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APEA Predictor Remediation Study Set 2026 | Verified Nursing
Exam Prep Questions & Complete Review Guide
AFIB/ EKG finding - ANSWER-Abnormal atrial depolarization w/ normal ventricular
depolarization
CHAOS IN THE ATRIUM
NO P waves
Types of AFIB - ANSWER-Controlled- <100 bpm
Uncontrolled- >100 bpm
Management & Meds ( rate control, rhythm control, anticoags) - ANSWER-Rate
control: Metoprolol (BBS) or Diltiazem (CCBs)
rhythm control w/ antiarrhythmics ( Amiodarone)
Anticoags- Warfarin - ASSESS CHADS-VASC score
CHADS-VASC score - ANSWER-Stroke risk tool used for AFIB
CHF, HTN, >/= 75 yo, DM, prior stroke/ TIA/Thromboembolism
Amiodarone (MOA, LONG TERM USE CAUSES?) - ANSWER-prevents conduction of
unwanted cardiac impulses
Test tip: assess chest x-ray & PFTs prior to initiation
Long term use can lead to hypothyroidism, pulmonary toxicity & optic neuropathy
Warfarin - ANSWER-normal:1 goal:2-3,
Tx: if <2 increase dose; antidote: Vitamin K
INR 2-9: hold & drop dose
, Page 2 of 31
INR >10 (- BLEEDING): Oral Vit K
INR >10 (+ BLEEDING_): IV vit K
Things to avoid with Wafarin - ANSWER-Green leafy vegs, mayo, canola oil, beef
liver,
Drug to drug interaction (Warfarin) 8 A'S - ANSWER-ABX, antifungal,
antidepressants, alternative (St. Johns wort, Gingko), antiplatelet, and anti-
inflammatories, amiodarone, acetaminophen
HTN (goal) - ANSWER-<140/90 in pts <60 and past hx of HTN/DM
<150/90 in pts >60 (more flexibity b/c arteries get stiff)
JNC <130/80; If ACVSD risk >10 initiate HTN meds
TX HTN (1ST) - ANSWER-Lifestyle modifications, herbal ( COQ10)
ACE Inhibitors ( slow down how much AT2 your body makes) - ANSWER-"PRIL"
Captopril, Enalapril, Afosiopril
Antihypertensive. Blocks ACE ( angiotension converting enzyme) lungs from
converting angiotensin I to angiotensin II (powerful vasoconstrictor). Decreases BP,
Decreased Aldosterone secretions, Sodium and fluid loss. Heart and renal protective
for DM
*Orthostatic Hypotension, cough, angioedema, HYPERKALEMIA RISK
ARB (Angiotensin Receptor Blocker) ( blocks the receptors that use AT2 use to
narrow the blood vessels) - ANSWER--Sartan (losartan
antagonizes action of aldosterone
Heart and renal protective for DM
, Page 3 of 31
Hyperkalemia risk, dizziness
THIAZIDE - ANSWER-HCTZ or chlorthalidone
Blocks the sodium chloride channel in the distal convoluted tubule of the kidney(
decrease sodium reabsorption and therefore decreases fluid reabsorption)
preferred in osteoporosis & AA pts.
