APEA 3P Predictor Exam 2025 Test
Questions with Answers and
Rationales
1. A patient presents with wheezing, dyspnea, and coughing mostly at night.
Spirometry reveals a reversible airway obstruction. What is the most likely
diagnosis?
A. COPD
B. Asthma
C. Bronchiectasis
D. Pulmonary fibrosis
Answer: B. Asthma
Rationale: Asthma is characterized by reversible airway obstruction and nocturnal
symptoms. COPD is irreversible. Bronchiectasis involves chronic infection and
mucus. Fibrosis shows restrictive patterns.
2. Which of the following antihypertensive medications is contraindicated in
pregnancy?
A. Labetalol
B. Nifedipine
C. Methyldopa
D. Lisinopril
,Answer: D. Lisinopril
Rationale: ACE inhibitors like lisinopril are contraindicated in pregnancy due to
teratogenicity. Labetalol, nifedipine, and methyldopa are considered safer
alternatives.
3. On abdominal exam, you note rebound tenderness and guarding in the right
lower quadrant. What is the next best diagnostic step?
A. Colonoscopy
B. Abdominal X-ray
C. CT scan of the abdomen
D. Liver function panel
Answer: C. CT scan of the abdomen
Rationale: Signs suggest appendicitis; CT scan provides the most accurate
visualization.
4. Which of the following lab values is most specific for diagnosing pancreatitis?
A. AST
B. ALT
C. Lipase
D. Amylase
Answer: C. Lipase
Rationale: Lipase is more specific and remains elevated longer than amylase in
acute pancreatitis.
5. A 65-year-old patient has a 40 pack-year smoking history and presents with a
chronic cough and occasional hemoptysis. What is the most appropriate next
step?
A. Start antibiotics
B. Order chest X-ray
,C. Begin corticosteroids
D. Refer to pulmonology
Answer: B. Order chest X-ray
Rationale: Initial imaging is necessary to evaluate for lung cancer or COPD
exacerbation.
6. Which cranial nerve is tested by asking the patient to stick out their tongue?
A. CN IX
B. CN VII
C. CN XII
D. CN V
Answer: C. CN XII
Rationale: The hypoglossal nerve (CN XII) controls tongue movement.
7. What is a common side effect of amlodipine?
A. Bradycardia
B. Peripheral edema
C. Dry cough
D. Hypokalemia
Answer: B. Peripheral edema
Rationale: Amlodipine, a calcium channel blocker, causes vasodilation leading to
edema.
8. A systolic murmur that increases with Valsalva maneuver suggests:
A. Mitral valve prolapse
B. Aortic stenosis
C. Aortic regurgitation
D. Pulmonary hypertension
, Answer: A. Mitral valve prolapse
Rationale: MVP is one of the few murmurs that becomes louder with decreased
venous return (Valsalva).
9. Which of the following best describes the pathophysiology of type 2
diabetes?
A. Absolute insulin deficiency
B. Autoimmune destruction of β-cells
C. Insulin resistance and relative insulin deficiency
D. Inadequate glucagon response
Answer: C. Insulin resistance and relative insulin deficiency
Rationale: Type 2 diabetes is primarily due to insulin resistance.
10. What is the best initial medication for a newly diagnosed patient with
generalized anxiety disorder (GAD)?
A. Lorazepam
B. Fluoxetine
C. Amitriptyline
D. Haloperidol
Answer: B. Fluoxetine
Rationale: SSRIs like fluoxetine are first-line for GAD; benzodiazepines are second-
line due to dependency risk.
11. Which of the following findings is consistent with macular degeneration?
A. Peripheral vision loss
B. Painful red eye
C. Central vision loss
D. Night blindness
Answer: C. Central vision loss
Questions with Answers and
Rationales
1. A patient presents with wheezing, dyspnea, and coughing mostly at night.
Spirometry reveals a reversible airway obstruction. What is the most likely
diagnosis?
A. COPD
B. Asthma
C. Bronchiectasis
D. Pulmonary fibrosis
Answer: B. Asthma
Rationale: Asthma is characterized by reversible airway obstruction and nocturnal
symptoms. COPD is irreversible. Bronchiectasis involves chronic infection and
mucus. Fibrosis shows restrictive patterns.
2. Which of the following antihypertensive medications is contraindicated in
pregnancy?
A. Labetalol
B. Nifedipine
C. Methyldopa
D. Lisinopril
,Answer: D. Lisinopril
Rationale: ACE inhibitors like lisinopril are contraindicated in pregnancy due to
teratogenicity. Labetalol, nifedipine, and methyldopa are considered safer
alternatives.
3. On abdominal exam, you note rebound tenderness and guarding in the right
lower quadrant. What is the next best diagnostic step?
A. Colonoscopy
B. Abdominal X-ray
C. CT scan of the abdomen
D. Liver function panel
Answer: C. CT scan of the abdomen
Rationale: Signs suggest appendicitis; CT scan provides the most accurate
visualization.
4. Which of the following lab values is most specific for diagnosing pancreatitis?
A. AST
B. ALT
C. Lipase
D. Amylase
Answer: C. Lipase
Rationale: Lipase is more specific and remains elevated longer than amylase in
acute pancreatitis.
5. A 65-year-old patient has a 40 pack-year smoking history and presents with a
chronic cough and occasional hemoptysis. What is the most appropriate next
step?
A. Start antibiotics
B. Order chest X-ray
,C. Begin corticosteroids
D. Refer to pulmonology
Answer: B. Order chest X-ray
Rationale: Initial imaging is necessary to evaluate for lung cancer or COPD
exacerbation.
6. Which cranial nerve is tested by asking the patient to stick out their tongue?
A. CN IX
B. CN VII
C. CN XII
D. CN V
Answer: C. CN XII
Rationale: The hypoglossal nerve (CN XII) controls tongue movement.
7. What is a common side effect of amlodipine?
A. Bradycardia
B. Peripheral edema
C. Dry cough
D. Hypokalemia
Answer: B. Peripheral edema
Rationale: Amlodipine, a calcium channel blocker, causes vasodilation leading to
edema.
8. A systolic murmur that increases with Valsalva maneuver suggests:
A. Mitral valve prolapse
B. Aortic stenosis
C. Aortic regurgitation
D. Pulmonary hypertension
, Answer: A. Mitral valve prolapse
Rationale: MVP is one of the few murmurs that becomes louder with decreased
venous return (Valsalva).
9. Which of the following best describes the pathophysiology of type 2
diabetes?
A. Absolute insulin deficiency
B. Autoimmune destruction of β-cells
C. Insulin resistance and relative insulin deficiency
D. Inadequate glucagon response
Answer: C. Insulin resistance and relative insulin deficiency
Rationale: Type 2 diabetes is primarily due to insulin resistance.
10. What is the best initial medication for a newly diagnosed patient with
generalized anxiety disorder (GAD)?
A. Lorazepam
B. Fluoxetine
C. Amitriptyline
D. Haloperidol
Answer: B. Fluoxetine
Rationale: SSRIs like fluoxetine are first-line for GAD; benzodiazepines are second-
line due to dependency risk.
11. Which of the following findings is consistent with macular degeneration?
A. Peripheral vision loss
B. Painful red eye
C. Central vision loss
D. Night blindness
Answer: C. Central vision loss
