QUESTIONS AND VERIFIED ANSWERS WITH rationales
2025\2026 UPDATE (GRADE A+)
INTRODUCTION
Prepare confidently for your Nurse Practitioner certification with the APEA 3P Exam 2025
guide. Includes 75 verified questions and detailed rationales covering pharmacology,
pathophysiology, assessment, and clinical management. Perfect for NP students and advanced
practice exam review. (GRADE A+)
EXAM STYLE QUESTIONS AND ANSWERS WITH
RATIONALES
1. .Which type of lesion is dark, raised, asymmetric, and has irregular borders?.
- a) Nevus
- b) Actinic keratosis
- c) Keratoacanthoma
- d) Melanoma
Answer: d) Melanoma
RATIONALE: Melanoma is characterized by dark pigmentation, irregular borders, and
asymmetry, indicating potential malignancy.
2. .A 32-year-old woman presents with dull puffiness around her eyes, showing pronounced
non-pitting periorbital edema. What condition does this suggest?.
- a) Nephrotic syndrome
- b) Myxedema
- c) Cushing syndrome
- d) Sinusitis
Answer: b) Myxedema
RATIONALE: Myxedema, commonly associated with hypothyroidism, presents as swelling
around the eyes.
, - d) Metoprolol (Lopressor)
Answer: b) Amitriptyline (Elavil)
RATIONALE: Amitriptyline is an effective prophylactic treatment for migraines.
4. .A pediatric patient has scaling areas on the scalp with round patches of hair loss. What does
this indicate?.
- a) Tinea capitis
- b) Seborrheic dermatitis
- c) Trichotillomania
- d) Alopecia areata
Answer: a) Tinea capitis
RATIONALE: Tinea capitis, a fungal infection, often presents with hair loss and scaling.
5. .During a visual acuity test, the nurse practitioner notes 20/30 vision in the left eye and
20/40 in the right eye. What should be done next?.
- a) Have the patient return in two weeks for a follow-up
- b) Dilate the eye and retest
- c) Refer the patient to an ophthalmologist
- d) Document this as a normal finding
Answer: c) Refer the patient to an ophthalmologist.
RATIONALE: Significant discrepancies in visual acuity warrant consultation with a specialist.
6. .According to the DSM by the American Psychiatric Association, how is Munchausen
Syndrome by Proxy defined?.
- a) A self-inflicted injury to gain attention
- b) A caregiver fabricating or inducing illness in someone under their care
- c) An abusive behavior that doesn't involve the caregiver
- d) A situation where the abuser is inattentive and uncaring towards the victim
Answer: b) A caregiver fabricating or inducing illness in someone under their care.
RATIONALE: This syndrome involves caregivers causing symptoms in others for attention.
, Answer: a) Dopamine.
RATIONALE: Altered dopamine levels can lead to mood changes, including depression.
8. .What is the appropriate preventive medication for an 18-year-old woman with a history of
migraines?.
- a) Sumatriptan (Imitrex)
- b) Propranolol (Inderal)
- c) Ibuprofen (Motrin)
- d) Dihydroergotamine (DHE)
Answer: b) Propranolol (Inderal).
RATIONALE: Propranolol is commonly used for migraine prevention.
9. .Why might a combined hormonal contraceptive be contraindicated for a 36-year-old woman
with a history of type 2 diabetes, obesity, chronic smoking, and a sedentary lifestyle?.
- a) She is obese.
- b) She has type 2 diabetes mellitus.
- c) Her age and tobacco use.
- d) She leads a sedentary lifestyle.
Answer: c) Her age and tobacco use.
RATIONALE: This combination significantly increases the risk of thromboembolic events with
hormonal contraceptives.
10. .During the breast examination of a perimenopausal woman, the nurse practitioner detects
spontaneous bloody discharge from the right nipple. What does this indicate?.
- a) Fibroadenoma
- b) Polycystic breast disease
- c) An intraductal papilloma
- d) Pituitary prolactinoma
Answer: c) An intraductal papilloma.
RATIONALE: Spontaneous bloody discharge can suggest an intraductal papilloma, a benign
condition.