Avoid in pts w/ hypercholestermia, gout and DM; causes increases in uric acid,
glucose, triglycerides, and calcium
Calcium channel blockers - ANSWER-agents that inhibit the entry of calcium ions
into heart muscle cells, causing a slowing of the heart rate, a lessening of the demand
for oxygen and nutrients, and a relaxing of the smooth muscle cells of the blood
vessels to cause dilation; used to prevent or treat angina pectoris, some arrhythmias,
and hypertension
Preferred in >65 yo & AA pts
SE: ankle edema, headaches
AVOID IN PTS WITH GERD- WEAKENS GASTRIC SPHINCTER
Idiopathic systolic HTN - ANSWER-Caused by stiff arteries; overactive thyroid, DM,
seen in pts >60; bp goal: <150 systolic
TX: CCB
Kawaski (CREAM) - ANSWER-Acute febrile illness of unknown cause resulting in
vascular inflammation
leading cause of heart disease in < 5 yo
high fever (up to 104 greater than 5 days), strawberry tongue, peripheral edema,
conjunctival redness, peeling polymorphic rash over trunk, cervical
lymphadenopathy (Often unilateral) dry lips, hand/foot swelling
, Page 4 of 31
TX of Kawasaki - ANSWER-Aspirin & IVIG
Resolves in 4-8 weeks; f/u w. cardiology
Murmurs s3 & s4 - ANSWER-S3- Gallop- heard @ the end of diastole, heard in HF or
pregnancy
S4- Atrial kick- heard right before systole caused by uncontrolled HTN or LV
hypertrophy; benign finding in elderly
Systolic murmur ( MR PASS MVP) - ANSWER-Mitral regurgitation- mitral valve
doesn't close properly and causes blood to flow backward into left atrium of the
heart; radiates to the axillae; can cause circulation issues
physiological- innocent murmur; turbulent blood flow
aortic stenosis- narrowing of the aortic valve, can cause dyspnea, syncope and angina
on exertion
systolic mitral valve prolapse- mitral valve's flaps bulge into the left atrium of the
heart during contraction phase of the heart.
Dental prophylaxis not necessary for MVP
Diastolic murmurs (ARMS DEALER)- sound when heart relaxes during beat -
ANSWER-Aortic regurgitation- aortic valve doesn't close tightly causing leaks
mitral stenosis- the mitral valve is narrowed
diastolic= DOOM- must be referred to cardiology
Grading of murmurs - ANSWER-• 1/6 murmur is just audible by an expert in
optimal setting.
• 2/6 is quiet.
• 3/6 is moderately loud.
• 4/6 is markedly loud and accompanied by a thrill.
• 5/6 is very loud and accompanied by a thrill.
APEA Predictor Remediation Study Set 2026 | Verified Nursing
Exam Prep Questions & Complete Review Guide
AFIB/ EKG finding - ANSWER-Abnormal atrial depolarization w/ normal ventricular
depolarization
CHAOS IN THE ATRIUM
NO P waves
Types of AFIB - ANSWER-Controlled- <100 bpm
Uncontrolled- >100 bpm
Management & Meds ( rate control, rhythm control, anticoags) - ANSWER-Rate
control: Metoprolol (BBS) or Diltiazem (CCBs)
rhythm control w/ antiarrhythmics ( Amiodarone)
Anticoags- Warfarin - ASSESS CHADS-VASC score
CHADS-VASC score - ANSWER-Stroke risk tool used for AFIB
CHF, HTN, >/= 75 yo, DM, prior stroke/ TIA/Thromboembolism
Amiodarone (MOA, LONG TERM USE CAUSES?) - ANSWER-prevents conduction of
unwanted cardiac impulses
Test tip: assess chest x-ray & PFTs prior to initiation
Long term use can lead to hypothyroidism, pulmonary toxicity & optic neuropathy
Warfarin - ANSWER-normal:1 goal:2-3,
Tx: if <2 increase dose; antidote: Vitamin K
INR 2-9: hold & drop dose
, Page 2 of 31
INR >10 (- BLEEDING): Oral Vit K
INR >10 (+ BLEEDING_): IV vit K
Things to avoid with Wafarin - ANSWER-Green leafy vegs, mayo, canola oil, beef
liver,
Drug to drug interaction (Warfarin) 8 A'S - ANSWER-ABX, antifungal,
