chronic cough, and peripheral edema. Physical examination reveals jugular venous
distention and hepatomegaly. Which pathophysiological process best explains these findings?
A) Left-sided heart failure with pulmonary congestion
B) Right-sided heart failure with systemic venous congestion
C) Chronic obstructive pulmonary disease without cardiac involvement
D) Cor pulmonale with left ventricular failure
Correct Answer: B
, 2
Rationale: Peripheral edema, JVD, and hepatomegaly are classic for right-sided heart failure
with systemic venous congestion. The smoking history and chronic respiratory symptoms
suggest COPD leading to pulmonary hypertension and cor pulmonale .
Question 3
A 45-year-old patient presents with sudden chest pain radiating to the left arm. Which is the
priority action?
A) Administer ibuprofen
B) Obtain a 12-lead ECG
C) Schedule stress test
D) Give oral fluids
Correct Answer: B
Rationale: Chest pain with radiation suggests acute coronary syndrome; ECG is the first
diagnostic step .
Question 4
A patient on furosemide for heart failure reports muscle cramps and fatigue. Which laboratory
value should the nurse practitioner monitor?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium loss, leading to hypokalemia
with symptoms of muscle cramps and fatigue.
Question 5
Which medication improves survival in heart failure with reduced ejection fraction?
A) Furosemide
B) Carvedilol
, 3
C) Digoxin
D) Hydralazine
Correct Answer: B
Rationale: Beta-blockers (carvedilol, metoprolol) improve survival in HFrEF.
Question 6
A patient with atrial fibrillation has rapid ventricular response. Which medication is indicated for
rate control?
A) Adenosine
B) Diltiazem
C) Amiodarone
D) Lidocaine
Correct Answer: B
Rationale: Diltiazem (calcium channel blocker) is used for rate control in AFib.
Question 7
Which finding indicates digoxin toxicity?
A) Heart rate 60
B) Nausea and visual disturbances
C) Hypertension
D) Tachycardia
Correct Answer: B
Rationale: Digoxin toxicity presents with nausea, vomiting, and visual disturbances (yellow-
green halos).
Question 8
A patient with heart failure has a BNP of 1200 pg/mL. This indicates:
A) Normal cardiac function
B) Heart failure
, 4
C) Pneumonia
D) COPD
Correct Answer: B
Rationale: BNP > 100 pg/mL suggests heart failure.
Question 9
A patient with hypertension has a BP of 220/120 with headache and confusion. This indicates:
A) Hypertensive urgency
B) Hypertensive emergency
C) Normal BP
D) White coat hypertension
Correct Answer: B
Rationale: Hypertensive emergency involves BP > 180/120 with end-organ damage.
Question 10
Which intervention is indicated for hypertensive emergency?
A) Oral labetalol
B) IV nitroprusside with gradual BP reduction
C) Rapid BP normalization
D) No treatment
Correct Answer: B
Rationale: IV nitroprusside with gradual BP reduction (25% in first hour) is indicated.
Question 11
A patient with DVT is at risk for:
A) Myocardial infarction
B) Pulmonary embolism
C) Stroke
D) Aortic dissection
APEA Predictor Test Bank 2025/2026: 200
Multiple Choice Questions with Verified
Correct Answers and Detailed Rationales
for FNP Certification Success A+
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1–25)
Question 1
A 68-year-old male with a history of hypertension presents with sudden onset of severe
"tearing" chest pain radiating to his back. Blood pressure is 100/60 in the right arm and 140/80
in the left arm. Which diagnosis is most likely?
A) Acute myocardial infarction
B) Acute pericarditis
C) Aortic dissection
D) Pulmonary embolism
Correct Answer: C
Rationale: Aortic dissection presents with sudden severe tearing chest pain radiating to the
back, often with a blood pressure differential ≥20 mmHg between arms. This is a medical
emergency requiring immediate CT angiography and surgical consultation .
Question 2
A 65-year-old male with a 40-pack-year smoking history presents with progressive shortness of
breath, chronic cough, and peripheral edema. Physical examination reveals jugular venous
distention and hepatomegaly. Which pathophysiological process best explains these findings?
A) Left-sided heart failure with pulmonary congestion
B) Right-sided heart failure with systemic venous congestion
C) Chronic obstructive pulmonary disease without cardiac involvement
D) Cor pulmonale with left ventricular failure
Correct Answer: B
, 2
Rationale: Peripheral edema, JVD, and hepatomegaly are classic for right-sided heart failure
with systemic venous congestion. The smoking history and chronic respiratory symptoms
suggest COPD leading to pulmonary hypertension and cor pulmonale .
Question 3
A 45-year-old patient presents with sudden chest pain radiating to the left arm. Which is the
priority action?
A) Administer ibuprofen
B) Obtain a 12-lead ECG
C) Schedule stress test
D) Give oral fluids
Correct Answer: B
Rationale: Chest pain with radiation suggests acute coronary syndrome; ECG is the first
diagnostic step .
Question 4
A patient on furosemide for heart failure reports muscle cramps and fatigue. Which laboratory
value should the nurse practitioner monitor?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium loss, leading to hypokalemia
with symptoms of muscle cramps and fatigue.
Question 5
Which medication improves survival in heart failure with reduced ejection fraction?
A) Furosemide
B) Carvedilol
, 3
C) Digoxin
D) Hydralazine
Correct Answer: B
Rationale: Beta-blockers (carvedilol, metoprolol) improve survival in HFrEF.
Question 6
A patient with atrial fibrillation has rapid ventricular response. Which medication is indicated for
rate control?
A) Adenosine
B) Diltiazem
C) Amiodarone
D) Lidocaine
Correct Answer: B
Rationale: Diltiazem (calcium channel blocker) is used for rate control in AFib.
Question 7
Which finding indicates digoxin toxicity?
A) Heart rate 60
B) Nausea and visual disturbances
C) Hypertension
D) Tachycardia
Correct Answer: B
Rationale: Digoxin toxicity presents with nausea, vomiting, and visual disturbances (yellow-
green halos).
Question 8
A patient with heart failure has a BNP of 1200 pg/mL. This indicates:
A) Normal cardiac function
B) Heart failure
, 4
C) Pneumonia
D) COPD
Correct Answer: B
Rationale: BNP > 100 pg/mL suggests heart failure.
Question 9
A patient with hypertension has a BP of 220/120 with headache and confusion. This indicates:
A) Hypertensive urgency
B) Hypertensive emergency
C) Normal BP
D) White coat hypertension
Correct Answer: B
Rationale: Hypertensive emergency involves BP > 180/120 with end-organ damage.
Question 10
Which intervention is indicated for hypertensive emergency?
A) Oral labetalol
B) IV nitroprusside with gradual BP reduction
C) Rapid BP normalization
D) No treatment
Correct Answer: B
Rationale: IV nitroprusside with gradual BP reduction (25% in first hour) is indicated.
Question 11
A patient with DVT is at risk for:
A) Myocardial infarction
B) Pulmonary embolism
C) Stroke
D) Aortic dissection