antidepressants, alternative (St. Johns wort, Gingko), antiplatelet, and anti-
inflammatories, amiodarone, acetaminophen
HTN (goal) - ANSWER-<140/90 in pts <60 and past hx of HTN/DM
<150/90 in pts >60 (more flexibity b/c arteries get stiff)
JNC <130/80; If ACVSD risk >10 initiate HTN meds
TX HTN (1ST) - ANSWER-Lifestyle modifications, herbal ( COQ10)
ACE Inhibitors ( slow down how much AT2 your body makes) - ANSWER-"PRIL"
Captopril, Enalapril, Afosiopril
Antihypertensive. Blocks ACE ( angiotension converting enzyme) lungs from
converting angiotensin I to angiotensin II (powerful vasoconstrictor). Decreases BP,
Decreased Aldosterone secretions, Sodium and fluid loss. Heart and renal protective
for DM
*Orthostatic Hypotension, cough, angioedema, HYPERKALEMIA RISK
ARB (Angiotensin Receptor Blocker) ( blocks the receptors that use AT2 use to
narrow the blood vessels) - ANSWER--Sartan (losartan
antagonizes action of aldosterone
Heart and renal protective for DM
, Page 3 of 31
Hyperkalemia risk, dizziness
THIAZIDE - ANSWER-HCTZ or chlorthalidone
Blocks the sodium chloride channel in the distal convoluted tubule of the kidney(
decrease sodium reabsorption and therefore decreases fluid reabsorption)
preferred in osteoporosis & AA pts.
Avoid in pts w/ hypercholestermia, gout and DM; causes increases in uric acid,
glucose, triglycerides, and calcium
Calcium channel blockers - ANSWER-agents that inhibit the entry of calcium ions
into heart muscle cells, causing a slowing of the heart rate, a lessening of the demand
for oxygen and nutrients, and a relaxing of the smooth muscle cells of the blood
vessels to cause dilation; used to prevent or treat angina pectoris, some arrhythmias,
and hypertension
Preferred in >65 yo & AA pts
SE: ankle edema, headaches
AVOID IN PTS WITH GERD- WEAKENS GASTRIC SPHINCTER
Idiopathic systolic HTN - ANSWER-Caused by stiff arteries; overactive thyroid, DM,
seen in pts >60; bp goal: <150 systolic
TX: CCB
Kawaski (CREAM) - ANSWER-Acute febrile illness of unknown cause resulting in
vascular inflammation
leading cause of heart disease in < 5 yo
high fever (up to 104 greater than 5 days), strawberry tongue, peripheral edema,
conjunctival redness, peeling polymorphic rash over trunk, cervical
lymphadenopathy (Often unilateral) dry lips, hand/foot swelling
, Page 4 of 31
TX of Kawasaki - ANSWER-Aspirin & IVIG
Resolves in 4-8 weeks; f/u w. cardiology
Murmurs s3 & s4 - ANSWER-S3- Gallop- heard @ the end of diastole, heard in HF or
pregnancy
S4- Atrial kick- heard right before systole caused by uncontrolled HTN or LV
hypertrophy; benign finding in elderly
Systolic murmur ( MR PASS MVP) - ANSWER-Mitral regurgitation- mitral valve
doesn't close properly and causes blood to flow backward into left atrium of the
heart; radiates to the axillae; can cause circulation issues
physiological- innocent murmur; turbulent blood flow
aortic stenosis- narrowing of the aortic valve, can cause dyspnea, syncope and angina
on exertion
systolic mitral valve prolapse- mitral valve's flaps bulge into the left atrium of the
heart during contraction phase of the heart.
Dental prophylaxis not necessary for MVP
Diastolic murmurs (ARMS DEALER)- sound when heart relaxes during beat -
ANSWER-Aortic regurgitation- aortic valve doesn't close tightly causing leaks
mitral stenosis- the mitral valve is narrowed
diastolic= DOOM- must be referred to cardiology
Grading of murmurs - ANSWER-• 1/6 murmur is just audible by an expert in
optimal setting.
• 2/6 is quiet.
• 3/6 is moderately loud.
• 4/6 is markedly loud and accompanied by a thrill.
• 5/6 is very loud and accompanied by a thrill.
